Posted by mtdewcmu on May 2, 2011, at 0:10:32
In reply to Re: Prestiq vs Cymbalta, posted by desolationrower on May 1, 2011, at 17:36:21
> > > I found pristiq to be slightly better than Pristiq, although not a miracle drug.
> >
> > There have been no miracle drugs in psychiatry since thorazine and lithium in the 1950s.
> >
> > > I'm on Cymbalta now and it doesn't seem to do anything, except messing w/ my bowels and causing male problems. Pristiq actually helped in that area.
> >
> > I grew to hate Paxil due to the bowel issues. Needless to say, I chose a different drug.
> >
> > It seems like the jury is still out on the merits of hitting norepinephrine as a treatment for depression. None of the specific NE reuptake inhibitors have even come close in efficacy to SSRIs and older drugs. So, until someone can persuade me otherwise, I will believe that SNRIs are just SSRIs with more side effects.
> >
> > You might think Effexor is a counterexample, in that it affects both 5-ht and NE and is as good of an AD as anything else. But venlafaxine itself operates mostly on 5-ht. Only the active metabolite has significant effects on NE. So, my gut feeling is that Effexor's effectiveness stems almost entirely from its SSRI-like properties.
>
> i'm not sure what you're on about since many 'old drugs' aka tcas are mainly NRIs.
>
> -d/rThat is a curious fact that some TCAs are basically NRIs and yet are considered effective. Are there any recent studies on them, though? The TCAs that are still used in studies seem to be the ones that affect 5-ht. And these drugs are more complicated than we give them credit for. Who knows why drugs like Reboxetine largely failed as ADs and some apparently similar ones succeeded? I don't pretend to know.
poster:mtdewcmu
thread:980216
URL: http://www.dr-bob.org/babble/neuro/20100607/msgs/984323.html