Posted by Jay_Bravest_Face on February 19, 2008, at 7:05:20
In reply to Re:Prozac Vs. Effexor SSRI's }}}Shenandoah and » Jay_Bravest_Face, posted by Shenandoah on February 18, 2008, at 19:34:52
> Thanks Jay for suggestions. Interesting, helpful & curious....What is SNRI & IMHO?
>Just internet shorthand..lol. SNRI is a Serotonin Norepinephrine Reuptake Inhibitor (That is what Effexor and Cymbalta are.) They work on both Norepinephrine and Serotonin. Prozac, Paxil, Celexa, Lexapro, et al, are SSRI's, because they mainly work on just serotonin. (But, there is a lot of argument over all of this lately though, so really, don't give it much value.) IMHO is In My Humble Opinion.
> "I think the best bet is to get the SNRI effect going. So, you want to look at:"
> "a)switching to meds like, Cymbalta"
>
> I am Already on Effexor. Will look up Cymbalta.
>Cymbalta, knock on wood, seems to be a fine ad for me, much less harsh then Effexor, I think.
> "b) combo of SSRI + Stimulant"
>
> Like What stimulant?Well, I think the couple of main ones out there are Dexedrine, Ritalin, and Adderall(sp?) From what I understand (and my personal bias...but not all true for everyone of course) is Dexedrine seems to be the "smoothest" of the stimulants. Especially the SR (sustained release formula).
But, it might take trial and error. I found them okay with Prozac...but JUST okay...that's all..no real improvement.> c)tricyclic + SSRI
>
> Will look up tricyclic?
>Ya, this would be my second, and first if Cymbalta wasn't around. Nortriptyline has both a bit of 'punch' and a bit of a relaxing quality. Amitrptyline is for sleep. Imipramine is good for both sleep and for that 'punch'.
> "d) possible combo of SSRI + Wellbutrin"
>
> Wellbutrin made me feel awful & haven't heard of combo with SSRI. Good question to ask though.
>Ya, the only time I ever did good on Wellbutrin was when I had Depakote (or Epival as called in Canada.) BTW...if you have any difficulty with mood swings and major anxiety with anger, there is a new form, Depakote ER or XR, taken once a day, that doesn't supposedly cause weight gain, and really help smooth the moods out.
> "e) if you can afford weight gain, add Remeron"
>
> Can't afford this one.
>
> "Anyhow, just IMHO, but I unfortunately waited too long in between meds and gave away years accepting that I just had to live "sub-satisfactorily" with just an SSRI."
>
> Interesting comment & I would like to hear more.
>Yeah, well, I stuck it out for almost 5 years with Prozac and all sorts of trial add-ons, then before that, about 5 years with Effexor, then a year or so with Zoloft, then before that only weeks at a time with the other SSRI's and such. But, I waited way too long on those 2 five year periods. I feel like I missed out on much. So, I say, be vigilant, and demand the best state of mind you can get from the meds. (Of course I know you have to do your bit....but it's hard to when you are curled up in bed and scared of the telephone ringing!..lol.)
> Wonder if I am living sub-satisfactorily with just SSRI. Can you give more info about combos you have experienced? & what IMHO is & what you did that helped?
>
> Many thanks- really need help understanding what worked for you. Excellent feedback & some new stuff to look at. Please reply if you have time.
>
> Sincerely, Deb (or Shenandoah, my home..)
>Hey, no problem! You might want to look at exploring some of the above options (like consider Cymbalta.) I'd do that before adding on the other meds. Oh ya, may I ask what your diagnosis is? Depression? Anxiety? Both? There are lots of good meds out there, it's just a bit of try and see, and I know that does suck..heh. Anymore questions, please feel free to ask!
P.S.....my medications...
Cymbalta 60 mg 1x a day (I am in my 2nd week of it.)
Clonazepam 4mg a day
Topomax 200 mg at bedtime
Risperdal 1mg at bedtimeTake care, Jay
poster:Jay_Bravest_Face
thread:813191
URL: http://www.dr-bob.org/babble/20080207/msgs/813556.html