Posted by oceansun on October 11, 2014, at 22:30:05
In reply to Re: viibryd -- and SLS, are you out there? :), posted by LouisianaSportsman on October 11, 2014, at 21:37:03
> > 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.
> > >
> > >
> > > - 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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> 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?Hmm...I certainly don't want more GI effects! I take Wellbutrin, Lamictal (now raising from 400 mg to 600 mg), and I was taking Abilify but just stopped due to EPS. I have depression and anxiety. I'm currently depressed and am concerned about worsening anxiety/depression while the Abilify works its way out of my system. I've tried most classes of psych meds; too long to list. My pdoc thought of an SSRI as a prophylactic, but they didn't have a great effect and made me emotionally numb, so I'm not particularly a great fan. Not familiar with the relatively new ones, though.
I looked up minocycline and saw that it can discolor teeth with long-term use, so that's a no-go. Do you have any suggestions? Nervous that just raising Lamictal won't be enough.
poster:oceansun
thread:1072031
URL: http://www.dr-bob.org/babble/20140914/msgs/1072125.html