Thoughts on SSRI Medications

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Due to recent events I have experienced PTSD symptoms and my doctor has recommended SSRIs to reduce the symptoms and improve my feelings of depression and anxiety. In particular he is interested in having me start Paroxetine along with psychotherapy. I have tried psychotherapy alone in the past without much success, but now I have found a therapist who has a strong understanding of what I am going through. My doctor still doesn't believe this is enough on its own and he strongly feels an SSRI is needed.

My doctor didn't seem to know if there were any side effects with Paroxetine which could occur with autism. He also has said he has been prescribing them for 30+ years and hasn't experienced having patients with complications. I'm still very hesitant to start them as I have read mixed reviews on the effects of the drug, but at the same time I don't want to turn something down that could really help me.

If anyone has any thoughts or experiences related to Paroxetine or other SSRI's I would really like to read them

Congrats on taking the steps to treat your PTSD. It's certainly a difficult road to take and there are no easy solutions. I have a long history with CPTSD and medications, so I'll share what I know but I'm not a medical doctor, and this is only my opinion.

I've never tried Paxil myself. My daughter took it for about eight months, maybe five years ago. She is HFA and she has CPTSD. The pros: It worked really, really well for her in the beginning, but the efficacy tapered off and she kept needing to increase the dose. She also slept well. She was very mellow. Cons: She became ravenously hungry. She gained about 60 lbs in less than a year. I'm not exaggerating. She gained a LOT of weight very quickly and she's always been petite. It took her about two years to lose the weight after taking it. I can barely recognise her in pictures from that time. I just asked her opinion of it now, in retrospect, and she said "Meh - There's definitely better". She now takes one called Vortioxetine at 20mg. No weight gain at all, in over a year. She's been stable with meltdowns and with managing trauma, for the most part. It's considered an atypical SSRI. It works for brain fog as well as anxiety and depression. No others treat brain fog, that I'm aware of.

I've tried many SSRI as well, but not Paxil. The one that worked best for me was Zoloft at the lowest dose. It's highly rated for trauma as opposed to depression. Higher doses of Zoloft made me unable to cry, and they seemed to push my daytime anxiety into my sleep, which gave me insomnia and nightmares. The lowest dose (25mg) worked best, and I had to take it in the mornings so I wouldn't have insomnia. I was most recently on Vorioxetine like my daughter but again at the lowest dose (5mg). I have severe trauma but lower doses have always worked better for me. Maybe because I'm Level 2 ASD. I don't know why. I'm off all SSRI now but I do comprehensive trauma therapy, and I take Minipress (Prazosin) which is a blood pressure medication proven to control nightmares associated with PTSD. I take it before bed. My nightmares are very well controlled.

SSRI are kind of on a sliding scale between sedating (Paxil) and stimulating (Pristiq). The sedating ones help you sleep better but according to studies have a higher likelihood of weight gain. That may or may not be an issue for you. The stimulant ones like Pristiq give you more energy but you may feel more restless and have sleep difficulties. They generally cause the least weight gain. My daughter liked Pristiq. I can't remember why she switched to Vortioxetine, but she's going to stay on it. Vortioxetine is likely somewhere near the stimulant end of the scale. It's likely better taken in the morning so you can sleep. Some people actually lose a bit of weight on it. You might feel a bit nauseated, but that should subside.

My boyfriend has acute PTSD and he started on Venlafaxine (Effexor) last summer, but switched to Zoloft.

Sorry for the infodump, but I know how hard it can be to take that plunge into SSRI when you already experience a stress disorder. I'll repeat that I'm not a doctor, but I hope some of this can help. PTSD isn't the same as depression, and some of the meds are designed for depression instead of anxiety.

I have only been physically attacked twice as an adult. Both assailants were on trial doses of anti-depressants.

Thank you so much IsabellaLinton for your insight and understanding of my situation. Your feedback and experience is very welcome and appreciated

There is no need to apologize for the infodump. I understand it can be difficult to discuss these difficult topics and I greatly appreciate any response I can get from this post to help me treat my PTSD symptoms.

I was put on Lexapro for anger issues in 2010 and it helped enormously. I'm still on it and it still helps. Also helps with my depression. Best of luck to you in finding the right med.

I have been on a number of SSRI's over the years for my mix of anxiety, depression, and trauma. I often ended up on very high doses of them because that's what I needed. I did run out of SSRI options a couple years ago after needing to be on such an extremely high dose that then stopped working. So I had to switch to an SNRI which works similarly to SSRIs. I have usually also been on other meds in conjunction such as atypical antipsychotics and mood stabilizers.

It's really important to keep in mind that it can take time to find the right medication or combo of medications. Medications affect everyone differently and it's often a bit of an educated guessing game to find what works. So don't feel discouraged if the first one (or few) that you try doesn't help.

Yeah I have found in the past that Zoloft would usually work for around 2or so weeks with a farily large gap between being on this medication but then it would just suddenly become ineffective. Despite saying that it takes around 4-6 weeks to be effective, I would say this isn't the case wth me. I did try od on it though and it made me violently ill. Yuk... the thought of what I did makes me feel reluctant to try and take antidepressants again.

I was prescribed Vortioxetine for a trial. I had extreme negative side effects.
I am suffer from sensory hypersensitivity problems as often associated with ASD.

If you suffer from sensory hypersensitivity problems, please be very careful about the type of antidepressants you take.
In particular be careful about any antidepressants that psychiatrists label as "stimulating", as these often can stimulate the production of noradrenaline (aka Norepinephrine).

Norepinephrine / Noradrenaline is the "get up and go" neurotransmitter that helps people with clinical depression get out of bed in the morning. If you are sensory hypersensitive, as many ASD people are. The boost in noradrenaline / norepinephrine can result in you becoming hyper vigilant.

I believe that this can occur with Vorioxetine (made me very ill instantly), as well as any antidepressant labelled as SSNRI or SNRI which includes cymbalta (duloxetine) and Venlafaxine.

It is also advised that people with ASD often benefit most on low doses of antidepressants.
I have read that Paroxetine, out of all the modern SSRI's, is the most successful overall.

If you experience problems with this one, i would suggest you ask your doctor to prescribe you an older generation antidepressant such as Clomipromine. I have been on this tricyclic antidepressant for a year now, and am much better than when on Venlafaxine / or / Cymbalta / or / Paroxetine.

Low dose Clomipromine and low dose diazepam PRN basis (use sporadically when necessary for meltdowns).
Clomipromine first of all tops up Serotonin levels (makes you less depressed) as well as regulates norepinephrine / noradrenaline without getting out of hand and causing hyper vigilance.

Before taking Clomipromine i was at the end of my tether and going borderline psychotic greatly due to sensory issues and live circumstance. I am managing a fair amount better than I was. Still have some problems but less likely of getting put in prison/hospital or putting people in hospital.

If interested, there is a survey for reference with regards to what meds are presently used in USA for the treatment of various ASD based symptoms.

Rating of the Effectiveness of 26 Psychiatric and Seizure Medications for Autism Spectrum DisorderRating of the Effectiveness of 26 Psychiatric and Seizure Medications for Autism Spectrum Disorder

SSRIs made me chemically castrated and emotionally numb. So I refused to take them. I'd rather be mentally ill than castrated and devoid of emotion.

Also, they didn't even fully cure all my mental illnesses. I had OCD, paranoia (subjective) and coprolalia (subjective) and only the OCD got "cured" by them. And at what cost...