Posted by phidippus on April 12, 2014, at 4:41:43
In reply to Eric, What do you think about this PDOC?, posted by LouisianaSportsman on April 11, 2014, at 22:26:46
>I think that I would to switch to a different antidepressant class, but I do know how there have developments.
A drug's class is not so important as the studies the drug has undergone. For example, one might think all SSRIs are created equal in regards to treating panic disorder, but one SSRI stands out as being short of data, namely Luvox. Its a good idea to survey the data available on any given antidepressant before switching to it. The class of a drug just indicates a general quality of the drug.
> I don't see what's so special about have a SNRI, especially such a weak one like Cymbalta.I wouldn't say Cymbalta is weak.
"Duloxetine potently inhibited binding to the human 5-HT transporters with a Ki value of 0.8 nM, whereas venlafaxine was 106 times less potent. Duloxetine also potently inhibited binding to the human NE transporter with a Ki value of 7.5 nM and venlafaxine inhibited binding to the human NE transporter with a Ki value of 2480 nM. Thus, venlafaxine inhibited binding to the NE transporter with 331 times lower affinity than duloxetine. " - http://www.nature.com/npp/journal/v2.../1395741a.html"
>The PDOC advocated moving to Fetzima, but uiltimately he decided against based on some bad reviews.
Fetzima is a young drug. I wouldn't place much weight on "reviews" given it. I would take the position of intrepid explorer if taking this drug.
More than 1700 adults with depression took part in clinical studies that evaluated Fetzima. In these studies, about half of the people had already used a depression medication, and about a quarter of the people in the studies were not helped by their previous depression medication. The patients in the studies included men and women who ranged in age from 18-80.
In these clinical studies, participants taking Fetzima had significant improvement in their overall depressive symptoms. Fetzima was also associated with a significant improvement in the overall ability of participants to function in their everyday lives.
> I like the idea of a MAOI + modafinil
Why do people value Modafanil as an antidepressant agent? One of its possible side effects is depression. Alas, one study does not agree with my position: http://www.sciencedaily.com/releases/2013/11/131127115355.htm.
>+ low-dose dexedrine/bupropion to get me out this funk.
Dexedrine and bupropion may share some qualities, but overall they are very different drugs that can produce very different results. So which one? Or do you want to take both?
> #30 Abilify 5mg.
> #60 Wellbutrin SR 150mg.
> #60 Provigil 100mg.
> #75 Tranxene T-Tab 15mg.I like this combination of drugs, but please be careful with Tranxene. Tranxene is Clorazepate and Clorazepate produces the active metabolite desmethyl-diazepam, which is a partial agonist of the GABA A receptor and has a half life of 20 179 hours; a small amount of desmethyldiazepam is further metabolised into oxazepam. That's right a half life of up to 179 hours!
> #30 Cymbalta 60mg.
You're not really reaping the benefit of NE reuptake until you go above 60 mg dosages of Cymbalta.
> #45 Abilify 5mg.
> #45 Lexapro 10mg.
> #60 Wellbutrin SR 200mg.
> #60 Provigil 200mg.
> #90 Tranxene T-Tab 15mg.
> #60 Dexedrine IR 10mg.Again, careful with the Tranxene.
Why only 10 mg of Lexapro?
> He also mentioned some "ADHD stimulants" and how I might have to start carrying around meds just like they do if I don't completely respond to the Provigil.I have no idea what this means.
Eric
poster:phidippus
thread:1063942
URL: http://www.dr-bob.org/babble/20140328/msgs/1064106.html