Do SSRI's reduce focus?

[Anonymous]

My doctor has referred me to a psychiatrist for an ADHD assessment. Hopefully this psychiatrist will help me explore this. In the meantime I have been given Celexa to treat my depression. Is this going to reduce my memory and focus?

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[Saffron]

Based on my own experience, I’m going to say yes, but with important qualifiers. I’m sure Dr. J will be along shortly to provide the bigger picture. *waving at Dr J*

First, there’s a point at which, without the SSRI, the depression definitely destroys your focus. Therefore, just having an SSRI kick in and experiencing relief from all of the negative mental noise and accompanying fatigue actually improves your mental performance. I know that I also sleep better, partly because I no longer have that “lying awake tormenting myself with self-recrimination for reasons that escape me” problem. So the increase in high-quality rest makes me perform better mentally too.

Second, I—and apparently many others—do experience a kind of decline in initiative (inertia, lack of get-up-and-go) after a while taking SSRIs. However, I have found that both exercise and my stimulant med counteract this problem nicely. And I do think that treating depression should be job number one.

By the way, that first uplifting phase when an SSRI kicks in, but before it encourages sluggishness, is the golden window for starting an exercise routine of some kind. Doing so could help prevent this side effect altogether. I hope you find yourself feeling better every day and that your assessment leads to more hope and positive changes.

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[ellamama]

I couldn’t agree more with Saffron’s comment and hope Dr. J will weigh in *yoo hoo!* I’m among those who appreciate the antidepressant benefit of Prozac, but am challenged by the inertia which can seep in. I don’t know if Celexa is similar to Prozac in that regard. I found Provigil helpful as a stimulant, but it’s not very long acting. Concerta provides me significant improvement with a longer duration. Provigil is more expensive but it’s easier to get (at least in the US). Getting the monthly Rx for Concerta gets rather tedious–especially if I’m traveling and need to get a new Rx.

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[Anonymous]

My $0.02,

I was given Cipralex [a.k.a. Lexapro] for my depression 3 years ago. Things started out okay for me at a nominal dose and my mood was starting to even out a bit. I was fine with it. The Doc decided that since some was good, more must be better. WRONG! It started to turn me into a zombie. I could hardly get out of bed and get to work on time (and a lot of times I didn’t). It got so bad I was calling in sick and skipping work at least a couple of times a month. I started feeling this sense of “inertia” that others here speak of; it was like I was smoking pot, just watching the world slip away. During a regularly scheduled visit, I told the doctor that this was starting to cause me more harm than good. I cut the dosage back down but it wasn’t enough. I had to quit cold turkey. I’m glad I didn’t suffer the withdrawal that usually happens to people. I don’t think I’ve ever been the same since. I feel like I’ve been permanently “altered” somehow.

I’ll be honest; the biggest mistake I think I made was drinking alcohol while taking Cipralex. (Yeah, I know, I know…) I became a borderline alcoholic because of it. I still am. I’m sure having to live isolated and alone didn’t help things either. I think it was a mistake for me to treat the depression instead of looking for help with the REAL problem, my ADHD. I tried getting help for ADHD once, the first time I dealt with depression, but I gave up when the help wasn’t there. For a lot of years, there was absolutely no acknowledgment of adult ADHD in my town and thus no help for it. I believe now that until the ADHD dragon is slain, treating the resultant depression with an SSRI is like putting a band-aid on a deep, jagged cut that needs stitches.

Today, I’m still waiting for that first appointment with an ADHD specialist that I’ve only discovered in my area recently. Take my story for what you will.

Cheers. (yeah right)

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[Anonymous]

Sorry for taking so long. Just tied up with work.

Many adults suffer from anxiety and ADHD- the double trouble. It is not unusual that they are often on a combination of something for both sides of the spectrum. they may need an antidepressant and an ADHD medications (just watch out for any drug interactions). This is a very usual combo and it is very effective. Don’t stop there….CBT, therapy, structure, routines, lifestyle…….that is the ultimate goal.

And for booze, Mr Bobcat665, it is washing away your serotonin while your SSRI is trying to keep it. Alcohol is a depressive agent and can be dangerous.

