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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Jay2112 on September 9, 2023, at 17:03:37
About 30 years ago, when Effexor XR came out, I found a very calming combination of Effexor XR and Celexa. My sleep improved like night and day, and my anxiety shot down immensely. But, either drug alone, Effexor XR or Celexa, did very little for me...even at high doses.
So, lately, I have been experiencing crushing fear and anxiety. So I thought I'd try Celexa's stronger twin, Cipralex/Lexapro, in combination with Effexor. Well, after 3 or so weeks, I am seeing vast improvements in all areas...anxiety, social fear, depression. Plus my sleep is awesome too! And, my anxiety about my skin cancer has gone down quite a bit.
I don't have the so-called typical SRI apathy, and that might also have to do with the large number of meds I am on. Risperdal, Tegretol, clonazepam, Adderall, and B12 + Folic Acid, and Ginger.oh and Lyrica and lithium.(600 mg) To me, it seems after experimenting with all these meds individually over 3 decades, I have found these little weapons that hit almost a bullseye. Plus, I take Androgel (testosterone) in a low-mid dose.
But, adding the Cipralex/Lexapro has been the clincher for me. As well, I think the testosterone guards against the sri apathy, as it blocks re-uptake of dopamine.
I don't, and can't, understand the opponents of INTELLIGENT poly-pharmacy. If you combine 2 or more drugs, with slightly different mechanisms, that have REALLY worked for you, there is a good chance they will work well together. No, not always, but possibly. And, I must emphasize INTELLIGENT, as this is NOT just writing down a bunch of meds you may likely have never tried, and gulping them down. Every med must be tried individually, maybe with a few others, and response noted.
Anyhow...that's my take. This method has worked very well for me. I hope it can help others, or someone else, and give hope.
Jay
Posted by SLS on September 10, 2023, at 6:43:47
In reply to Addition of escitalopram to venlaflaxine...wow!!, posted by Jay2112 on September 9, 2023, at 17:03:37
Hi, Jay.
> About 30 years ago, when Effexor XR came out, I found a very calming combination of Effexor XR and Celexa. My sleep improved like night and day, and my anxiety shot down immensely. But, either drug alone, Effexor XR or Celexa, did very little for me...even at high doses.
>
> So, lately, I have been experiencing crushing fear and anxiety. So I thought I'd try Celexa's stronger twin, Cipralex/Lexapro, in combination with Effexor. Well, after 3 or so weeks, I am seeing vast improvements in all areas...anxiety, social fear, depression. Plus my sleep is awesome too! And, my anxiety about my skin cancer has gone down quite a bit.
>
> I don't have the so-called typical SRI apathy, and that might also have to do with the large number of meds I am on. Risperdal, Tegretol, clonazepam, Adderall, and B12 + Folic Acid, and Ginger.oh and Lyrica and lithium.(600 mg) To me, it seems after experimenting with all these meds individually over 3 decades, I have found these little weapons that hit almost a bullseye. Plus, I take Androgel (testosterone) in a low-mid dose.
>
> But, adding the Cipralex/Lexapro has been the clincher for me. As well, I think the testosterone guards against the sri apathy, as it blocks re-uptake of dopamine.
Interesting! I had no idea.Adding testosterone made no difference to me, and it didn't increase my sex=drive at all. I did get pimples on my chest - like I used to have - so I assume it did its job. I recovered much of my sex-drive with the remission of my bipolar depression. You have to careful with lithium, though. It reduces testosterone secretion.
> I don't, and can't, understand the opponents of INTELLIGENT poly-pharmacy. If you combine 2 or more drugs, with slightly different mechanisms, that have REALLY worked for you, there is a good chance they will work well together. No, not always, but possibly. And, I must emphasize INTELLIGENT, as this is NOT just writing down a bunch of meds you may likely have never tried, and gulping them down. Every med must be tried individually, maybe with a few others, and response noted.
>
> Anyhow...that's my take. This method has worked very well for me. I hope it can help others, or someone else, and give hope.
>
> JayThere is no medical basis for avoiding polypharmacy. It is merely a philosophy without meerit.
If you haven't combined Effexor with Wellbutrin yet, I would recommend that instead of adding a SSRI. My belief is that Effexor is superior to Pristiq, although I know someone who attained remission with Pristiq. Since she never used Effexor in place of Pristiq, I can't use her case to make a comparison. Previously, she had been struggling with Parnate for years.
- Scott
Posted by SLS on September 13, 2023, at 10:23:48
In reply to Addition of escitalopram to venlaflaxine...wow!!, posted by Jay2112 on September 9, 2023, at 17:03:37
Oh.
I forgot to mention that my friend who has achieved remission with Pristiq also takes Wellbutrin, which is necessary for her treatment to work. That was my primary reason for my previous post.
When Zoloft first came out, it was discovered that Wellbutrin made an effective adjunct. The first SSRI to be approved after Prozac was Zoloft. It didn't take long to discover that Wellbutrin made a good adjunct to Zoloft. So much so, that the nicknmame for this combination emerged quickly:
Zoloft + Wellbutrin = "Welloft".
I am disppointed that using Wellbutrin as an adjunct to Effexor hasn't been used more routinely. It makes sense to try Zoloft first, however. If it fails to produce results, discontinuing it is much easier than discontinuing Effexor. Of course, if either treatment works, there will never be a need to discontinue it.
There is no one on Psycho-Babble that I'm aware of who should even contemplate discontinuing a treatment that has produced a remission. This has long been the observations and advice of competent psychopharmacologists. If it ain't broke, don't try to fix it. You may not respond nearly as completely when you relapse and attempt to restart the same treatment. This is particularly true of SSRIs, and Paxil in particular.
- Scott
This is the end of the thread.
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