Posted by AndrewB on August 21, 2000, at 11:17:14
In reply to Hostile looks/ irritability/anxiety on Reboxetine, posted by acer on August 21, 2000, at 0:40:15
Acer,
Reboxetine can often cause over agitation that can manifest itself in a variety of forms (i.e. anxiety, irritability, impatience, impaired concentration.). One report listed paranoia and irritability as a result of reboxetine. Ask yourself whether the hostile looks you perceive are a reality or a manifestation of paranoia.
There are several possible ways to deal with rebox related over agitation. Some people find that reboxetine is better for them at smaller doses, 4 to 6mg./day. Sometimes a person can up their dosage later on without re-experiencing agitation, as the body has now acclimated to the reboxetine.
Another way to deal with over agitation is to add an SSRI. Unfortunately, the only antidotal report I have on file of using SSRIs for rebox. agitation describes successful augmentation with Paxil. So I am at a loss to suggest what SSRI is best to try next.
My information confirms that rebox is broken down by CYP3A4. Other information I have says that rebox is excreted principally renally, has no inhibitory effects on the major enzymes involved in drug metabolism, and has negligible interference with the pharmokinetics of other drugs, thus fewer drug-drug interactions are expected.
Another possible way of dealing with rebox agitation, and this is pure speculation on my part, is to add clonidine. Clonidine is an alpha 2 andrenergic agonist. It can be effective for anxiety, panic, irritability and impaired concentration. Clonidine can be sedating however so it may compromise some of the arousal effect you derive from reboxetine.
I have a couple of further suggestions further afield. If reboxetine's side effects can't be overcome, there are numerous other arousal agents you can trial. Try not to settle for less from your medicines than full recovery with little or no side effects. Secondly, an experienced psychopharmocologist will more likely be able to give you useful advice concerning rebox (and not hide behind legal concerns). You may also contact a British psychiatrist via phone or email to have your questions answered. Deja.com has a board for Brits with depression. You can pose a question to this board asking for a psych. you can contact.
Best of luck,
AndrewB
poster:AndrewB
thread:43428
URL: http://www.dr-bob.org/babble/20000811/msgs/43448.html