Thank you, DejaVu...for those nice words!
It is nice to see you posting again.

The SSRI's can however lead to dopamine depletion over time and this may lead to muscle dystonias... These are called extrapyramidal side effects. Also called Parkinsonism.

http://www.psychiatrictimes.com/arti...sociated-ssris

Sometimes these side effects appear on the face, mouth and neck first. But some of the PNers here in the past have had RLS appear when on SSRIs.

This may mean some people have less dopamine than others and are more sensitive to the dopamine lowering effects of long term SSRI treatments. (over 6mos).

Hi Healthgirl and MrsD,

Healthgirl:

I cannot tell you SSRIs are "safer" than any other medication. I honestly feel the use of SSRIs are somewhat "controversial." I have been struggling with several rather severe medical conditions for over 30 years now. I have seen many "experts." I have done a lot with "complementary/integrative" approaches from the onset. The medical conditions keep progressing. I now often must try some of the allopathic approaches for relief. Four of my current specialists insist I am on an SSRI to assist with pain management and with some of the spasticity.

My advice to you: If you can find safe alternatives to using medications, do so.
If not, find the safest medication that will do what you need it to do.
If magnesium and other supplementation is not enough for your spasms, then find the safest med possible. Valium causes me significant depression. We are all a bit different in our stages of illness progression and in our med tolerances, etc.

MrsD:

Thanks so much for the information on dopamine depletion. It's important information! Much appreciated! I am in the position, right now, where I need to heavily rely upon my medical specialists at the teaching hospital. They each insist I use an SSRI at this time. I will mention this info you have shared! It seems like this info should be taken into consideration. Thank you!

To Our Healing!
DejaVu

There are quite a few sites now that discuss this SSRI problem.

However, Wellbutrin is also an antidepressant, and works on dopamine...so it does not have that extrapyramidal side effect.

But it can be stimulating to some people with sensitive hearts...some people get palpitations from it. But there have been several posters here over the years who use(d) it for pain management.

Interesting! I am not completely up-to-date on everything. Thus, am truly grateful. I have been too ill to keep up with information the way I used to do so. I have been aware of the issues with the "atypicals" and the misinformation and misuses when they had first become available. They were even being (mis)used for sleep, for pain, etc. I have not been aware of the SSRI issues.

Wellbutrin has been a favorite of one of my Neurologists. I will propose we try Wellbutrin instead. I think they were thinking of some of the potential pain-relieving properties of SSRIs. Will discuss with them at next appointment.

Thanks again, MrsD!
DejaVu

A quick update:

mrsD-

Again, thank you.

My physicians have already responded to these concerns about SSRIs.
I was getting significant pain relief using Lexapro as an adjunctive med.
However, I don't need to risk the dopamine depletion nor EPS. I have already discontinued the SSRI. (A taper wasn't needed, as it had only been a week on it.)
They are looking at different options. I have a few different meds and we also need to consider potential med interactions.

To Our Healing!
DejaVu