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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by PaintItBlack on August 29, 2001, at 9:12:08
My pdoc is gung-ho on combining Wellbutrin with Effexor. I am slowly titrating up on Wellbutrin, and it appears to be the best-tolerated AD I've ever been on.
Effexor, which I tried to start simulaneously, made me dizzy and zombielike. That's typical of an SSRI. To get to the point where Effexor was giving noradrenergic effect, I would be overwhelmed by the serotonin side effects.
Are there any meds which produce NE effects similar to Effexor? (After all, it's the noradrenergic stuff my pdoc is looking for.) The chemistry of receptor site X and agonist Y and blocker Z is way beyond me.
Any takers? Thanks.
Paint It Black
while sipping skyblue Wellbutrin
Posted by SalArmy4me on August 29, 2001, at 14:48:39
In reply to Noradrenergic Similar To Effexor ?, posted by PaintItBlack on August 29, 2001, at 9:12:08
Desipramine, Reboxetine, and Mirtazapine have effects on NE like Effexor.
Posted by Andre Allard on August 31, 2001, at 23:21:14
In reply to Noradrenergic Similar To Effexor ?, posted by PaintItBlack on August 29, 2001, at 9:12:08
The higher the dose of effexor, the more stimulation you will feel because of the norandrenergic effects.
If you have an experienced pdoc you could push the dosage above 300mg all the way up to 600mg if needed.
It is unlikely that you would be zombie like with a dosage of 375mg or higher.
But, if the wellbutrin is working stick with it.
Good luck!
Posted by PaintItBlack on September 1, 2001, at 8:00:54
In reply to Re: Noradrenergic Similar To Effexor ?, posted by Andre Allard on August 31, 2001, at 23:21:14
> The higher the dose of effexor, the more stimulation you will feel because of the norandrenergic effects.
>
> If you have an experienced pdoc you could push the dosage above 300mg all the way up to 600mg if needed.
>
> It is unlikely that you would be zombie like with a dosage of 375mg or higher.
>
> But, if the wellbutrin is working stick with it.Actually, the WB isn't working yet. But at least the side effects aren't too bad.
If 37.5 mg of Effexor made me dizzy, unable to concentrate, etc., wouldn't it be much worse at 375 mg, where the NE effects start? Those zombie side effects are pretty much what I get with any SSRI. I understand that the NE effects don't kick in until higher doses, but I haven't heard that the SSRI effects stop working.
My question was whether it wouldn't make more sense to skip the SSRI effects (which I know are bad for me) and take something that was mostly noradrenergic? Nortriptyline and desipramine come to mind, though there must be others. But I don't know if anyone is using those combos with WB.
Paint It Black
Posted by DebbieLynn on September 1, 2001, at 22:05:17
In reply to Noradrenergic Similar To Effexor ?, posted by PaintItBlack on August 29, 2001, at 9:12:08
> My pdoc is gung-ho on combining Wellbutrin with Effexor. I am slowly titrating up on Wellbutrin, and it appears to be the best-tolerated AD I've ever been on.
My pdoc also has added Wellbutrin Sr 100mg twice a day with my 225mg dose of Effexor XR. I am a nursing student...I was doing research on Wellbutrin and Effexor used together, and apparently they have similar chemical makeup. Personally, I was at 300mg of Effexor and 100mg of Wellbutrin and I was extremely TIRED. I have decreased my dose of Effexor to 225mg and increased my dose of Wellbutrin to 200mg. I take 150mg of FXR and 100mg of WB in the am, and 75mg of FXR and 100mg of WB in the afternoon. I have had insomnia and I have been jittery, other than that I think I will do fine.
Good Luck...(just my input)
Debbie
>
> Effexor, which I tried to start simulaneously, made me dizzy and zombielike. That's typical of an SSRI. To get to the point where Effexor was giving noradrenergic effect, I would be overwhelmed by the serotonin side effects.
>
> Are there any meds which produce NE effects similar to Effexor? (After all, it's the noradrenergic stuff my pdoc is looking for.) The chemistry of receptor site X and agonist Y and blocker Z is way beyond me.
>
> Any takers? Thanks.
>
> Paint It Black
> while sipping skyblue Wellbutrin
Posted by Andre Allard on September 2, 2001, at 1:36:53
In reply to Noradrenergic Similar To Effexor ?, posted by PaintItBlack on August 29, 2001, at 9:12:08
I am not a big fan of desiprimine, nortriptyline or any of the old dirty ADs. If you really want to baddle with some nasty side effects then go nuts on the two drugs listed above.
When you began the effexor at 37.5mg you should have waited for the side effects to disapate then titrated the dosage up very slowly. Effexor has been known for zombie like effects with dosages below 150mg. You see, the noradrenergic effects do not begin until dosages of 125mg. The higher you push the dosage the more alert you will become.
Effexor has been proven to result in much higher response rates then other ADs including wellbutrin. Effexor is also more broad spectrum, meaning that it shows a higher efficiousy rate over a broader range of disorders including, treatment resistent and severe depression as well as anxiety.
If wellbutrin is not even working then quit wasting your time and get your ass on effexor. You can begin with a dosage as small as 18.75mg and titrate the dosage no earlier than every four days. It could take as long as a month to get up to an effective dosage but it should be well worth the wait.
Good luck!
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