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Re: Effexor with Mirapex? » Maverick

Posted by Rick on September 4, 2002, at 22:28:10

In reply to Re: Effexor with Mirapex?, posted by Maverick on September 4, 2002, at 20:16:11

Not positive, but my understanding was that Mirapex can cause some cognitive dulling, even if it *is* a dopamine agonist. While it might have more side effects (especially nausea and hypotension), bromocriptine/Parlodel might be a better choice. Bromocriptine is sometimes considered a "smart drug." Both Mirapex and bromocriptine have been shown to potentiate antidepressants, too, so you might be able to cut down your Effexor dose a bit, which could further help the sexual dysfunction.

A few other "antidotes" to consider include a small dose of selegiline/deprenyl (although this dopaminergic agent is an MAOI, so strictly speaking it's contraindicated and there's a small possibility of serotonin syndrome...be careful); Buspar; Ginkgo Biloba; and Serzone (again, might allow you to cut the Effexor dose). There are lots of other antidotes to try -- though no guarantees, of course, and some can take awhile to kick in even if they do work.

If none of the add-ons work, maybe you could "ease" into a trial of Serzone or Remeron monotherapy (or moclobemide if you're NOT in the U.S., although this would require a washout period, I believe). I know that's easier said than tried, especially if you've been on Effexor awhile and it works well for your depression.

Good Luck,
Rick

>
> I haven't started any form of dopamine agonist yet, but I will let you know when I decide on one.
>
> I have tried Wellbutrin SR in the past and don't find it to be of any benefit. It just increased my anxiety andthe Effexor side effects.
>
> What would your suggestions be to reclaim my sex life? I am unable to decrease my Effexor without the depression returning.
>
>
>
> In this scenario, the effexor is not
> > causeing the sexual disfunction by means
> > of dopamin down-regulation. It is more
> > likely caused by an overstimulted seretonin
> > receptor. Unlike SSRI's Effexor actually
> > raises brain Dopamine to a certain extent.
> > I personally found Effexor to be the best
> > for cognition, (certainly better than some of the
> > SSRI meds). I don't know of any interactions,
> > but be careful of Seritonin Syndrome. Dopamine
> > reputake inhibitors can tend to raise seritonin
> > as well. It may also raise the insommnia.
> >
> > Let me know if you do - I am interested.
> >
> >
> >
> >
>
>


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poster:Rick thread:118729
URL: http://www.dr-bob.org/babble/20020829/msgs/118830.html