Dr. Carlo Carandang explains how Selective Serotonin Reuptake Inhibitors (SSRIs) work. SSRIs are the most widely prescribed medications for anxiety and depression.
Widely prescribed for:
Social Anxiety Disorder (Social Phobia)
Obsessive Compulsive Disorder (OCD)
Generalized Anxiety Disorder (GAD)
Post traumatic Stress Disorder (PTSD)
i have a really bad case of short term memory loss and i cant tell if it's my Lexapro or my Vyvanse, but i also had it when i took just Celexa. is the memory loss permanent / does it get worse ? im genuinely worried about it and i don't see my doctor for another month ah
If you are having memory problems with Lexapro, then please see your doctor immediately, as this could be a serious side effect: https://anxietyboss.com/anxiety-treatments/prescription-drugs/#escitalopram
Flovoxamin caused me a very rare reaction, it was a nightmare my body started to shake weirdly on the left side starting from my lips down to my left arm and leg.
The doctor stopped me from taking it and prescribed a TCA..
thank you Sir for the time............ so, some of me is gonna change? if so i would love to change myself in positive thinking even though part of me is not me anymore . i am done being stress because of anxiety hope God will help me too. i just want to see the happy world thats why i am taking this Ser(zoloft)
This video was done so well! Explained it with accuracy and parsimony. Every other video I’ve seen explains that “depression is due to low levels of serotonin in the brain” which is incorrect. Thank you for making a great video!
Here are some answers to your questions: https://anxietyboss.com/what-are-some-foods-that-help-with-anxiety/ https://anxietyboss.com/anxiety-treatments/herbal-and-nutritional-supplements/ https://anxietyboss.com/what-are-some-over-the-counter-medications-that-help-for-anxiety/
I searched the internet. I have EVERY sign of low dopamine. Is a dopamine med the answer now? God I don't want to live any longer. P.S I should clarify I don't have depression. I'm an optimistic striving person all my life. but since trying Brintellix, everything changed to the worse.
I'm in a weird situation right now. My diagnosis is social anxiety (situational). I had it since childhood. Paxil worked excellent for me. Side effects: only delayed orgasm and some insomnia. I stupidly quit Paxil just to see how I'd cope. I couldn't deal with the WD syndrome tho (wrong timing). I tried Prozac after but it caused me severe sexual dysfunction. I then went on several other meds. One was Brintellix. This one worked but I felt it had a different effect on my anxiety compared to all other meds i took ,and it gave me a terrible thing called anhedonia (loss of pleasure). This did not go away. I went back on Paxil. but to my shock, it worsened the anhedonia and I felt apathy this second time around. I'm on Pristiq right now and the same thing but less apathy. I don't know what the hell happened to me???? I'm so stupid for quitting Paxil the first time. Now, how can I go back to how I was before the damn Brintellix?
I first took an SSRI 19 years ago and thought that as I got better several months later that they must work. I used to argue against people who claimed they where ineffective or even dangerous to some but nearly 20 years on from first taking them I've worked out they make me worse mentally, prolong the recovery period and stopped me from having more than 6-12 months of happiness before I fell ill again. Without them I stay calm and happy indefinitely and it takes prolonged stressful and unhappy circumstances to get me down. While on them and even more so when coming off them I find they disrupt sleep, make me angry, diminish my motivation and creativity and Increase cravings for food and alcohol. In the end I worked out a sort of DIY behaviour therapy which I think of as exercising my brain to keep it in shape a bit like going for a swim to improve and maintain your physical health. Maybe they work for some people but the dangers and risks are definitely understated and certainly misunderstood by GPS who will chuck these drugs at you for anything.
Sounds like you may have persistent sexual dysfunction from antidepressants: https://psychcentral.com/lib/sexual-dysfunction-persists-after-discontinuing-antidepressants/. Unfortunately, there is not much you can do about it besides not taking the offending antidepressants any longer, and even when you quit taking them, the sexual dysfunction persists. Contact me at https://anxietyboss.com/ask-us/. I can put in in contact with an expert who may be able to help you.
hi doctor. first tablet of faverin I lost interest in sex...after 4 days I told my doc. but he asked me to go a head with it ....since that day 7/1998 till now, no interest in sex, no dreams, no excitement & very hard to ejaculate...after ejaculation my libido goes down to zero for14 days....got problem in having kids...did a lot of IVF operations & all failed...lost 87000$ bcoz of these operations...my whole family (mum, dad, sisters) suffered a lot bcoz of this situation. did hormones test (was ok), changed medicine to Romeron started to gain some libido....but this drug is not practical(makes u sleepy for a long time) it seems to me that SSRI's cause a permanent damage , but still many doctors do not know that. Valdoxan makes no delayed ejaculation, but did not bring back libido....same for Wellbutrin....note: prescriped 13 medications before Faverin (tricyclics & benzodiazepines,) but these medications had no effect on my libido....the problem started with Faverin....any solution for this disaster? do u think the drug ADDYI can do something? .
