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Dr. Bob is Robert Hsiung, MD,
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Posted by jay2112 on November 5, 2020, at 22:35:50
Ok...these are the (so varied???..right) splendid and HUGE amount of new antidepressants we get to choose from....levomilnacipran or vilazodone???
I want to try the levomilnacipran alone, or vilazodone with a tricyclic nri.I was fudged on effexor and anafranil, and felt like complete hell!! Frozen, for years!! I couldn't leave the house for almost 4 years!
I have a pain component too, so I need that bit of noradrenic surge. Noradrenaline, not so much dopamine, is involved in pain relief. (That is why I love getting Novocane at the dentist!..lol)
I am also on Suboxone, and may go to methadone.
And also, I have found I am super-sensitive to 5htp. Even just a grain of it, and I feel the most uncomfortable feeling...can't explain. L-Tryptophan is fine. Anyone else?
Jay (the psychonaut)
Experiences and or comments/suggestions?
Posted by linkadge on November 14, 2020, at 15:54:25
In reply to Help... levomilnacipran or vilazodone???, posted by jay2112 on November 5, 2020, at 22:35:50
I can mirror your response to 5-htp vs. tryptophan. I find tryptophan fine, but 5-htp leaves me feeling crappy. Tryptophan metabolizes to a variety of substances which can have differing effects (besides serotonin enhancement).
Levomilnacipran is a more selective towards serotonin (about 2:1). It is probably better for pain, energy, motivation, concentration etc. Whereas, vilazodone is probably better for anxiety, sleep and possibly core depressive thoughts.
It's difficult to say, however, if pain was a significant issue, I would start with levomilnacipran. However, if you were also going to use a TCA, you might get by with vilazodone + a noradrenergic TCA like desipramine.
Linkadge
This is the end of the thread.
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