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Re: Fluoxetine (Prozac) vs Fluvoxamine (Luvox) ed_uk2010

Posted by tensor on June 5, 2020, at 14:22:24

In reply to Re: Fluoxetine (Prozac) vs Fluvoxamine (Luvox) tensor, posted by ed_uk2010 on June 5, 2020, at 13:53:53

> Hi M,
>
> Nice to hear from you too. Life isn't treating me too badly, thanks. Nothing particularly exciting to report though. It's the first time I've been on p-babble in ages.
>
> I'm curious that your doctor would allow you to take nortriptyline in combination with escitalopram, but not a higher dose of escitalopram alone. Both would seem to have similar risk RE the QTC. In reality, the risk to those with structurally normal hearts is probably very low, but doctors practice with caution... they know the legal implications if something goes wrong and they haven't followed the manufacturer's advice. The manufacturer does advise not to use it in combination with TCAs though!
>
> I really hope fluoxetine works out for you. If not, you might find that venlafaxine proves more tolerable this time. It often works like that... with the passage of time and taken in combination with different meds, the side effects (and efficacy) of a med can change remarkably!
>
> I think you're right to half the nortrip, to be honest, it sounds sensibly cautious, especially if you've previously had side effects on higher doses.

It's really great to hear your life is going great for you, I can't really complain either, there's so much horrible things going on in the world with people suffering hell every minute of the day. I really have all I need.

The thing is, she kind of inherited my medication list, I got this new female doctor a couple of years ago when my all-time fav doctor retired. While this new (new to me) is experienced and all she isn't nearly as chill as my previous doc and is rather formal in most regards, but listens to me and generally agrees with most of my ideas. Like for example, this switch from escitalopram to fluoxetine had to be done with a taper, first 10mg esc for one week, stop esc and then start flu at 10mg for one week, although in practice I cut corners a bit :D I have feeling my old doc would have made this switch a lot quicker if not instant, I really don't think there would be any problem to swap 20 esc for 20mg flu, but due to my anxious nature I (almost) followed my doc's advise.
You're of course right in that meds can change the way they treat you over time, so much stuff has happened since last time, that if I were to restart venlafaxine it probably wouldn't recognize my brain. I really focus a lot less on meds now than I used to, if I find a combination that manage to find the right balance between anxiety and not being too sedated/tired, it's good enough. Being anxiety free AND having energy is a big no-no :)

M


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poster:tensor thread:1110189
URL: http://www.dr-bob.org/babble/20200511/msgs/1110497.html