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Re:cylert v. dexedrine

Posted by Toby on January 15, 1999, at 8:56:08

In reply to *** C Y L E R T vs. D E X A D R I N E, posted by Jef* on January 10, 1999, at 14:54:40

Dexedrine: rapidly absorbed from the gi tract; peak level in 2 hours. Can cause increased blood pressure and pulse rate, especially in African-Americans, but it is usually not clinically significant; decreased appetite, delayed sleep.

Cylert: rapidly absorbed by the gi tract; is chewable, may be smoother and beter tolerated; reaches a steady state in 2-3 days; has less stimulant effect than dexedrine; litle abuse potential; can reduce appetite and delay sleep in some people but more likely in kids.

With regard to using stimulants for treatment resistant depression: Help in geriatric depression and medically-induced depression (as a result of diabetes, kidney failure, cancer, other severe illnesses or medication-induced depression). Stimulants are not better than placebo as first treatment of depression. Stimulants help a small group of patients who have failed at least 2 other antidepressant classes (TCA's, SSRI's or MAOI's), have a serious or life-threatening illness that prevents them from tolerating other antiderpessants; or need an adjunct to an antidepressant. Stimulants develop tolerance more often than conventional antidepressants (about 20-40%).

If energy or depression is very bad on the Effexor alone and your doctor doesn't feel another antidepressant would be more helpful and the stimulant is too strong, Cylert may be a better choice as it doesn't make most people jittery. On the other hand, fenfluramine is another choice some docs in the Western US favor as an adjunct to antidepressants that doesn't cause jitteriness.


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