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Re: 80 mg. celexa-anyone? or effexorcelexa?

Posted by Bekka H. on January 6, 2002, at 15:19:05

In reply to 80 mg. celexa-anyone? or effexorcelexa?, posted by edward602 on January 3, 2002, at 10:32:15

Is anyone on such a combo. Thanks. Edward


My doctor had prescribed a Celexa + Dexedrine combination a couple of years ago. It worked well for about 10-14 days and then, the two drugs seemed to cancel each other out. Each one seemed to negate what was good about the other. By the way, I had taken each one separately at other times. The same thing happened to me when I tried to combine Zoloft and Wellbutrin. I'm not certain why this happened, but I have some ideas. I read in Joseph Glenmullen's "Prozac Backlash" that Celexa and other SSRIs lower dopamine levels by at least 50%. In other places, I've read that SSRIs deplete dopamine, but I've also read that stimulants deplete serotonin over the long run. I also read in another good book on psychopharmacology by Keltner and Folks (I'll try to provide more information on that book in another post) that one of the things that causes amphetamine tolerance is that the presynaptic receptors have greater affinity for dopamine than the post-synaptic receptors. Consequently, as dopamine levels fall, via a feedback mechanism, the dopamine will be more likely to end up on the presynaptic end than the postsynaptic end. My very crude understanding of this is that if SSRIs lower dopamine (Glenmullen cites several studies indicating that this does happen), then the little dopamine that is there will have greater affinity for the presynaptic receptor and never make it across the synapse. As I said, this is my crude understanding of the picture, and if someone wants to enlighten me on this, I'd like to hear what you have to say.

In any event, I brought all this up to say that I don't think SSRI + stimulant combos are helpful for me. I have heard from other psychopharmacologists that SSRI + mood stabilizer combos are more successful. By "mood stabilizer," I mean anti-seizure drugs that now have psychotropic uses: Lamictal, Neurontin, Depakote, Topamax. I've heard that Topamax is effective, but it impairs cognition more than the others. By the way, I took Depakote a long time ago, and it was the worst drug I've ever taken. My hair fell out, I developed bruises all over my body, and I slept all day. So much for it's "anti-depressant" properties.




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