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Re: Cam

Posted by ben on May 26, 2001, at 15:07:54

In reply to Re: Cam » ben, posted by Cam W. on May 26, 2001, at 13:01:03

> Ben - Paxil™ (paroxetine) is a bugger (no pun) for sexual disfunction (unless you have a hair-trigger). Also, be aware of the delayed weight gain that is very common with Paxil. Four or five months after starting the drug you realize that none of your clothes fit. I recommend that everyone who start Paxil get some kind of dietary counseling (ie. keep a food diary to make sure that your eating habits don't change and keep a decent exercise program).
> As for the Edronex™ (reboxetine), it is not my favorite drug. We had a clinical trial or two with it at our University hospital and, after some seemingly initial success, many of the people who tried it relapsed. I believe that, if ever released in the U.S. and Canada, may find a niche market for those who cannot tolerate or don't respond to SSRIs. The side effects that you had do sound like start-up side effects. Another trial may be in order, but like I said, only a select few respond and maintain response on Edronex.
> I am not totally convinced that taking away either norepinephrine- or serotonin-reuptake blocking activity from an antidepressant works as well as an antidepressant that has both activities. It seems that TCAs which affect both of these mechanisms work better than either SSRIs or NRIs. Perhaps blocking both leads to a third action in the brain; one we haven't figured out, yet.
> I'm sorry, I can't remember whether you tried Wellbutrin SR™ (bupropion), yet. It would seem a logical choice. You could also add it to Celexa™ (citalopram) to try to reverse the sexual stuff. Ask your doc about this.
> - Cam

Thanks Cam

But I think Edronax could be a good ad on if someone doesnt get full relief with an ssri alone. I didnt have side effects like dizziness, anxiety, nausea... which are mostly common with ssri`s (not only in the initial period of 3 weeks). Celexa was good for me because I adjusted very quickly to each dose increase (side effects and probably the effect too) but I didnt give me a full remission after one year (dose up to 100 mg). And it made me tired (took it at 8 pm)......was always yawning.
My doc doesnt want to put me back on Celexa cause of the reasons I described above. He hasnt good experiences with Floxyfral (fluvoxamine) so he suggested Paxil if the Zoloft fails of any reasons. I would try the Paxil but I have fear of the sexual side effects; thats not funny. Prozac takes very long to act ... Another opinion of my doc was to try the MAO inhibitor Aurorix (moclobemide). I read about this drug and there are some points I hesitate to start a trial:
-short half life: intake of 3-4 daily
-effectiveness: very different reports and studys
-side-effects: restlessness, insomnia,anxiety

Interestingly it could be combined with a NRI like Edronax (read it in the web) for some reason (counteracts the cheese like-effect ?).
Pearsonaly I think moclobemide could be combined with small (recommended starting dose) amounts of ssris when its done very carefully (slowly). There are a few reports of successfull combination these two drug classes.




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