Why do doctors prescribe SSRI

[Birdman]

I have been doing alot of research and have seen alot of post. I have not seen anyone that has gotten help from an SSRI being prescribed, they usually get better when they are prescribed a benzo or an MAOI Why do psychiatrist prescribe SSRI then. . So i have a couple questions

1. How long did it take to get a Benzo or an MAOI prescribed after taking your first SSRI Med? Did you ask for it or did your Doc mention it to you.

2. What med worked best for you?

3. how much percent do you think your cured.

4. If you are better at what times do you start to feel your anxiety coming back

 

[chris87]

I can't answer your specific questions, because I don't take any medicine. As for why doctors prescribe SSRIs, it seems that they consider them the safest of the antidepressants. I don't know if this is necessarily true, but I assume that from a doctor's standpoint, they don't have to worry about dependency (Benzos) or a hypertensive crisis (MAOI). I have read positive stories about SSRIs for some people, but I have also read many complaints.

I feel like doctors stay away from MAOIs, because many have never prescribed one (or haven't prescribed one in years). A lot of this probably has to do with the hypertensive crisis risk, but it seems largely exaggerated if you are careful with what you eat.

As for the Benzos, I think the major issue is dependency and tolerance. Their efficacy seems to fade as your body becomes more tolerant to them. Although they do work, I'm assuming that they're not meant to be a long-term solution, but I could be wrong. I know that some people end up having a dependency on them.

 

[sabbath92002]

kickbacks

 

[KurtG85]

I have been doing alot of research and have seen alot of post. I have not seen anyone that has gotten help from an SSRI being prescribed, they usually get better when they are prescribed a benzo or an MAOI Why do psychiatrist prescribe SSRI then. . So i have a couple questions

You are going to see more people who are pissed that something didn't work for them complaining online than the people who found it worked great.
Posts you have read by people who have tried SSRI's online are no where close to being comprehensive enough to form a scientific theory.

In most forums I frequent (crazymeds, adhd forums, crazyboards) SSRI meds are the most successful at treating various anxieties and depression and people are reprimanded when they go spouting off that a whole class of meds is worthless. At the two social anxiety specific forums I have recently started posting in (this one and social anxiety support) there is this strange group dynamic where even people who have never tried or maybe only tried a few SSRI's openly deride SSRI's as all being worthless to everyone despite the laughable irresponsibility of that assertation. This kind of irrational subjectivity is pretty sad as it leads to the confusion, misinformation and sometimes unsuccesfull treatment of people new to meds like yourself who might be lead to believe stupid ideas like this. Put simply: don't believe the hype. You won't know if a med helps you until you are on it for the necessary length of time needed to evaluate it.

As far as the general reasons docs stick to prescribing SSRIs before the others: I believe Chris87 hit the nail right on the head. For a small percentage of docs, corrupt 'kickbacks' from big pharm companies probably play a role as well. However I have talked face to face to a couple docs who will not prescribe MAOI's because they have histories of patients who have had horrible reactions to them (like having a stroke and having to re-learn how to walk as a result of a bad reaction to them).
That patient could have destroyed the life of that doc if he wanted to due to our idiotic law system. Most docs are not to blame for not more often trying MAOIs and benzos but rather our backwards law system which allows idiots and unlucky people to blame their idiocy and lack of luck on doctors who were just trying to help them.

1. How long did it take to get a Benzo or an MAOI prescribed after taking your first SSRI Med? Did you ask for it or did your Doc mention it to you.

I got a benzo prescribed as the second med I trialed (xanax). I didn't ask for it. I knew nothing about meds at the time. It is pretty irresponsible medicine to not try at least one of the meds with less risk first because its almost all luck anyway when it comes to finding what meds will help you.

2. What med worked best for you?

adderall, lexapro, cymbalta, imipramine In that order. (I've tried most all meds other than most MAOIs and most benzos) Adderall is by far the most potent med I have ever taken (at only 5mgs) and it was prescribed after about 2 questions by my GP at the time.

3. how much percent do you think your cured?

Well, that is subjective. How far you have really come all depends on what level you started out at but if 100% is entirely average level of functionality, ease of social interaction and quality of general mental health I would say I am at around 70%. I would guess I started at about 15%. I would reference schizophrenic symptoms and other severe psychosis due to unbearable stress beginning at about 10-15% on this made-up scale because I was quite close to severe dellusions.

4. If you are better at what times do you start to feel your anxiety coming back

During all the situations that have always caused me anxiety; it just is not as intense. If you no longer experience any anxiety there is probably something very wrong.

 

[Slothrop]

I have not seen anyone that has gotten help from an SSRI being prescribed

That will heavily depend on where you look. Web forums can be misleading, as people with complaints are much more apt to post than people for whom they are working decently. I myself benefitted from an SSRI, but I rarely mention it because it was only a part of a long process of self-improvement. It helped greatly, but in the sense that a crutch helps an injured person to walk—the walking is the important part.

I think also that people are often disappointed that any given medication they take does not grant them the level of relief that they had anticipated, and may be prone to blame the drug for not meeting those expectations, rather than applauding what effect they do have. This is probably most common with SSRIs because they are typically the first such drug that a person tries, and they can take as much as a month to have any remarkable positive effect.

1. How long did it take to get a Benzo or an MAOI prescribed after taking your first SSRI Med? Did you ask for it or did your Doc mention it to you.

Several months after starting an SSRI, I had a severe panic attack, and I was prescribed a small amount of Xanax pro re nata, or "as needed". My understanding is that this is a very common situation. SSRIs are long-acting and have a very diffuse effect, benzos are short-acting and have a very direct and obvious effect. The complement one another nicely.

Potent benzos can give you the feeling of having no anxiety at all, but they are so brief and have such a dulling effect that they can hardly be considered a long-term treatment. Becoming reliant on them is no way to fix your social anxiety, but having them available can be very useful.

I believe most psychiatrists would prescribe some benzo for this purpose for a patient reporting panic attacks, regardless of whether you were to ask.

2. What med worked best for you?

For daily use, Wellbutrin, which is not commonly prescribed for SA/SP. I made no particularly great strides while taking it, but as far as overall positive effect on my mental health, it was great at the time. And Xanax, during exceptionally tense moments in my life, was a godsend. Fluoxetine (Prozac) was the only SSRI I've taken, and it was instrumental in my getting out of the associated depression that kept me from doing anything about my anxiety.

None of them had the lasting effect that self-awareness and learning to take control of my own mind has, though.

3. how much percent do you think your cured.

Difficult to answer. For some activities, approaching 100%, but for others, 0%. Again though, the medication is only a tool to make improvement easier. It depends on what you work towards. If you take medication but don't go out and try to push your boundaries, you won't see any lasting benefit.

4. If you are better at what times do you start to feel your anxiety coming back

Any time I am pushing my boundaries farther than I have before. The thing is, the more I do it, the larger my comfort zone gets, and the more rarely I have to do this. I have also gotten far better at dealing with the anxiety, so that even when I experience it, I can dissipate it enough to do what I need to do.