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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by tensor on June 30, 2009, at 23:35:13
How much is noradrenaline affected by fluoxetine?
Posted by morganpmiller on July 1, 2009, at 0:11:03
In reply to Fluoxetine and noradrenaline, posted by tensor on June 30, 2009, at 23:35:13
http://biopsychiatry.com/fluoxdopnor.htm
http://www.mindandmuscle.net/forum/index.php?showtopic=38276
Posted by tensor on July 1, 2009, at 0:13:57
In reply to Fluoxetine and noradrenaline, posted by tensor on June 30, 2009, at 23:35:13
I'm thinking of fluoxetine for primarily anxiety, if it help with my depression it's a plus. Does anyone take fluoxetine nowadays? Zoloft does nothing for my anxiety, it's really +/-0, strong noradrenergic agents does, like milnacipran and reboxetine. But they don't help completely plus they have some hard to tolerate side effects, like rapid heart beat, high blood pressure, muscle weakness (can't exercise). I'm thinking that fluoxetine is somewhere in between a pure SSRI like escitalopram and the SNRIs and NRIs.
Do you think fluoxetine is more likely to help than escitalopram? Fluoxetine was the first med I took for panic disorder, but it's ages ago, can't really recall how effective it was./Mattias
Posted by garnet71 on July 1, 2009, at 0:37:36
In reply to Re: Fluoxetine and noradrenaline, posted by tensor on July 1, 2009, at 0:13:57
Yes, Prozac worked for severe anxiety in my case...don't know about being able to tolerate the side effects though.
Posted by Phillipa on July 1, 2009, at 0:39:48
In reply to Re: Fluoxetine and noradrenaline » tensor, posted by garnet71 on July 1, 2009, at 0:37:36
Caused severe panic in me by day three. How come it conquers anxiety in so many? Phillipa
Posted by morganpmiller on July 1, 2009, at 2:02:54
In reply to Re: Fluoxetine and noradrenaline, posted by tensor on July 1, 2009, at 0:13:57
How long were you on Zoloft and at what dose?
I loved Prozac when I took it years ago. If I go back to an SSRI though, it would probably be Zoloft since I was on it for 8 years and it is low in toxicity(the safest SSRI for pregnancy).
I think Prozac is a great medication. If you give it some time, maybe 2 or 3 months, and find the right dose, you may find that it helps you tremendously. Also, given some time, you may notice side effects going away the longer you are on it. If you don't want to try Nardil or Parnate, I say give Prozac a try. Just be patient. Any antidepressant can agitate anyone in the beginning of treatment. You have to try to tough it out if you do feel panicked or aggitated. Most likely, these side effects will pass. If you are lucky, you won't have any agitation or worsening of anxiety in the beginning. Just remember, if you do, it does not mean that Prozac ill not and cannot help you.
I would not reccommend using a benzo during the beginning of treatment. Benzos are CNS depressants and can therefore interfere with the efficacy of antidepressant treatment. Just try your best to tough it out for 3 or 4 more weeks. You will be happy you did when you start experiencing significant relief on the antidepressant alone.
I hope Prozac works for you! If you try it of course.
Posted by bleauberry on July 2, 2009, at 18:44:55
In reply to Fluoxetine and noradrenaline, posted by tensor on June 30, 2009, at 23:35:13
Fluoxetine actually has more affinity for the norepninephrine reuptake pump than does effexor. In other words, even though it is marketed as an SSRI, fluoxetine is more of an SNRI than effexor is.
Fluoxetine elevates brain levels of serotonin, norepinephrine, and dopamine. And that is greatly magnified when combined with Zyprexa.
Posted by bleauberry on July 2, 2009, at 18:51:32
In reply to Re: Fluoxetine and noradrenaline, posted by morganpmiller on July 1, 2009, at 2:02:54
> How long were you on Zoloft and at what dose?
>
> I loved Prozac when I took it years ago. If I go back to an SSRI though, it would probably be Zoloft since I was on it for 8 years and it is low in toxicity(the safest SSRI for pregnancy).
>
> I think Prozac is a great medication. If you give it some time, maybe 2 or 3 months, and find the right dose, you may find that it helps you tremendously. Also, given some time, you may notice side effects going away the longer you are on it. If you don't want to try Nardil or Parnate, I say give Prozac a try. Just be patient. Any antidepressant can agitate anyone in the beginning of treatment. You have to try to tough it out if you do feel panicked or aggitated. Most likely, these side effects will pass. If you are lucky, you won't have any agitation or worsening of anxiety in the beginning. Just remember, if you do, it does not mean that Prozac ill not and cannot help you.
>
> I would not reccommend using a benzo during the beginning of treatment. Benzos are CNS depressants and can therefore interfere with the efficacy of antidepressant treatment. Just try your best to tough it out for 3 or 4 more weeks. You will be happy you did when you start experiencing significant relief on the antidepressant alone.
>
> I hope Prozac works for you! If you try it of course.
