Posted by mtdewcmu on April 19, 2011, at 15:46:36
In reply to Re: Prestiq vs Cymbalta » Jean brady, posted by Conundrum on March 21, 2011, at 13:59:31
> I found pristiq to be slightly better than Pristiq, although not a miracle drug.
There have been no miracle drugs in psychiatry since thorazine and lithium in the 1950s.
> I'm on Cymbalta now and it doesn't seem to do anything, except messing w/ my bowels and causing male problems. Pristiq actually helped in that area.
I grew to hate Paxil due to the bowel issues. Needless to say, I chose a different drug.
It seems like the jury is still out on the merits of hitting norepinephrine as a treatment for depression. None of the specific NE reuptake inhibitors have even come close in efficacy to SSRIs and older drugs. So, until someone can persuade me otherwise, I will believe that SNRIs are just SSRIs with more side effects.
You might think Effexor is a counterexample, in that it affects both 5-ht and NE and is as good of an AD as anything else. But venlafaxine itself operates mostly on 5-ht. Only the active metabolite has significant effects on NE. So, my gut feeling is that Effexor's effectiveness stems almost entirely from its SSRI-like properties.