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Re: Reboxetine - No Go Ľ galtin

Posted by SLS on October 7, 2001, at 23:19:18

In reply to Re: Reboxetine - No Go, posted by galtin on October 7, 2001, at 17:35:15

> Scott- The FDA rejection you mention is the one I was thinking of, though it doesn't seem like a year. I was not aware of round two. Since my depressions seem to involve primarily norepinephrine, I had been interested in the Reboxetine. But your comments throw a new light on things. I don't need to try any medications that WORSEN depression. Thanks for the info.
> galtin

Hi Gatlin.

I think it is important to note that every single antidepressant has the potential to exacerbate depression. Having posted here for about 2 years, I canít think of an antidepressant that I havenít seen do this (maybe trazodone). However, it has been my observation that reboxetine does this more often than the others. That said, I donít think it makes sense to forever cross it off your list. You will just have to determine how high up to place it based on your history of drugs tried.

Why do you feel that norepinephrine is involved in your case? What drugs have you tried (dosages and duration)?

Your answer may involve the use of multiple antidepressants that potentiate NE through different mechanisms. For instance, combining Effexor (NE reuptake inhibition) with Remeron (NE alpha-2 antagonism) would theoretically act synergistically to potentiate NE neurotransmission. Many experts consider this to be a highly effective treatment in difficult cases. Wellbutrin makes a good adjunct medication with just about everything. I guess it is the universal augmentor. I donít think researchers yet have a good handle on what this drug does. However, I think most feel that norepinephrine is somehow involved. I have seen more than one person respond well when Wellbutrin has been added to Effexor. Thyroid hormone and the amphetamines along with Ritalin are pro-noradrenergic. The stimulants are primarily NE releasers, although they do inhibit its reuptake to varying degrees. Thyroid hormones are thought to increase the sensitivities of NE receptors Ė primarily beta-1, I think.

Iím sure youíll strike gold if you keep digging.

- Scott




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