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Re: Cognitive Impairment, lack of motivation, etc. » ed_uk2010

Posted by SLS on March 28, 2018, at 16:45:05

In reply to Re: Cognitive Impairment, lack of motivation, etc. » SLS, posted by ed_uk2010 on March 28, 2018, at 15:23:30

> >I like Effexor + nortriptyline.
>
> Hi Scott,
>
> Do you think that would be better than nortriptyline plus an SSRI such as sertraline?

From what I read recently, SSRIs are better than SNRIs for anxiety disorders. For depression, I guess it depends on treatment history. For me personally, I respond better to venlafaxine (Effexor) than any of the SSRIs I've tried. This falls in line with some of the early work comparing venlafaxine to SSRIs in general. I respond even better when nortriptyline is added to the venlafaxine. I like sertraline (Zoloft) as a choice, even though I did not react well to it. I guess it makes sense to go with sertraline first unless there are reasons not to - if for no other reason than to avoid the more intense withdrawal symptoms of venlafaxine discontinuation. However, if venlafaxine works, and long-term treatment is indicated, it is likely that there will be no reason to discontinue it.

I have heard success stories involving the combining of bupropion (Wellbutrin) with sertraline. I know someone who achieved remission combining bupropion with desvenlafaxine (Pristiq).

Ed, how do you compare sertraline with escitalopram (Lexapro; Cipralex)? For awhile now, I think the first choice of American doctors has been escitalopram. It had been sertraline previously.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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