Shown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by mtl on January 25, 2000, at 1:06:22
Just wondering if selegiline can be used with venlafaxine?
Looking to augment for anorgasmia, and chronic low energy. I'm currently taking 150mg venlafaxine/day. Already tried wellbutrin - no help for either issue.
How about stimulants with venlafaxine? Dexidrine or ritilan? Would that be likly to help both issues, or just the low energy?
Or has anybody tried pindolol with venlafaxine?
Thanks,
mtl
Posted by Cam W. on January 25, 2000, at 7:15:40
In reply to med augmentation, posted by mtl on January 25, 2000, at 1:06:22
> Just wondering if selegiline can be used with venlafaxine?
>
> Looking to augment for anorgasmia, and chronic low energy. I'm currently taking 150mg venlafaxine/day. Already tried wellbutrin - no help for either issue.
>
> How about stimulants with venlafaxine? Dexidrine or ritilan? Would that be likly to help both issues, or just the low energy?
>
> Or has anybody tried pindolol with venlafaxine?
>
> Thanks,
>
> mtlMTL - Sorry to here about your antidepressant-induced problem. Anorgasmia is more common than reported, in the literature. Wellbutrin is the first thing to try, but, for you, is not useful.
I am not sure of anything that will work 100%, but
have seen a study where it is said that Viagra may work (am skeptical). As for pindolol, it blocks the shut-off mechanism for the release of serotonin, so it will increase levels of serotonin in the synaptic gap. Serotonin may be what is causing your anorgasmia and quite possible, lack of energy. Pindolol is usually used to make SSRIs work faster.As for selegiline, a drug normally used in Parkinsonism, it is an MOA-B inhibitor.I have seen no studies for anorgasmia or fatigue with this drug. It is thought to increase dopamine in Parkinsonism patients, but what it would do for anorgasmia, I really don't know. It is an awfully potent drug and would only use it as a last resort.
How long have you been taking Venlafaxine? Many times the sexual side effects caused by antidepressants will abate after about 6 months. Maybe try giving your body a little more time to adjust.
Also, stimulants like dexedrine may help, but the addictive potential would make me consider using them only with great caution. They can also interupt sleep patterns. I have seen no studies using dexedrine for anorgasmia, but have seen it augment the antidepressant activity of SSRIs.
Search the literature. Try PubMed or GratefulMed and do a search for anorgasmia. See what the experts have said. PubMed is at
Posted by Mrs. G on January 25, 2000, at 9:59:09
In reply to med augmentation, posted by mtl on January 25, 2000, at 1:06:22
How kind of you to offer your expert help. Thank you so much. What about augmentation for Serzone? It doesn't have the side effects of sweating, and appetite stimulation and weight gain that I have had on other AD's. But even at 500 mgs a day, I am still having lots of rummination, anger problems, sometimes, and insomnia. Also have to go to bathroom VERY frequently. I wake up several times each night and sometimes wake at 2 AM and can't ever get back to sleep. My only other medication is Prevacid for stomach ulcers. Any suggestions?
Posted by Renee N on January 25, 2000, at 22:44:39
In reply to med augmentation, posted by mtl on January 25, 2000, at 1:06:22
> Just wondering if selegiline can be used with venlafaxine?
>
> Looking to augment for anorgasmia, and chronic low energy. I'm currently taking 150mg venlafaxine/day. Already tried wellbutrin - no help for either issue.
>
> How about stimulants with venlafaxine? Dexidrine or ritilan? Would that be likly to help both issues, or just the low energy?
Just the energy...:(
> Or has anybody tried pindolol with venlafaxine?
>
> Thanks,
>
> mtl
Posted by Cam W. on January 25, 2000, at 22:55:19
In reply to Cam W: med augmentation for Serzone?, posted by Mrs. G on January 25, 2000, at 9:59:09
> How kind of you to offer your expert help. Thank you so much. What about augmentation for Serzone? It doesn't have the side effects of sweating, and appetite stimulation and weight gain that I have had on other AD's. But even at 500 mgs a day, I am still having lots of rummination, anger problems, sometimes, and insomnia. Also have to go to bathroom VERY frequently. I wake up several times each night and sometimes wake at 2 AM and can't ever get back to sleep. My only other medication is Prevacid for stomach ulcers. Any suggestions?
Mrs.G. - You can basically think of Serzone as an SSRI like Paxil, Prozac, Zoloft, etc. with the added features of Serotonin-2 & Serotonin-3 receptor blockade. What this means is that they tried to make a selective serotonin reuptake inhibitor (SSRI) without the side effects. By blocking serotonin-3 receptors they are trying to (in theory) stop the SSRI-induced stomach upset and diarrhea. It didn't really work that well, but Serzone is an effective antidepressant in many people.
