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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Bob on February 17, 2010, at 14:19:39
Does anyone have an idea of how the ratio of Serotonin to Norepinephrine reuptake ratio of Savella or Cymbalta might be reproduced with appropriate doses of Citalopram with Nortriptyline, or maybe Zoloft with Nortriptyline?
In other words, what dose ratios might I use to recreate my own 'SNRI'?
Posted by Phillipa on February 17, 2010, at 17:01:24
In reply to SSRI/SNRI ratio: Citalopram/Nortrip vs. Savella, posted by Bob on February 17, 2010, at 14:19:39
Seriously is that possible to do? Great question never saw it posted before. Phillipa
Posted by bleauberry on February 17, 2010, at 17:50:30
In reply to SSRI/SNRI ratio: Citalopram/Nortrip vs. Savella, posted by Bob on February 17, 2010, at 14:19:39
Rather than shooting for a predetermined ratio, the appropriate dose would be the one that "feels" right to you. Which would take some experimenting.
There really is no direct comparison anyway, because Nort is doing a lot of other stuff besides NE, some of which may be therapeutic and some not, we don't know. Savella, same thing, there is more going on at a molecular level than we currently know. Even with old meds like Nort, there is so much we don't know. Much more research is needed.
The right ratio is the one that feels best to you. That might be 1:3, 2:5, 7:2, who knows.
Based on my own experimenting with Nort and Zoloft, it felt to me like 12:5mg Zoloft and 20mg Nort were about equal. That said, no dose of any size felt like it had the direct yet clean emphasis on NE. Even a tiny dose of Savella had a pleasant ummph on NE with a soft touch of 5ht. Whereas Nort did not feel potent or clean, and Zoloft felt like it was messing with something else unwanted besides just serotonin.
But that's just me.
Posted by polarbear206 on February 18, 2010, at 9:40:14
In reply to SSRI/SNRI ratio: Citalopram/Nortrip vs. Savella, posted by Bob on February 17, 2010, at 14:19:39
> Does anyone have an idea of how the ratio of Serotonin to Norepinephrine reuptake ratio of Savella or Cymbalta might be reproduced with appropriate doses of Citalopram with Nortriptyline, or maybe Zoloft with Nortriptyline?
>
> In other words, what dose ratios might I use to recreate my own 'SNRI'?Here's something for you.
Posted by Bob on February 18, 2010, at 19:37:16
In reply to Re: SSRI/SNRI ratio: Citalopram/Nortrip vs. Savella, posted by polarbear206 on February 18, 2010, at 9:40:14
> > Does anyone have an idea of how the ratio of Serotonin to Norepinephrine reuptake ratio of Savella or Cymbalta might be reproduced with appropriate doses of Citalopram with Nortriptyline, or maybe Zoloft with Nortriptyline?
> >
> > In other words, what dose ratios might I use to recreate my own 'SNRI'?
>
> Here's something for you.
>
> http://www.psychotropical.com/dual_action_ads.shtmlGood link. Thanks!
Posted by Bob on February 18, 2010, at 19:39:36
In reply to Re: SSRI/SNRI ratio: Citalopram/Nortrip vs. Savella, posted by bleauberry on February 17, 2010, at 17:50:30
All good points. I didn't necessarily mean to reproduce exactly a med like Savella or Cymbalta, but rather to merely simulate the 5HT/NE ratio to a certain extent. Like you say, there are myriad other variables involved.
Posted by viper1431 on February 19, 2010, at 1:48:57
In reply to Re: SSRI/SNRI ratio: Citalopram/Nortrip vs. Savella, posted by polarbear206 on February 18, 2010, at 9:40:14
> > Does anyone have an idea of how the ratio of Serotonin to Norepinephrine reuptake ratio of Savella or Cymbalta might be reproduced with appropriate doses of Citalopram with Nortriptyline, or maybe Zoloft with Nortriptyline?
> >
> > In other words, what dose ratios might I use to recreate my own 'SNRI'?
>
> Here's something for you.
>
> http://www.psychotropical.com/dual_action_ads.shtmlinteresting, according to the link imipramine shouldn't work as an anti-depressant. Tet isn't it considered one of the gold standards?
Amitriptyline is in the same boat.
This is the end of the thread.
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