I agree prozac is a very good ssri. Probably an unsung hero. There are some important points to be aware of though...-It probably does take longer to reach full effectiveness.
-Early side effects do mostly vanish within a few months.
-Early side effects can be managed with the orange juice trick...stir the contents of a capsule in a glass of orange juice, stir well (it won't dissolve), a drink a custom size dose. You can go from 1mg to 2mg to 3mg all the way to your target dose. I started at 1mg, worked up to 5mg, stayed there a while, worked up to 10mg, kept on climbing to 20mg, and it was a smooth journey.
-At the time, about 10 years ago, the doctor who prescribed it to me said he had hundreds of patients on prozac and only a few dozen on all the others. The reason was because he said he saw it worked a lot better than the others.
Posted by sowhysosad on July 3, 2009, at 5:42:39
In reply to Re: Fluoxetine and noradrenaline, posted by bleauberry on July 2, 2009, at 18:51:32
There's a lot to be said about a drug that's relatively so old but still so commonly prescribed. It's tried-and-tested and obviously works for a lot of people.
Just waiting to hear back from the pdoc about what he's prescribing for me and it's likely to be fluoxetine.
I feel way more confident returning to it than I would starting some trendy new drug.
> I agree prozac is a very good ssri. Probably an unsung hero. There are some important points to be aware of though...
>
> -It probably does take longer to reach full effectiveness.
> -Early side effects do mostly vanish within a few months.
> -Early side effects can be managed with the orange juice trick...stir the contents of a capsule in a glass of orange juice, stir well (it won't dissolve), a drink a custom size dose. You can go from 1mg to 2mg to 3mg all the way to your target dose. I started at 1mg, worked up to 5mg, stayed there a while, worked up to 10mg, kept on climbing to 20mg, and it was a smooth journey.
> -At the time, about 10 years ago, the doctor who prescribed it to me said he had hundreds of patients on prozac and only a few dozen on all the others. The reason was because he said he saw it worked a lot better than the others.
>
Posted by bearfan on July 4, 2009, at 8:43:36
In reply to Re: Fluoxetine and noradrenaline, posted by sowhysosad on July 3, 2009, at 5:42:39
Prozac is the least selective of the SSRIs. By "least selective" I mean that it targets Serotonin, but also has a slight impact on NE and DE. For Prozac starters, it is best to take 10mg for 1-2 weeks then bump up to 20mg. It doesn't help anxiety for everyone, but it can help after being on it for awhile. Keep in mind it is FDA approved for both OCD and Panic Disorder (part of the anxiety spectrum).
Posted by sowhysosad on July 4, 2009, at 11:08:27
In reply to Re: Fluoxetine and noradrenaline, posted by bearfan on July 4, 2009, at 8:43:36
> For Prozac starters, it is best to take 10mg for 1-2 weeks then bump up to 20mg.
I'm doing just that at the moment.
Haven't actually got the new scrip back from the pdoc yet, but it'll be fluoxetine or paroxetine and I can't see them giving me paroxetine because of it's rep for difficult withdrawal. I had some generic liquid I'd kept from a couple of years back so I started taking 10mg on Friday.
I felt an improvement in mood, energy and motivation within a few hours of taking the fluoxetine. Been off SSRI's for a few months and as miserable as all hell. It seems clear that a serotonin boost and the "activating" effect was what I was needing.
Posted by bleauberry on July 4, 2009, at 19:46:20
In reply to Fluoxetine and noradrenaline, posted by tensor on June 30, 2009, at 23:35:13
Lots of good points already made.
This one needs to be top priority if the choice is prozac...
The first prescription HAS to be, no exceptions, brand LIlly Prozac, NOT generic fluoxetine. If you want to significantly increase the chance of prozac not working for you, accept generic. You'll never know how the good the real stuff would have been.
Posted by bearfan on July 4, 2009, at 23:04:24
In reply to Re: Fluoxetine and noradrenaline, posted by bleauberry on July 4, 2009, at 19:46:20
I started on the 'real' brand before it went generic. Although the generic seems to be about the same after awhile, the delivery feels slightly different.
Posted by bearfan on July 4, 2009, at 23:07:59
In reply to Re: Fluoxetine and noradrenaline, posted by bleauberry on July 4, 2009, at 19:46:20
I started on the 'real' brand before it went generic. Although the generic seems to be about the same after awhile, the delivery feels slightly different.
Posted by Brainbeard on July 10, 2009, at 5:45:19
In reply to Fluoxetine and noradrenaline, posted by tensor on June 30, 2009, at 23:35:13
I don't want to post the same message twice, but I think this post in another thread is relevant to this thread as well: http://www.dr-bob.org/babble/20090709/msgs/905985.html. To summarize: the first mechanism through which Prozac elevates noradrenaline levels is 5HT2C-antagonism. Prozac's 5HT2C-antagonism is stronger than its serotonin reuptake inhibition, which means that at low doses, Prozac will hardly boost serotonin at all, but will significantly boost noradrenaline (as well as dopamine).
This is the end of the thread.
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