Always speak to your doctor before making any changes to medications. Dr. Jain provides advice generically and not for any one person. Advice does not constitute a therapeutic relationship or promise of care. Please consult the privacy policy for more information.

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[Anonymous]

After struggling with Wellbutrin and then Straterra for two years I am now on Adderall XR (six months) and notice a significant positive difference. Found out that Wellbutrin made things worse for me and likely caused siezures. However I have been on Paxil for over a year and don’t think it does anything so am trying to wean down and have also stopped Quetiapine (took for 7 months to help with anxiety sleep disorders). In two weeks I haven’t noticed any side effects of being off Quetiapine. Any ideas of how to monitor your own behavior when dropping from 20mg to 10mg of the Paxi (I have two friends who have had real reactions tryng to get off Paxil) and how long it may take to comfortably get off it. How do you know whether it is helping you or not?

I heard that reps from totallyadd are coming to Calgary to do a conference or seminar? Anyone know details of this?Unlike Toronto there are not support groups or much discussion here on ADD tjhat I am aware off.

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[Anonymous]

Paxil is evil. Once you go on it you’re never the same after I too have anxiety issues and may go back to ssri type things in low as possible (yet effective) doses. I think you need some anxiety in your life. The fight or flight response helps make important decisions and if you’re too tuned down the drive or fight to change just won’t be there.

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[Anonymous]

OK, OK. Paxil is not evil but you are correct in saying that it is very hard to come off. It strongly binds to Cytochrome 2D6 enzymes in the liver. One strategy to come off is to take the medication on alternative days. This is a type of tapering effect.

Anxiety is a basic animalistic response to outward danger. Too much is paralyzing. Too little and you don’t care. We need to have a balanced level of arousal. Finding that middle can be facilitated using yoga, exercise, relaxation therapies etc. Of course, meds are also available.

Always speak to your doctor before making any changes to medications. Dr. Jain provides advice generically and not for any one person. Advice does not constitute a therapeutic relationship or promise of care. Please consult the privacy policy for more information

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[Anonymous]

Hi, I am currently taking 40 mg/day of Prozac for social anxiety/depression. I was taking 20 mg of Zoloft from March 2009 to June 2010 but I was advised to switch to Prozac to get a better handle on my impulsiveness problems.

Out of all the medications I’ve tried both Zoloft and Prozac were the best medications I’ve taken with very little side-effects and very effective at combating social anxiety/depression. I have also done CBT group therapy and individual therapy and this has been extremely helpfull in getting me to face the fears and become de-senzitised to them. The behaviour changes that the medication facilitated have been fantastic. The problem is that the SSRI’s have never address any of the ADHD like symptoms I experience and I experience really horrible fatigue.

I am in the process of being assessed for ADHD and wanted to know if there are any problems with taking 40mg of Prozac and either Concerta or Adderall XR?

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[Anonymous]

The SSRI will not address the ADHD issues. You will feel better but still can’t your taxes done, for example. You just won’t care as much. Yes, you can combine an SSRI and a psychostimulant like Adderall XR or Concerta.

Always speak to your doctor before making any changes to medications. Dr. Jain provides advice generically and not for any one person. Advice does not constitute a therapeutic relationship or promise of care. Please consult the privacy policy for more information

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[Anonymous]

A close relative with ADD (age 28) after five years on Paxil and Wellbutrin stopped taking both 10 days ago. I have been told you can have awful reactions — she was sick (flu type symptoms) for five days but has continued to work each day. After trying for months to reduce on it she gave up and went off it cold turkey. Now that she has made it through the ten days is there any chance of any further reactions or is she in a safe place ? She lives in a remote place with limited medical care.

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[Anonymous]

She should be OK, presuming that she was generally healthy before hand. There may be some rebound symptoms like increased appetite and excessive sleepiness but otherwise OK.

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[Anonymous]

I was on Celexa and Paxil (not at the same time) for anxiety. It did help me concentrate more, but I’m not sure if it’s because it made me less anxious or whether it would also have an effect on someone only dealing with ADHD.

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