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Re: Fluoxetine (Prozac) vs Fluvoxamine (Luvox) tensor

Posted by ed_uk2010 on June 5, 2020, at 12:43:34

In reply to Fluoxetine (Prozac) vs Fluvoxamine (Luvox), posted by tensor on May 17, 2020, at 6:29:47

Hi M,

Nice to see your post. Sorry to hear things aren't too good.

Although it's not something you mentioned....

Potentially, I'd consider:

1. Tapering and stopping nortriptyline over a few weeks.
2. Cross-tapering off escitalopram and over to venlafaxine. Increasing venlafaxine from 75mg/day up to 150mg-225mg fairly rapidly, then increasing to 300-375mg in future if necessary.

Venlafaxine has efficacy in both anxiety and depression over a very wide dose range, which is potentially useful for those with treatment-resistance.

I recall that you experienced uro-gential adverse effects previously, due to NRIs with unopposed alpha blockade. Although these are usually minor with the SNRI venlafaxine in comparison with the likes of reboxetine, it would be possible to remedy them if necessary with a low dose of an alpha blocker, such as doxazosin 1mg at night. I would avoid tamsulosin for this purpose, since it tends to impair ejaculation.

What do you think?

 

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poster:ed_uk2010 thread:1110189
URL: http://www.dr-bob.org/babble/20200511/msgs/1110492.html