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People get quite jazzed up the first week on any SSRI--they can feel anxious, restless, agitated. A benzo works wonders for this, and then it's gone by the second week. Perhaps that's what you experience?
Also, some people are slow metabolizers and react strongly to almost all meds. One way of showing a doctor that it's physical and not psychiatric that you have big reactions is to have your P450 enzyme system typed for drug metabolism. It's a routine quest lab now. It's cytochrome P450 2C19 and 2D6 that they run. Maybe more, but those I've found on the quest site. But getting those typed would cover the Prozac, benzos and Cymbalta. 2C19: Proton Pump Inhibitors: lansoprazole omeprazole2 pantoprazole rabeprazole E-3810 Anti-epileptics: diazepam=>Nor phenytoin(O) S-mephenytoin1 phenobarbitone amitriptyline carisoprodol citalopram Celexa chloramphenicol clomipramine cyclophosphamide hexobarbital imipramine N-DeME indomethacin R-mephobarbital moclobemide nelfinavir nilutamide primidone progesterone proguanil propranolol teniposide R-warfarin=>8- 2D6 Beta Blockers: carvedilol S-metoprolol propafenone timolol Antidepressants: amitriptyline clomipramine desipramine imipramine paroxetine Antipsychotics: haloperidol perphenazine risperidone=>9OH thioridazine zuclopenthixol alprenolol amphetamine aripiprazole atomoxetine bufuralol1 chlorpheniramine chlorpromazine codeine (=>O-desMe) debrisoquine2 dexfenfluramine dextromethorphan1 duloxetine (Cymbalta) encainide flecainide fluoxetine fluvoxamine lidocaine metoclopramide methoxyamphetamine mexilletine minaprine nebivolol nortriptyline ondansetron oxycodone perhexiline phenacetin phenformin promethazine propranolol sparteine tamoxifen tramadol venlafaxine Effexor
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LizaJane . --- LYME neuropathy diagnosed in 2009; considered "idiopathic" neuropathy 1996 - 2009 ---s/p laminectomy and fusion L3/4/5 Feb 2006 for a synovial spinal cyst |
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