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Re: Switching from Abililfy to Saphris.

Posted by SLS on July 14, 2018, at 11:54:42

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on July 14, 2018, at 7:18:55

> >I'm guessing that the Effexor has made it worse temporarily. There is a trill in my voice and my hands are shaky.
>
> I think that could easily happen if you increase Effexor too rapidly. I do think the anxiety would respond to lorazepam or diazepam though.
>
> I do believe venlafaxine is a good antidepressant, although hardly first-line with the high incidence of withdrawal symtoms and initial nausea etc. Although higher dose are more effective for a subset, I must admit I'm unconvinced by the usefulness of ultra high doses vs licensed doses - especially since the approved maximum dose is already very high. Increasing beyond the approved dosage range often seems to cause more fatigue rather than more efficacy. I think it's probably more useful to wait longer (on 75mg/day in moderate depression and 150-225mg in severe depression), rather than ramping it up to 300-375mg too fast. I think people usually have fewer adverse effects and comparable response by doing this. Less initial agitation, nausea, tiredness etc.
>
> Oh, and you may find this interesting. Perhaps it is why duloxetine isn't a very good antidepressant compared to venlafaxine!
>
> https://www.ncbi.nlm.nih.gov/pubmed/26437230

Interesting. Thanks, Ed.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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