Posted by bleauberry on October 22, 2011, at 4:18:26
In reply to What is most like effexor?, posted by ander35 on October 19, 2011, at 18:36:07
The exact mechanisms of most of our meds are not known. We have general theories of what they do on a macro level. At the micro level there are probably mechanisms we aren't even aware of. What I am trying to say is that effexor is effexor, zoloft is zoloft, abc is abc, and each one is uniquely different. You saw that yourself with pristiq compared to effexor. That said, I do not think it is possible to find a substitute for effexor. You can try other drugs to see if one might work as good with a better side effect profile, but trying to predict in advance what that drug might be is kinda hard to do.
Effexor is called an snri for marketing terms. It's a strategy angle to boost sales. In reality, it only hits norepinephrine at about 1/30th the potency it hits serotonin. Prozac boosts brain norepinephrine considerably and yet is not an snri by marketing terms. Cymbalta hits norepinephrine at about 1/9th the potency it hits serotonin. Effexor 30:1; Cymbalta 9:1; Savella 3:2.
There are unknown indirect effects of effexor on the opioid system. Maybe that is one of the reasons it is so hard to get off of? Dunno. In any case, it is a unique drug and we cannot thoroughly explain how it works. That makes it hard to find a substitute except through trial and error. For example, the goodness you get from it could have nothing to do with norepinephrine or serotonin, but maybe a result of the unknown other stuff. Or maybe it has nothing to do with norepinephrine or the other stuff, but instead is all about serotonin except that the particular mechanism has some quirk about it that makes it work for you where other serotonin meds didn't have the right mechanism? Ya know?
Anyway, sexual side effects are pretty common with just about all the antidepressants. Sometimes even with the ones that are generally pro-sexual, such as wellbutrin, a drug can have negative sexual side effects.
You could try some antidotes. Which ones would depend on what the sexual complaints are. For example if it is desire, ritalin a couple hours before planned sex could help. Adding wellbutrin fulltime could help maybe. Adding the herb rhodiola rosea could be good all around. If the problem is anorgasmia, that is more difficult to deal with. I have not personally found anything hepful for that except maybe longer waiting periods between sexual activity, longer foreplay time, and just about any trick you can think of to make the room/moment more romantic.
Viagra can be helpful to both men and women for sexual ability as well as pleasure, but might not be any help at all for anorgasmia. My experience anyway.
If you are feeling a lot better on effexor, I personally wouldn't mess with it. Don't rock the boat because our boats tip over real easy and are hard to get upright again. Better to deal with the sexual side effects with other meds and/or herbs. IMO.
Effexor does change behavior at higher doses, hitting a little bit more NE and dopamine. I have seen people at this board report improved sexual side effects at higher doses, so anything is possible. Of course, if it were me I would not be messing with or changing a dose that was working good for me.
Tramadol is probably the closest thing to effexor I am aware of. It probably has some sexual side effects but I have not seen many complaints of that in other forums where a lot of people have taken it. There are some complaints, but not of the intensity or the frequency of most other antidepressants.
poster:bleauberry
thread:1000244
URL: http://www.dr-bob.org/babble/20111016/msgs/1000469.html