It is interesting that you brought up that you are taking Prevacid. Serzone and Prevacid are metabolized partially by the same enzyme system (called the cytochrome P-450 system 3A4 - CYP-3A4)
Serzone inhibits this enzyme system, meaning that it causes less of the CYP-3A4 isoenzyme to be produced. With less enzyme present to metabolize both the Serzone and especially the Prevacid may not be (and I do mean MAY not be - other enzymes systems are also involved - CYP-2C19-, so the effect MAY be insignificant) being metabolized and you MAY have higher levels of Prevacid in your body than you should. The effect would be like taking extra Prevacid. This could be causing some of your side effects, especially the diarrhea and perhaps abnomal thinking, agitation, confusion, anxiety and nervousness.Now, again I caution you on taking this as gospel because it would be hard to prove. Discuss it with your doctor and maybe a change of stomach medicine might be in order to see if the bothersome side effects subside. Perhaps suggest Axid (nizatidine) or Pepcid (famotidine) to your doctor for a trial. If the side effects clear up, then you know it was the Prevacid (probably) and if they don't, you can always go back to taking the Prevacid. Give the Axid (or Pepcid) a trial of at least a month to ensure that the Prevacid is washed out of the body.
Let me know how things turn out. I would be EXTREMELY interested to see what happens. Contact me through this forum if you doctor wants to talk to me about this. Good luck - Cam W.
Posted by Cam W. on January 26, 2000, at 7:20:48
In reply to Re: Cam W: med augmentation for Serzone?, posted by Cam W. on January 25, 2000, at 22:55:19
> > How kind of you to offer your expert help. Thank you so much. What about augmentation for Serzone? It doesn't have the side effects of sweating, and appetite stimulation and weight gain that I have had on other AD's. But even at 500 mgs a day, I am still having lots of rummination, anger problems, sometimes, and insomnia. Also have to go to bathroom VERY frequently. I wake up several times each night and sometimes wake at 2 AM and can't ever get back to sleep. My only other medication is Prevacid for stomach ulcers. Any suggestions?
>
> Mrs.G. - You can basically think of Serzone as an SSRI like Paxil, Prozac, Zoloft, etc. with the added features of Serotonin-2 & Serotonin-3 receptor blockade. What this means is that they tried to make a selective serotonin reuptake inhibitor (SSRI) without the side effects. By blocking serotonin-3 receptors they are trying to (in theory) stop the SSRI-induced stomach upset and diarrhea. It didn't really work that well, but Serzone is an effective antidepressant in many people.
>
> It is interesting that you brought up that you are taking Prevacid. Serzone and Prevacid are metabolized partially by the same enzyme system (called the cytochrome P-450 system 3A4 - CYP-3A4)
> Serzone inhibits this enzyme system, meaning that it causes less of the CYP-3A4 isoenzyme to be produced. With less enzyme present to metabolize both the Serzone and especially the Prevacid may not be (and I do mean MAY not be - other enzymes systems are also involved - CYP-2C19-, so the effect MAY be insignificant) being metabolized and you MAY have higher levels of Prevacid in your body than you should. The effect would be like taking extra Prevacid. This could be causing some of your side effects, especially the diarrhea and perhaps abnomal thinking, agitation, confusion, anxiety and nervousness.
>
> Now, again I caution you on taking this as gospel because it would be hard to prove. Discuss it with your doctor and maybe a change of stomach medicine might be in order to see if the bothersome side effects subside. Perhaps suggest Axid (nizatidine) or Pepcid (famotidine) to your doctor for a trial. If the side effects clear up, then you know it was the Prevacid (probably) and if they don't, you can always go back to taking the Prevacid. Give the Axid (or Pepcid) a trial of at least a month to ensure that the Prevacid is washed out of the body.
>
> Let me know how things turn out. I would be EXTREMELY interested to see what happens. Contact me through this forum if you doctor wants to talk to me about this. Good luck - Cam W.
>
Mrs. G. - Further to my last comments. I did a little more digging and have found that another side-effect of Prevacid is urinary urgency. Hmmm, I wonder, Prevacid by itself could be the culpert in you side-effects or it's they are being augmented by the Serzone. Cam W.
Posted by Mrs. G on January 26, 2000, at 12:03:21
In reply to Re: Cam W: med augmentation for Serzone?, posted by Cam W. on January 26, 2000, at 7:20:48
I sincerely thank you for your help. This board has such good folks! I will try replacing the Prevacid with Pepcid. Everything is worth a try at this stage of the game. I had a cystoscopy done yesterday. It showed patches of abnormal tissue in my bladder with lots of inflammation. The Urologist says he doesn't know what that means. Well, I sure don't either! But I get a lot of burning in my pelvic region as well as a lot of burning, stinging and pain in my hands and feet and arms and legs, while my bladder discomfort is going on. So far, this is all being sort of ignored because I am a depressed female of menopausal age. When I ask about the possibility of neuropathy, communication just kind of stops. Gosh, it feels nice to be heard. Thank you so much. Mrs. G
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