Posted by LouisianaSportsman on March 3, 2014, at 21:02:20
In reply to Re: Sudden sensitivity to SSRIs/side effects? » Dispossessed, posted by SLS on March 3, 2014, at 20:31:02
I think the Latuda (lurasidone) would be an excellent choice to try next regardless of the "no AP without AD" philosophy you have, Eric. The only 5-ht activity that isn't good is the 5-HT2A antagonism which is balanced out by 5-HT1a partial agonism and perhaps the benefits of 5-HT7 antagonism. Lurasidone also has less of a cognitive imprint with its D2 receptor blockade pattern comparatively to other AAPs and actually has benefits (5-HT7).
It's too bad Viibyrd won't hit the market until the later part of 2014 and Brintillex is unknown. I am on my first day of Brintillex, Dispossessed, it's a shame the UK market is so far behind (via benzo prescribing too, I see).
Scott, BRAVO! for mentioning Luvox, a OCD SSRI posterboy and clomipramine, the heavy-hitter of OCD medications. The poster does not need to discredit trying these if at all possible.
<on combining Brintellix and nortriptyline
Scott, are you asking about combining Brintellix and nortriptyline for yourself because I'm not sure of augmenting nortriptyline for a patient suffering from OCD because why would you want to add 5-HT2A antagonism and clomipramine is so successful of a TCA for OCD due to selectivity to 5-HT over NE, unlike nortriptyline.
For yourself, I guess it turns it into a Cymbalta-lite by adding in the NE. The 5-HT2A antagonism from nortriptyline here may also make the 5-HT reuptake from vortioxetine more efficacious. That is a major pharmacological interaction right there, and I'm not sure if I would really like to play around with it. There might be more ways to boost vortioxetine? You're thinking it might not be strong enough compared to your MAOI?
poster:LouisianaSportsman
thread:1061454
URL: http://www.dr-bob.org/babble/20140214/msgs/1061793.html