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The degree of enzyme inhibition varies among SSRIs.
Effects on blood levels and bioavailability of coadministered drugs, as well as pharmacodynamic interactions, account for most clinically significant SSRI-drug interactions.
At some point we decided to change to escitalopram, brand name Lexapro, a newer SSRI that has a high potency and somewhat less activation.
Routine use of doses above those recommended rarely increases antidepressant effect.Choice of antidepressant is also based on individual patient factors.If a patient has responded well to an antidepressant in the past then that drug should be considered first choice. epilepsy, cardiovascular disease and bipolar disorder will also influence choice.Even at a relatively high dose of fluoxetine, she continued to experience significant anxiety.
Fluoxetine is ‘activating’ in some people, meaning that it sometimes increases the person’s sense of energy, which can, in turn, increase anxiety.Primary care doctors, especially family physicians, are the first responders in mental health care in the United States.