Posted by LouisianaSportsman on October 11, 2014, at 21:37:03
In reply to Re: viibryd -- and SLS, are you out there? :) » SLS, posted by oceansun on October 10, 2014, at 15:50:29
> Thanks, Scott! Unfortunately I'm having the full array of GI effects -- not even 16 mg of Zofran is touching the nausea -- and since the bathroom is far away at work I had to take the day off :(. So it's not practical for me to continue with Viibryd...
> I'll look into Brintellix...afraid of the nausea side effect from that one too... Reading through this board, I'm thinking of minocycline, just cause it has a different MOA from anything I've ever tried. How long does it take to have an effect?
>
> > > Nevermind -- I took my first dose last night and the gastro effects are so bad I'm not taking it again. On to the next drug...
> >
> > It is possible that the G.I. side effects would have disappeared quickly. I don't know if there is any way to know this in advance. People often experience nausea as a startup side effect of SRI antidepressants - particularly SNRIs. This can last for as little as a half a day, but can linger for a week or more. Vilazodone (Viibryd) is a rather potent SRI. It is 30 times stronger than fluoxetine (Prozac). Perhaps this renders vilazodone more apt to produce startup nausea.
> >
> > Vortioxetine (Brintellix) is an interesting drug that is similar to vilazodone in some ways. However, it adds serotonin 5-HT7 receptor antagonism. This receptor is currently being investigated for its activity in the etiology and treatment of depression. There may be an interplay between 5-HT7 and 5-HT1a receptors that is important in the ability of vortioxetine to produces an antidepressant effect and improvements in cognition.
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> >
> > - Scott
> >
> > ---------------------------------------------
> >
> > From Medscape:
> >
> > http://www.medscape.com/viewarticle/811959_2
> >
> > Vortioxetine (Brintellix)
> >
> > Mechanisms of Action
> >
> > Vortioxetine is considered a new multimodal antidepressant. It has demonstrated antagonistic properties at 5-HT3A and 5-HT7 receptors, partial agonistic properties at 5-HT1B receptors, agonistic properties at 5-HT1A receptors, and potent inhibition of the serotonin reuptake transporter.[6] Of note, preclinical data suggest that these multiple (and in combination) unique effects on numerous serotonin receptors result in regional increases in noradrenaline and dopamine[7] as well as glutamatergic transmission.[8]
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> >
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>If you suffered GI effects on vilazodone, Id caution a trial of vortioxetine [Brintellix]. Vortioxetine is purported to have stronger GI effects; also, it seems prone to initiate hypomania. (Caution for those with bipolar depression and those on concomitant bupropion therapy since bupropion increases mean plasma concentration of vortioxetine due to a metabolic interaction with a liver enzyme.)
I would go an alternative route due to your failure with vilazodone.
Minocycline has strong evidence for the treatment of schizophrenia, and it has neuroprotective properties that may make it efficacious for the off-label treatment of other psychiatric disorders. I would not advise minocycline therapy due to the presence of other medications that present more clinical evidence for psychiatric treatment. Id consider it a last resort.
What medication are you taking presently and what medication have you failed? What psychiatric symptomlogy do you present right now that you necessitates medication?
poster:LouisianaSportsman
thread:1072031
URL: http://www.dr-bob.org/babble/20140914/msgs/1072120.html