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Why do some ssri antidepressants (paxil, luvox) cause insomnia in some patients while it helps others sleep?

Question: Why do some ssri antidepressants (paxil, luvox) cause insomnia in some patients while it helps others sleep?

(Posted by: on 2012-01-18 16:31:22)

I have been prescribed Paxil and Luvox for anxiety, and I had to quit them because they caused acute insomnia. My partner, however, has taken Paxil at bedtime and has experienced no changes in sleep cycles. This same problem has arisen with the pain reliever Ultram, prescribed for my scoliosis. Doctors recommended I take it in the evening, and I can't fall asleep? Is there a medical reason for this unintended side effect? If it helps, I have moderate anxiety and sometimes experience hypo mania because of SSRIs. To clarify, I am no longer taking these SSRI drugs. My condition is stable thanks to alternative meds.


Answers:

Posted by: Erika on 2012-01-18, 16:34:23

It affects each person differently

  

Posted by: gardensallday on 2012-01-18, 16:59:35

If you are getting mania from ssri's, you are taking one heck of a risk to take them anymore, and you are taking that risk for only moderate anxiety? Not worth it! For you, the risks FAR exceed any potential benefit. I ended up kicked out of graduate school, and forever severe bipolar because of mania caused by prozac. The same exact thing happened to my brother, who was a machinist. Now maybe we would have gotten sick later anyway, maybe not, but for moderate anxiety, do you want to take that risk? That risk was not known at the time that we took prozac. *** It could have been mania, if you felt GOOD (euphoria) but if all you were was extremely agitated, that was akathisia (sometimes spelled akasthisia). Doctors have NO IDEA what these drugs do except for affecting brain chemicals - but the drugs affect brain chemicals throughout the brain, not just in the emotional areas, and there can be all kinds of unintended results. It's genetic or environmental factors that are unknown that affect people. In addition, you may be a poor metabolizer for drugs that are metabolized by the CYP 450 2d6 enzyme (which is in the liver). Some people are missing this enzyme altogether, and others have too much of it, or too little, and so they get much more side effects, due to slow metabolism, or the drugs don't do anything at all because the drug is metabolized too quickly, which can also lead to withdrawal side effects. Almost all drugs that affect the mind are metabolized by that 2d6 enzyme. Other drugs, like statins, for one example, are broken down by different enzymes. In the case of ultram, it may be a paradoxical effect, also. Anyway, there are a fewf google terms for you - akathisia, CYP 450 2d6 and paradoxical effect.

  

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