Q. I've been on Dilantin for seizures and 200 mg Luvox for OCD. I'm also being treated in therapy for BPD. The Luvox has helped much with the OCD but made the BDP more apparent. After reading your letters extensively I discussed them with my doctor and raised the Luvox to 250. We may go higher. It seems to be helping a bit.
Now here's my concern: When I'm very angry or upset I sometimes get suicidal thoughts. I've never acted out on any of them. I usually picture taking a gun to my head and I don't own a gun. (This sounds so awful). I used a 22 with a friend and my only urge was to get as close to the target on the other side of the brook as possible.
But I recently read "The Dark Side of Prozac" which listed lots of research on the web linking Prozac to suicide. In fact it claimed that more people commit suicide on Prozac than people on nothing. I looked at characteristics of Luvox (this is all on http://www.drkoop.com/ .) It described Luvox also as being a problem. You don't mention this complication at all and I'd like to know what you have to say about it. You also seem to prefer Effexor to Luvox. What is the difference? I suggested using that to my doctor but he's reluctant to switch therapies midstream. The suicidal thoughts are not frequent and not overwhelming, but they are scary. Also, being as I have OCD, the IDEA that Luvox can do this upsets me in fact more than the thoughts themselves do and I wonder why the Luvox would do such a thing. I almost feel like it's God telling me I should not be on this or even any medication, that it's wrong to jerk around with what you've got.
I also have some problem with daytime fatigue. My doctor doesn't think that Effexor would be much different than Luvox in that regard. By the way, although most doctors don't recommend Dilantin anymore, my doctor likes it because of its lack of much side effect (and even promotion of tissue healing) and I have not had a seizure in several years.
A. None of the antidepressants cause suicidal thoughts. People take them so they can get over suicidal thoughts. Where the statement came from that more people commit suicide on them then nothing is totally absurd. Some people on antidepressant medications might commit suicide, but that is because they were put on it for suicide, and it did not work. There are fanatics that do not believe in psychotropic or many other medications, but the medicines help, without any question.
Luvox is fairly sedating, so some of the others may or not work better. If daytime sedation is a problem, there is a newer medication out called Provigil that can be added on to help in the morning. Ask your doctor about it. It probably will not reduce your seizure threshold based on its mode of action.
