Should I switch SSRIs?

[Griffo_]

Hi all,

I’ve been on sertraline for around 14 years on varying dosages. Most recently I was on 150mg, but over the past few weeks I’ve been coming down and I’m now on 50mg, in preparation for a switch to Paroxetine.

I take sertraline as I was originally diagnosed with OCD and also had an eating disorder. The switch is due to me recently feeling I’m not getting much from the sertraline, as my OCD (in the form of health ocd/anxiety) and anxiety this year has been really bad.

Dr thinks that I should try switching to Paroxetine to see if that helps.

Should I?

I’m currently going through more testing for having an under active thyroid as I have a high tsh and also high antibodies and I know this can cause mental health problems. I had this confirmed with a medichecks blood test but the GP wanted to do their own, which I did yesterday and will follow up on tomorrow for the results.

Hopefully I can now finally get medicated for my thyroid.

So my question Is, what would you do? Would you stay on sertraline and increase the dose again? Would you stay on the 50mg sertraline and see if doing something about my thyroid helps? Or would you switch over to paroxetine and then come off them if the thyroid treatment helps?

I’m just cautious as I’ve read that quite a lot of people say paroxetine is even harder to come off than sertraline.

Thanks!

[HealthStarDust]

Anxiety is a symptom of Underactive Thyroid. My excessive anxiety went away with days of treatment )though of course everyone varies and I started at a very high dose).

As for Paroxetine, this is a very difficult drug to come off. One of the worse for long term antidepressant withdrawal symptoms. Based on that alone, no I wouldn’t start it. And, as for the sertraline, I would with draw from it very very gradually and do you own research on how withdraw from it checking multiple reliable sources.

[radd]

Griffo_

The exact causes of OCD are unclear. Conventional medicine tries managing the brain chemical changes directly (serotonin, dopamine, etc) but functional medicine will say OCD’s complexity is individual and someone genetically predisposed may never fully develop OCD unless the exact trigger is set off such as chronic stress or (early life) trauma.

Other factors may include insufficiencies in thyroid/sex hormones, our environment and (childhood) experiences. Therefore, the OCD will never be well managed unless the factors are addressed also.

I know my own felt loss of control was intensified whilst thyroid antibodies were most elevated. A highly activated autoimmune response can make you feel very weird on both a physical and mental level, with symptoms convention medicine never believe, and all intensified if thyroid hormone levels are insufficient.

Research has shown interactions exist between the sympathetic nervous system and immune system which goes into a wholly unnatural response when thyroid antibodies are high and own WBC’s attack own body tissue. In turn these autoimmune attacks are influenced by environmental conditions, depth and type of stress, other health conditions/autoimmune disease, eg which immune cells are activated.

If I was you I be would looking at thyroid hormone levels first. We’ve seen some members under medical supervision able to wean slowly from antidepressants when thyroid hormones were optimised and the autoimmune response has calmed.

Optimising thyroid hormone alone helps the autoimmune response by calming thyroid activity and further insight can be found by reading books such as The Root Cause by Isabella Wentz. I became completely hooked.

Another great practitioner is Datis Kharrizian whose knowledge in modulating the immune system and the sympathetic nervous system is immense. Learning gave me back some control on both a physical and mental level, and instead of inciting anxiety, I channeled OCD tendencies into learning the world of thyroid physiology and autoimmunity. Oh, and answering questions like this instead is being asleep 😜.

[Shelleyblue]

I wouldn't change anything yet. See if its your thyroid first. My GP did the same thing , I found out it was my thyroid ! So well worth waiting and getting the thyroid tested. However, make sure you have the full panel done - TSH, fT4, fT3 and antibodies tests too. If the GP orders them and he says they're fine you need to ask for the numbers and the ranges of those tests. If you still feel bad post your thyroid tests here, because GP normal may not actually be normal !! And you may need to get a referral to an endocrinologist to have all the thyroid tests done ! :/