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[QUOTE=Anxious Annie]Do you think it's okay for me to insist on which meds I want to try?

My doctor has admitted being somewhat ignorant to the whole SSRI thing.

I currently take Fluvoxamine which I am finding out is NOT the best thing for panic disorder. I've been doing a lot of research online on the pharmacutical sites, etc.

I'd like to try Lexapro as I have friends with the same issues who have had success with it.

All my doctor knows about is Paxil which I have tried and didn't like and know too many scary stories about people trying to come off of it.

Is it "okay" for me to insist my preference with my doctor or will it seem like I am just looking for drugs?


I'm actually in a similar situation. I've been researching SSRI's to try to decide which one I want to try or which one might be best. My psychiatrist is good. He originally prescribed Paxil, which I took at a very low dose, but still felt very anxious on (I don't know if it's the drug, or just my fear of the drugs.) The thought and act of taking an SSRI does scare me and make me worry about not being myself or having the drug make me feel out of control, etc. I mostly have Panic Disorder and Agoraphobia, but I do have some OCD issues too, so it may doubt and fears from OCD. For me Panic and OCD feel like they are related in some ways, even though they are technically two different disorders. I believe all the Anxiety disorders are really related to each other, obviously with the main symptoms being Anxiety, fear, or worry. After the Paxil, he recommended Fluvoxamine which you mentioned you tried. I was asking about Celexa or Lexapro because my brother has taken them for depression and thought I might be less afraid to try a medication my brother already took, and still takes. Well, we settled on Fluvoxamine at first. He said it is fairly mild to start, and I also had tried it once awhile ago and didn't feel too bad on it. Well, Fluvoxamine is definitely effective for treating Panic Disorder, OCD, GAD, Social Phobia, etc. Just do any internet search on Fluvoxmine and Panic Disorder and you will find many studies confirming its effectiveness. Fluvoxmine/Luvox is just not marketed as much as the other SSRI's. If you want to get technical, only Prozac, Paxil, and Zoloft are FDA approved for treating Panic Disorder. For Panic Disorder, it's just those 3 right now. For Depression, it's Prozac, Paxil, Zoloft, Celexa and Lexapro. For OCD, it's Luvox/Fluvoxamine, Prozac, Paxil, and Zoloft. For Social Phobia, it's Paxil and Zoloft only. For GAD, I am not sure, but I think Lexapro is, and maybe 2 of the others are but I'm not sure which ones exactly without checking. However, all the SSRI's, Fluvoxamine/Luvox, Fluoxetine/Prozac, Paxil, Zoloft, Celexa, and Lexapro are all basically as effective as each other and most experts agree they all work for all the Anxiety disorders as well as depression. The patent expired on Luvox awhile ago and it was not making money in the US for the original manufacturer Solvay. Solvay actually pulled out of selling the drug in the US because it could not compete with the other companies. Solvay still sells the drug in other countries, and it is used for Panic, OCD, Social Phobia, and Depression out of the US as well. Fluvoxamine is actually approved for depression is many countries. The drug Fluvoxamine is available generic still here in the US and it is still a good and useful drug though. Just like the others. Prozac is available in a generic version now, and prescriptions will go down with that as well I'm sure. Paxil CR is basically replacing Paxil, because Paxil has become available in a generic version, and Lexapro is basically replacing Celexa because Celexa has just become available in a generic version. All the drugs basically work for all the disorders. There have been numerous studies and years or use confirming the safety and efficiency of Fluvoxamine, Fluoxetine, Paxil, Zoloft, and Celexa in treating Panic Disorder. Lexapro is newer and has fewer studies and years or use to back it up, but I am sure it is also a good drug and works well too. It's about finding the right one for you, some of them have very slightly different side effects, and they don't all work for everyone. You may have to try one or two to find the one that works the best for you with the least side effects. Some people get no side effects, I would say most people get a few minor ones (and they usually pass), and some people seem to get a lot of side effects and either have to stop taking the drug, change to another drug, or if they wait it out the side effects may pass. Personally if I had a lot of side effect, I would want to switch drugs rather then wait to see if they pass, but that's just me. I would go on your doctors advice, but it is best to see a psychiatrist because general practitioners have less knowledge and are more likely to just prescribe what the new drug is, or the drug that is being marketed the most. Good luck and I hope you find a drug that works well for you. I have taken Fluvoxamine for about 2 weeks and I don't like the way I feel on it although it is mostly just my fear, because I haven't had any real side effects. I'm thinking about asking to switch to Celexa or Lexapro just because of knowing that my brother is on it will probably make me less fearful of it, but I think if I do take Fluvoxamine for a long enough time, it would work out fine too and I'd obviously become less fearful of it. I guess the only advantage I feel right now to taking Lexapro or Celexa is that it much more frequently prescribed now and that I can get it as a brand name drug instead of the generic version, and that might make me feel more safe with it, however, Fluvoxamine has years and years of use that has shown it to be safe and effective. Kinda ironic that people (including myself) or doctors are always looking for the new drug, when the others seem to work just as well. Anyway, good luck, let me know how you're doing and which one you decided to try. I'm gonna make up my mind by this coming Monday whether or not to take Fluvoxamine and work on getting to a higher dose, or whether or not to switch to Celexa or Lexapro.

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