Posted by bleauberry on April 28, 2012, at 8:37:40
In reply to Re: i cant even smile. » SLS, posted by Alexei on April 28, 2012, at 6:40:58
> (From bleauberry) .... "Such as combos of zoloft or prozac with nortriptyline or desipramine; savella by itself or combined with any other common antidepressant; clomipramine."
> I've come to think these combos are more effective than the newer, more marketed snri's such as effexor and cymbalta.
Yeah, me too. That is partially based on just what my eyes have casually anecdotally observed over the years, and on experiences of others such as Dr Gillman for one example.
One reason the existing SNRIs don't measure up, imo, is because they really aren't SNRIs. It's more of a marketing ploy than an accurate name. Cymbalta ratio of serotonin to norepinephrine is 9:1....not much NE there. I think prozac actually increases NE in the brain more than the snris do and it isn't even a snri. Effexor is 30:1. Savella is the closest to a true SNRI at a ratio of 2:3.
With any med however, the ratio is fixed. That's where combos come in handy.