Dr I have a question I'm a anxiety disorder patient. But I'm very interested in this and I love to study about it. My question is if the serotonin gets recycled and released then where is the problem? I think you forgot to mention that the patient with the disorder gets his serotonin lost or dies or decreases off???? Because if the same level of serotonin that gets recycled is the same as when it gets released then there is no illness and there is no need for the ssri mediciation to block the vacumes inorder for the serotonin to add up and be reserved in the synapse. That was the question what happens in the process of recycling to my serotonin why does it decreases in number when it gets released again and not enough serotonin is there to fill the receptors to give the signal to the other nerve? Thank you
Yes, you can increase serotonin in your brain naturally, and the list of natural supplements that can do this is located at the following link: https://anxietyboss.com/anxiety-treatments/herbal-and-nutritional-supplements/
Dr I'm sorry I didn't mean to annoy I'm just over curios. I think I understand what your saying but I wanted to know is there a way where I can stimulate my neuron naturally so it can produce serotonin naturally ? Or without taking the SSRI that help in concentrating the serotonin in the synapse ?
Ok good I'm learning this better. What I'm trying to understand, or what I have from information, is that the serotonin get ejected from the presynaptic nerve to the receptors they hit give the signal then they get sucked back to be recycled again. That's what I know if that is correct? Then my question is why do the serotonin lessen in a brain with a disorder? I'm trying to understand biologically, because I watched the video again and it says that these SSRI meds block the vacuums therefor more serotonin can be saved and be collected in the synapse to have an enough number of serotonin to hit or the receptors.
Dr Carlos I'm sorry for bothering again. I was reading about antipsychotic as an off label treatment for anxiety. I just have an interest in the whole area as I come from a science background. if antipsychotic block dopamine, would this not take away the persons reward mechanism? how can they improve depression if the block both d and serotonin receptors?
Treatment of anxiety and depression with atypical antipsychotics are linked to their effect on serotonin. Blocking too much dopamine can lead to apathy and amotivation, as seen in people who take antipsychotics that are dosed too high. I'm not keen on using antipsychotics for any disorders other than psychosis. There are many other options to treat anxiety and depression, with much less side effects.
Hi Shane, I will gladly add this topic to the list of videos I will shoot shortly. In the meantime, this article I wrote will help you to understand rumination/OCD and the basal ganglia loop: https://anxietyboss.com/study-shows-how-ocd-adhd-parkinsons-and-psychosis-are-related/. Regards, Dr. Carlo
in my opinion the feel good emotion is given to the user from the exchange of touching the serotonin transporter receptors every time it fires serotonin to the receptors, but the ssris desensitizes the receptors and therefore normal activities that were once enjoyable now become boring because you don't feel the touch of the neuron being exchanged and communicated, so that's why serial killers become rampant and aggressive when things don't go their way because they need excessive amount of serotonin exchange to feel anything that a normal person would and they go the extra mile to feel good.. I'm 20 years old and know nothing about neurology but its so interesting that I've been studying about he effects of dopamine adrenaline epinephrine norepinephrine serotonin and their brother receptors aswell and the effects they have on mood, its so easy to learn something about their specific mechanism with a few videos and pure isolation and some weed to concentrate
if the reuptake gets blocked then the serotonin will acumilate and maybe they'll start leaking and become desensitized, and maybe the serotonin that has been blocked by both holes (either by accumulation and saturation)is being oxidized and maybe that's why ssris stop working with time!
The desensitization of the serotonin receptors (5-HT1a) presynaptically is correlated with the therapeutic effect of the SSRI for depression and anxiety. In adddition, the desensitization of the serotonin receptors postsynaptically correlates with tolerance to the side effects of SSRIs. While desensitization is one explanation for SSRIs tachyphylaxis (SSRI "poop-out"), other possible causes include medication nonadherence, worsening underlying depression, and alteration of hippocampal neurogenesis with chronic exposure to SSRIs. Thanks for sharing.
