Posted by bleauberry on September 29, 2011, at 6:18:53
In reply to Effexor...is there hope, posted by mellow on September 28, 2011, at 21:31:53
I just wanted to comment that effexor really isn't a NRi or SNRI. It's impact on norepinephrine is very weak and it is actually mostly a SSRI. Ratio of serotonin to NE is 30:1, For comparison, savella is 3:2, cymbalta is 9:1. Not that those numbers make any difference really. Just worth noting.
That said, all the meds have unique features and effexor might do the trick. I like the idea of the low dose. At med rating forums I remember seeing several reports of people doing well at 37.5mg but not so well at higher doses.
I would also wonder, since things have been progressively getting worse for 5 months, why the other meds are not being questioned. Three meds and you are still in bad shape? That kind of hints to me that at least 1 or 2 of them are either useless or making things worse instead of better.
I prefer to make custom NRIs by combining ssri + tca, such as zoloft+nortriptyline.
Whenever I've been in your shoes....a few times too many....what was able to bring it under control rather quickly was either zoloft or savella, though savella initially made it worse for a couple days. The "sensitive to rejection" thing points to serotonin dysfunction. Having no interest in your guitars is more of a dodpamine/norepinephrine thing. So we're probably dealing with something that is impacting everything globally and not just one neuro or the other.
Of your meds the one I would be most suspicious of is risperidone. Especially if you started it anywhere within the last 6 months. The primary symptoms you've mentioned are common side effects with it. The "anxiety" like stuff and the emotional emptiness stuff. 1.5mg is a pretty hefty dose for many people. If it were me, my next move....in addition to adding an antidepressant....would be to wean down the dose of risperdone to see what happens. There are much better means of mood stabilization than risperdal. Personally anyone I know of who wants input on bipolar stuff, I usually mention magnesium before meds.
poster:bleauberry
thread:998197
URL: http://www.dr-bob.org/babble/20110925/msgs/998222.html