Posted by SLS on March 15, 2002, at 10:47:58
In reply to Re: My intuition says no to Effexor + Luvox. . . ?AnneL, posted by Janelle on March 14, 2002, at 0:11:11
Hi Janelle.
I'm glad you were able to elude a severe serotonin-syndrome reaction. I have developed a healthy respect for this thing. I once tried taking a very small dose of Effexor - less than 20mg - while I was taking Parnate (an MAOI). Within 30 minutes, I ended up in a dilerious stupor, confused and babbling nonsense. I was lucky. I chose Effexor because of its short half-life. I almost managed to have a half-life of my own.
What sorts of things did you experience that brought you to the conclusion that it was serotonin-syndrome?
> To answer your question, based on everything I've read and heard, yes, Effexor (and any other SSRI for that matter) can just poop out all of a sudden.
Effexor does not seem to "poop-out" nearly as often the SSRIs do. However, it might not be so unusual that someone fails to respond to its reintroduction once they have relapsed as a result of its discontinuation. Effexor is not an SSRI, even though it is a potent serotonin reuptake inhibitor. It also inhibits the reuptake of norepinephrine, and to a lesser degree, dopamine. It is sometimes referred to as serotonin/norepinephrine reuptake inhibitor (SNRI) The order of potency in which Effexor inhibits the reuptake of the monoamine neurotransmitters is as:
serotonin (5-HT) > greater than norepinephrine (NE) >> much greater than dopamine (DA)
Effexor is perhaps 4 or 5 times more potent at 5-HT than it is at NE.
A new drug, duloxetine, might be released within the next year. Like Effexor, it also inhibits the reuptake of both 5-HT and NE. However, it does so nearly equally. Because of this, one might dare to hope that this antidepressant would get a whole bunch of people well that had not responded adequately to the others. Duloxetine has been developed by Eli Lilly, the makers of Prozac. Lilly is also pushing to get approved a single preparation containing a combination of Prozac and Zyprexa. They are looking to market it as being particularly useful for treatment-resistent depression. What a silly idea. I should think that anyone would want the flexibility to titrate each drug individually to optimize efficacy versus side effects. Like Serafem, it is an attempt to reincarnate Prozac (fluoxetine) and sell it as a brand new drug with a brand new patent. Silly.
Be Well.
- Scott
poster:SLS
thread:97900
URL: http://www.dr-bob.org/babble/20020313/msgs/98151.html