@AnxietyBoss Is there any truth in the claim that SSRIs are dangerous? I have been taking 100mg of Sertraline a day for severe depression for about 6 weeks now. I've been reading that Serotonin is hard for the body to produce (hence it recycles it) so using SSRIs will deplete the amount Serotonin in the presynaptic neuron and ultimately, the brain. This apparently will lead to some rather drastic side effects. This is worrying me. Can you advise?
Sounds like you had some bad side effects to sertraline. Remember, these prescription medications are synthetic and man-made. For people who have side effects to these synthetic medications, then natural supplements for anxiety may be helpful, with minimal side effects. KalmPro is a natural supplement that was formulated with natural ingredients that have research studies showing it is both safe and effective for anxiety.
look put it this way the drug is broken down in the liver and cleaned out by the kidneys so the more larger miller grams ove this chemical you take the more harder it is for your body to get rid ove it aka gets stored in your brain for weeks and months and this then will brake down your synaptic neurons over time since there's no real re uptake tbh i have sertraline tablets and when i was using them they killed my amune system and to sleep was impossible
+youjustdontknow76 SSRIs can be safely prescribed when monitored by a doctor. They do have side effects, but these risks are weighed against the benefits of treatment. What you mention about serotonin is false and not based on the neurobiology of how SSRIs work in the neurons.
I was prescribed Paxil 20mg and I'm very skeptical about taking it cause I've read that people get suicidal or stop feeling human *no emotions. My anxiety doesn't let me work. It started from a traumatic psychosis caused by weed and alcohol. Any advice?
+AnxietyBoss Thank you so much for replying back. Your answer in your previous video on how serotonin is blocked actually helped a lot to understand how it works. Yes I've read that young adults under 25 are at greater risk. I'm not suicidal but have had thoughts of dying, not killing myself cause death terrifies me. I'm 21 which is why I'm very skeptical since my brain is not fully developed yet. It was a doctor that prescribed me with it and I told him about my concerns with meds mostly cause I've spoke with other people that have used Paxil and that the bad outweighs the good. I read your bias on them and I feel the same way. Again, thank you so much for answering back. I really appreciate it.
+B- Rand My advice is to follow-up with your prescribing doctor, preferably a psychiatrist. Paxil, or paroxetine can be helpful for anxiety, but it does have the potential for side effects. If you are under the age of 25, then there is an increased risk of suicide when taking an SSRI such as Paxil, which led to the FDA Black Box Warnings in the mid-2000's. Also, if you are dosed too high, then the SSRI can cause psychic numbing, where you feel numb. You can learn more about Paxil and SSRIs by clicking here: https://anxietyboss.com/anxiety-treatments/ssris-selective-serotonin-reuptake-inhibitors/. This is the reason why a psychiatrist should be monitoring the treatment of an SSRI such as Paxil, given the potential for serious side effects, as you mentioned. On the other hand, if it works, then it can help you become functional and help you get back to work.
+Tony M Yes, the increase of serotonin in the synapse leads to the eventual downregulation of serotonin receptors. This downregulation of serotonin receptors can take weeks, and is thought to be associated with the delayed efficacy of antidepressants for depression and anxiety, and also associated with the eventual decrease in side effects that is seen when first taking the antidepressants.
Antidepressants are medications that can help relieve symptoms of depression, social anxiety disorder, anxiety disorders, seasonal affective disorder, and dysthymia, or mild chronic depression, as well as other conditions.
They aim to correct chemical imbalances of neurotransmitters in the brain that are believed to be responsible for changes in mood and behavior.
Depression Medications (Antidepressants)
These are the most commonly prescribed type of antidepressant.
Serotonin and noradrenaline reuptake inhibitors (SNRIs) are used to treat major depression, mood disorders, and possibly but less commonly attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety disorders, menopausal symptoms, fibromyalgia, and chronic neuropathic pain.
SNRIs raise levels of serotonin and norepinephrine, two neurotransmitters in the brain that play a key role in stabilizing mood.
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They are effective in treating depression, and they have fewer side effects than the other antidepressants.
SSRIs block the reuptake, or absorption, of serotonin in the brain. This makes it easier for the brain cells to receive and send messages, resulting in better and more stable moods.
They are called "selective" because they mainly seem to affect serotonin, and not the other neurotransmitters.