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Re: Melancholic depression - what med is the best choi Racer

Posted by yxibow on September 11, 2008, at 19:35:31

In reply to Re: Melancholic depression - what med is the best choi hansi555, posted by Racer on September 11, 2008, at 17:04:57

> Quick and dirty, because I gotta get out the door:
> Scary things about Effexor -- most of the scary things about Effexor have to do with the discontinuation effects. ("Withdrawal.") My doctor considers it to be an "old faithful," because it works reliably for so many of his patients. If you are one of those it works for, it's no more "scary" than any SSRI, really. It has a broader range of action, so it may be more effective for you than the SSRIs.

For those who respond to stimulants that calm them, Effexor can be quite effective -- I'm not one of those people.

> Cymbalta is like Effexor Lite -- same mechanism of action, same drug class, but with a slightly different "feel" to it. Of the two, I found it more friendly, but it was not effective on its own for me. (Nota Bene: I was not in a place that ANY medication could have treated effectively at that time, AND have not had a remission for about six years now. DO NOT think that my experience has any real predictive value for you. It almost certainly does not.) It was very good for some things for me, and I took it for about a year and a half. The side effects I did experience were milder FOR ME with Cymbalta than Effexor.

I would concur, though always its just a personal experience. When I took Effexor years ago, it was like a magnitude of pitchers of coffee, and I couldn't sleep. Cymbalta partially worked for me up to 120 (Lilly does say that 60 or 120 does not make a difference) -- your insurance may not pay above 60.

Cymbalta has only a 6:1 average 5HT to NE dosage. One thing to remember, withdrawing from any SNRI is a slow process because if it is done fast it can be hideous for some. That's just information, not meant to discourage a trial.

> Lamictal is an anticonvulsant often used to treat mood disorders. I can't remember if it's officially approved as a mood stabilizer or not, but it's also used to treat depression. MANY people here have found it helpful.

My doctor more classifies it as an antidepressant, but again that is also just for me, it may be different for you. It takes a long time to build up a dose because essentially it is a test for SJS (not the petit rash but the BIG internal rash).




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