Posted by Geezer on February 24, 2002, at 10:28:08
In reply to What a geezer! » Geezer, posted by lula on February 24, 2002, at 7:57:16
> Really appreciate your post, geezer. I have one question/comment. I am taking Effexor (150mg) along with 300 mg Wellbutrin but I am sleepy all of the time. Not a problem I have with wellbutrin by itself. I am going to see the doc tomorrow and I was planning on suggesting that I begin to wean myself off of it and stay with the Wellbutrin (I don't smoke when I take it)and suggest that we look into MAOIs when I finish my dissertation (in about 2 months). At what dosage does effexor impact norepinephrine levels? I know it doesn't touch depression until 225mg.
> Once again, thanks for your help!Hi lula,
Can't answer the question about effexor "scientifically" but I would think you would have to go to at least 225mg. to get any norep. benefit. Effexor is way over balanced on the side of serotonin and this could explain why people have such problems with "Side-Effexor Withdrawal" = serotonin withdrawal. People complain about problems they have when missing doses of Effezor, in my opinion, this is nothing more than serotonin withdrawal due to the short Effexor half life. Solution - get some prozac tabs. 10mg. begin titrating Effexor down, when you begin to feel poorly add 1 Prozac 10mg in AM.
Leave your Wellbutrin constant, continue down titration of Effezor until you are off. If you feel the need decrease the Prozac to 5mg./day for a week then stop the Prozac - no withdrawal due to Prozac long half life.NOW, you are on 300mg. of Wellbutrin. Next suggestion - find out for REAL if you are Bipolar or not. The Wellbutrin is IMHO the best AD for you at this point BUT a differential DX of BIPOLAR + Specifiers adds a whole new concept to your future. It has been said on this board we are "only treating symptoms". I respectfully disagree - I have spent 30 years treating symptoms, maybe you won't have to do the same.
Another opinion. This heavy emphasis on serotonin is due to the AMERICAN MODEL for treating depression - in Europe you would have a better shot at Norep. and Dopamine.
Would love to know the topic of your dissertation!
Please undertake your treatment changes with your pdocs approval.
Best regards
Geezer
poster:Geezer
thread:95123
URL: http://www.dr-bob.org/babble/20020222/msgs/95305.html