Posted by JohnL on August 14, 2001, at 15:56:24
In reply to Is Paxil and Efexor together save ?, posted by ben on August 14, 2001, at 15:21:02
> There is a theoretical interaction between Paxil and Efexor: Paroxetine (Paxil) inhibits the enzyme CYP2D6 which is responsible for the metabolism of Venlafaxine (Efexor). Could this drugs be combined "in praxis". I take 40 mg Paxil and have the idea of adding some Efexor. Any experiences or suggestions ?
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> P.S
> I know someone who takes 450 mg Efexor along with 20 mg of Prozac instead there is the same theoretical interaction (Fluoxetine and Norfluoxetine are inhibitors of CYP 2D6 as well as Paroxetine). She didnt developed some strong or dangerous side effects.Hi Ben,
I think what is safe and what is not safe varies considerably from one person to the next. However, over the years I've seen people combine all kinds of drugs that probably shouldn't have been combined, with no ill effects. That includes me. I've tried quite a few wild combinations. On the other hand, sometimes people have very bad reactions to just a single medication. So as with everything in psychiatry, I think trial and error is the only way to answer tough questions.Whatever you decide to do, the way to keep is safe is to start slow and low. It's wise, for example, to add a second drug at half or less of its minimum dose. Then as you see how you tolerate it, it can be increased slowly and in little steps.
In the example you provided of someone taking 450mg Effexor plus 20mg Prozac, that just indicates to me they are barking up the wrong tree. Such high doses are (just my opinion) indicative of a drug that is not targeting the real problem. Nobody's serotonin is so low that they need that much medicine. Their symptoms are more likely caused by a different chemistry which is only being partially affected by their current drugs, and thus it takes huge doses.
Over the years I have noticed a trend that people who do real well with whatever medicine usually only need small doses. That's because the med is hitting a bullseye. People who don't do so well require massive doses, where they would probably be a lot better off finding a better drug instead.
poster:JohnL
thread:75069
URL: http://www.dr-bob.org/babble/20010814/msgs/75072.html