Posted by AndrewB on October 28, 2000, at 4:50:14
In reply to Re: Reboxetine onset of efficacy Q more....., posted by JahL on October 27, 2000, at 16:15:38
JahL,
I am tracking peoples’ responses to amisulpride and sulpiride. In particular I would like to know how amisulpride compares to sulpride. Any details of your experience with the two would be appreciated. If you prefer, email me at andrewb@seanet.com with this information. Thank you.
I've taken reboxetine and have followed the posts on it and can perhaps pass some useful information on to you. Reboxetine is notorious for causing a variety of side effects at first, most of which are transient. But people have found out the hard way that it is important to move up slowly in dosage. This means a trial at 4mgs. for 2 weeks. If side effect are too much reduce the dosage down to two. Only when the side effects subside somewhat, move up to 6mg.s and eventually onto 8mgs.
If the side effects fade away for the most part, you may find reboxetine a useful arousal agent that will increase your motivation toward action, including socialization. My impression is that it has limited if any effectiveness in reducing social anxiety. I'm also under the impression that it provides an antidepressant response for only an isolated number of patients. I know company literature touts it as being efficacious for depression and social anxiety, but I take this with a grain of salt.
Me and others have noted that reboxetine’s arousal effects may wear off after a number of months. I wonder how common this poop out is.
I would suggest you keep you drug trials separate. Not only do you multiply the likelihood of drug interactions by taking a 'pot full' of meds but it becomes hard to distinguish which drug is doing what for you. Drug trials should be a learning process from which your experience with one drug gives you clues as to what meds may finally give you relief. I know you want relief now, but a systematic approach is more likely to locate what you need in the long run.
On an unrelated note, the combo of dysthymia with social anxiety can often be indicative of dopaminergic dysfunction. I believe a trial with dopaminergics is indicated for this symptomology when a trial of one or two SSRI has provided no mood or anxiety relief. The fact that sulpride has helped your anxiety further indicates that you may suffer from dopaminerigic dysfunction.
Drugs to try in this class include stimulants (i.e. adderall), low dose selegiline at 5mg/day (it may take 45 days or longer to take effect but the results can be dramatic). Mirapex also, studies indicate, can be another drug that helps with depression. I found pramipexole not to work for me (while amisulpride has), but your results may differ. Pramipexole is started at 1/4mg. doses taken three times a day. As nausea or other side effects subside, the dose is increased by 1/4mg. Effective dosage may be as high as 5mg/day. Farmacia Cerati sells Mirapex. Requip, seems to be similar and may act in the same manner but it lacks studies to support its efficacy as an AD.
I wouldn’t bother with tianeptine or (especially) piramacetam. Neither seems to have the track record to justify trying them except as a last resort as an AD. Do a search of previous posting on this and other boards if you don’t believe me.
I have to add, in my opinion you need a locate a qualifeid psychopharmocologist to give you counsel and help you in your search for effective medication. People with social anxiety tend to avoid psychiatrists like the plague, but believe me, there is expertise out there that will work with you to best identify the meds that can help with atypical disorders such as yours while making sure you don’t poisen yourself.
Best wishes,
AndrewB
poster:AndrewB
thread:47408
URL: http://www.dr-bob.org/babble/20001022/msgs/47588.html