Home Forums DISCUSSION FORUMS GENERAL HEALTH SSRI dose Adrenal Fatigue

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  • #1658

    Hey Everyone,

    I have a quick question really. I am a 24 year old male. So I have pretty much no doubt excessive norepinephrine signaling from “adrenal fatigue” (HPA dysregulation). I was wondering about the dosage of ssri. I am at 5mg Celexa and it makes me feel very tired and I can’t concentrate on anything (this is great, I haven’t felt like this in 6 months). My plan has been to up the dose by 2.5mgs every week until I get to 20mg and then stay there until the fight or flight system on my body is shut off, and then stay on the 20mg for 3 more months before I call myself “cured”.

    The problem I ran into is the week at 2.5 and 5.0 mg went great, but the day I tried to do 7.5mg I had massive increases in anxiety. I know that you say excessive serotonin signaling leads to excessive norepinephrine signaling.

    All I can find is you saying that 1/8th of 10mg Lexapro is sufficient in some cases. The problem is that will taking that dose over a long period permanently turn the HPA axis back to neutral? My overall question is: Should one with hpa dysfunction and excessive norepinephrine target a slow build up to “standard” dosages? Or will whatever initial dosage the body can handle be sufficient (i.e. 5mg in my case)?

    If anyone wants to help out that would be great.

    Some background on me: I had “anxiety” 1.5 years ago. I took Celexa at 20mg and did not feel anxiety increase. I felt tired and depressed for about 8 weeks, but then from 8-16 weeks I slowly got better and at week 16 I got off it. Well, I was off it and then by month 4 off of it my symptoms slowly crept back. This is really all due to the fact that I didn’t change one little thing about my life that got me in the mess. I have since quit my stressful job that I hated, started to meditate, and have cut the horrible high sugar foods in favor for a balanced diet of fat protein and good carbs. The problem is, my norepinephrine signaling is insane. If I workout, eat any high sugar food, or get stressed I get heart palpitations and other anxiety. Because of constant high norepinephrine signaling for the last 6 months I am tired all the time, but still excessively stimulated. It sucks.

    #4684
    saltimbanc0
    Member

    Questionng – if troubleis HIGH NE then why are you not trying to reduce this rather than raise Serotonin – altho the hae opposing effects you will just be cuasing a second high level to mask the problems of the first. Also NE has many systemic effects tht raising serotnin wont cancel out.

    Have you tried GABA supplements?

    #4685

    Yeah I have used drugs that act on GABA briefly. I don’t think GABA is close at all in efficacy to Serotonin signaling in decreasing chronic high norepinephrine.

    http://forum.mesomorphosis.com/mens-health-forum/adrenal-fatigue-getting-worse-134249714.html

    “Increasing serotonin is useful since it quickly reduces the perception of stress. Blocking stress is the most predictable effect of an SSRI. This results in a reduction in anxiety, a reduction of overall stress signals (e.g. norepinephrine, ACTH) to the adrenal glands – giving the adrenal glands some breathing room to rest and recover. Over time, as the adrenal glands recover from fatigue, their improved output can reduce norepinephrine levels, helping restore dopamine production, and reduce depressive and anxiety symptoms. Brain function changes to a more non-depressed state. The reduction in norepinephrine and increase in serotonin helps reduce premature ejaculation – which tends to be caused by high norepinephrine levels (since a burst of norepinephrine triggers orgasm, high norepinephrine levels can cause one to be trigger happy so to speak).

    Excessively increasing serotonin levels, however, will reduce dopamine production from dopamine neurons. This will further increase norepinephrine production from norepinephrine neurons – since a tract from the dopamine neurons helps control norepinephrine production. The reduction of dopamine and increase in norepinephrine creates a side effect called akathisia. Symptoms include agitation, restlessness, insomnia, anxiety, tension, irritability, fidgetiness, etc. At its worse, it leads to a feeling of wanting to jump out of one’s skin – leading sometimes to impulsive behaviors such as suicide. The increase in suicide risk from antidepressants lead to the FDA requiring warnings about this. Of course, they could not explain it as I have. I usually tell patients to reduce the dose themselves when they get akathisia – to prevent problems like suicide from even occurring.

    In any case, serotoninergic medications are useful in the toolkit to help reduce adrenal fatigue. The key is the dose – a balance needs to be made. But they are also only one component of many that may be necessary to get as complete a treatment as one can for adrenal fatigue. And there are some people who cannot tolerate them at all – e.g. people with a family history of Parkinson’s Disease – where they may have lower than usual levels of dopamine production to begin with.”

    #4686

    Should I see a psychiatrist about this issue? Would they know what to do when even a super small dose of an ssri has massive effects on someone?

    #4683

    I suggest you call Dr. Mariano’s office for an appointment. 831-375-6655.

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