Posted by Cam W. on January 29, 2000, at 11:17:10
In reply to Re: Effexor XR and Serzone?, posted by Cindy W on January 29, 2000, at 10:00:55
> > > > > I am having some trouble with all day effectiveness on 225 mg. of effexor xr. We have tried several augmentations but none have worked. When i was on Paxil my doc prescribed 5 mg of protriptyline. does anyone know how this same prescript might work with the effexor xr or have any other suggestions?
> > >
> > > James here....
> > >
> > > Effexor + TCA is a good idea.
> > >
> > > j
> > Teresa - Protripyline has norepineephrine reuptake blocking properties, as well as serotonin reuptake blocking properties, whereas Effexor mainly blocks only serotonin reuptake (it does not have significant norepinephrine reuptake blocking properties as is usually believed according to receptor binding studies). The TCAs, like protriptyline, with their dual action are considered by European psychiatrists to be better antidepressants than SSRIs, like Effexor, but TCAs have more pronounced side effects.
> > This said, by augmenting Effexor with Protriptyline may give enhanced antidepressant action without causing the increased TCA side effects, because the protriptyline dose can be kept lower than it would be if it was used alone (without Effexor). Give it a try, it may work. Good luck. - Cam W.
> Cam, what do you think about combining Effexor-XR and Serzone? I am taking Effexor-XR 225 mg/day but it makes me feel edgy, and keeps me awake sometimes...I used to sleep very well on Serzone. What about adding a tiny dose of Serzone, say, 30-40 mg/day, up to l50?--Cindy W
Cindy - I have not seen that combination (yet), but Serzone is similar in structure to Desyrel (trazodone) and I have seen Desyrel used, in low doses (25-100mg) as a sleeping aid in combination with the SSRIs, Wellbutrin and Effexor. The effects have generally been good, with little morning "hangover" effect. Ask your doctor about adding low dose Desyrel, rather than Serzone, for sleep. It is non-addicting and also works well and safely in seniors. I am only staying away from recommending Serzone because I have not seen that combination and do not like asking people to be guinea pigs. Desyrel (or if there is a generic) will be cheaper than Serzone. Good luck - Cam W.