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Re: Fixes for venlafaxine side-effects » NKP

Posted by SLS on December 29, 2022, at 13:47:34

In reply to Fixes for venlafaxine side-effects, posted by NKP on December 29, 2022, at 4:21:13

Sorry. I forgot to respond.

> Would you say that venlafaxine is a better antidepressant than sertraline?

Yes.

> Especially when combined with bupropion?

Yes.

> Considering that bupropion has norepinephrine reuptake inhibition too?

From what I have seen written over the years, the norepinephrine and dopamine reuptake inhibition by bupropion are minimal compared to the magnitude of reuptake inhibition by other antidepressants of NE and/or 5-HT. Of course, that doesn't mean that reuptake inhibition should be ignored. I am dubious of its importance, though.

Nitric oxide is now considered to be a neurotransmitter, and I think should be looked at more closely when evaluating the mechanisms of action of bupropion. Bupropion has remained an enigma from its inception.

How long have you been taking these drugs? Is there a possibility that the side-effects may yet mitigate?

As I indicated, I don't think you should abandon treatment with venlafaxine and bupropion until dosages of both drugs reach 300 mg/day. I think Pristiq (desvenlafaxine) is milder with respect to side effects. However, my guess is that fewer people respond to this active metabolite of Effexor. I think the way to look at this is that you either need the parent compound, venlafaxine (Effexor), or you don't. If you need only the active metabolite, you might be able to respond equally well to both Pristiq and Effexor, but the side effects might be milder with Pristiq.

Try not to let side effects cause you to abort this trial prematurely.


- Scott


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

The only thing necessary for the triumph of evil is that good men do nothing.

 

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