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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by bearfan on May 7, 2010, at 16:12:00
Its hard to tolerate Wellbutrin, and the SSRIs don't do enough for my social anxiety and motivation. Both Effexor, and Cymbalta have intolerable side effects and Ixel and Pristiq cause me anxiety. Is there anything I can do to have that same effect with another drug or combo? It's really frustrating.
Posted by chujoe on May 7, 2010, at 17:40:14
In reply to How can I get the SNRI effect without using SNRI, posted by bearfan on May 7, 2010, at 16:12:00
What were your side effects with Cymbalta? How much were you taking?
Posted by bearfan on May 7, 2010, at 18:19:08
In reply to Re: How can I get the SNRI effect without using SNRI, posted by chujoe on May 7, 2010, at 17:40:14
40 or 60mg, gave me alot of constipation and constant bad bloating
Posted by linkadge on May 7, 2010, at 19:19:15
In reply to Re: How can I get the SNRI effect without using SNRI, posted by bearfan on May 7, 2010, at 18:19:08
Can you take an SSRI with some custom dose of wellbutrin?
Linkadge
Posted by bearfan on May 7, 2010, at 19:27:18
In reply to Re: How can I get the SNRI effect without using SNRI, posted by linkadge on May 7, 2010, at 19:19:15
Last time I tried wellbutrin, I usually try it for a few days and its very intolerable (bad headache almost seizure like feelings). What about Focalin isn't that an Dp-Ne reuptake inhibitor?
Posted by desolationrower on May 7, 2010, at 19:34:42
In reply to Re: How can I get the SNRI effect without using SNRI, posted by bearfan on May 7, 2010, at 19:27:18
well, you would take an nri + an sri
eg desipramine + l-citalopram
-d/r
Posted by bearfan on May 7, 2010, at 19:37:54
In reply to Re: How can I get the SNRI effect without using SNRI, posted by desolationrower on May 7, 2010, at 19:34:42
How would desimpramine + other SSRIs do (ie fluoxetine)?
Posted by Phillipa on May 7, 2010, at 19:53:49
In reply to How can I get the SNRI effect without using SNRI, posted by bearfan on May 7, 2010, at 16:12:00
I wonder why cymbalta at 60mg didn't do a thing to me? Nada. Did have the benzos though. Stopped after three months. I just don't feel ad's stop anxiety. Phillipa
Posted by chujoe on May 7, 2010, at 19:56:26
In reply to Re: How can I get the SNRI effect without using SNRI » bearfan, posted by Phillipa on May 7, 2010, at 19:53:49
Well, Cymbalta stopped my anxiety dead in its tracks and has kept it under control for six weeks -- I switched to it from Zoloft, which had worked before, but not this time. I'm lucky, I guess, because I've had very few of the side effects Cymbalta can give you & I'm taking 90.
Posted by desolationrower on May 8, 2010, at 2:12:44
In reply to Re: How can I get the SNRI effect without using SNRI, posted by bearfan on May 7, 2010, at 19:37:54
> How would desimpramine + other SSRIs do (ie fluoxetine)?
i'd guess most nri + most sri would be about the same, i'm not aware of any studies done comparing combinations. it woudl be a lot of possible combinations adn no reason to think one woudl be better
-d/r
Posted by tensor on May 8, 2010, at 5:08:21
In reply to Re: How can I get the SNRI effect without using SNRI, posted by desolationrower on May 8, 2010, at 2:12:44
> > How would desimpramine + other SSRIs do (ie fluoxetine)?
>
> i'd guess most nri + most sri would be about the same, i'm not aware of any studies done comparing combinations. it woudl be a lot of possible combinations adn no reason to think one woudl be better
>
> -d/rAlso, reboxetine + SSRI and atomoxetine + SSRI.
/Mattias
Posted by linkadge on May 8, 2010, at 7:51:33
In reply to Re: How can I get the SNRI effect without using SNRI, posted by tensor on May 8, 2010, at 5:08:21
Not all the NRI's have equal secondary binding effects. Nortriptyline probably causes less anxiety / insomnia than desipramine since it interacts with 5-ht2a and histamine more potently.
Wellbutrin (although touted as having N/DRI effects as primary MOA) is thought to exert its antidepresant effects through cholingeric receptor interaction or even monoamine release rather than reuptake.
Linkadge
Posted by desolationrower on May 9, 2010, at 0:53:09
In reply to Re: How can I get the SNRI effect without using SNRI, posted by linkadge on May 8, 2010, at 7:51:33
> Not all the NRI's have equal secondary binding effects. Nortriptyline probably causes less anxiety / insomnia than desipramine since it interacts with 5-ht2a and histamine more potently.
yeah, sri choice also can matter.
> Wellbutrin (although touted as having N/DRI effects as primary MOA) is thought to exert its antidepresant effects through cholingeric receptor interaction or even monoamine release rather than reuptake.
by whom? personally, i think the reduction in tnf-alpha is the important mechanism
-d/r
Posted by bleauberry on May 9, 2010, at 19:27:09
In reply to How can I get the SNRI effect without using SNRI, posted by bearfan on May 7, 2010, at 16:12:00
I'm not a fan of wellbutrin, but it can go well with ssris. So that's one option. Another is to combine ssri with nortriptyline. That way you can modify the ratio of snri to your liking. Zoloft plus Nort.
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