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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by wyzeguy on September 1, 2004, at 0:20:25
Hello everyone,
I've been reading this board for quite some time now, but this is my first post. After quietly suffering from some form of depression for roughly 9 years, I finally had enough and sought therapy roughly 8 months ago. I was diagnosed with borderline moderate/severe clinical depression, although my humble opinion (I'm working towards a career in medicine) is that I have more of a dysthymia set of symptoms for the past few years. Since then I have been prescribed several antidepressants, each with negative effects. First was Lexapro, which had the greatest AD effect but nausea and very frustrating sexual side effects. I then tried a Wellbutrin supplement, but that did nothing but cause my appetite to go through the roof (weird huh?). I tried fluoxetine, paroxetine, and Wellbutrin separately with no avail.
My question is this: what are some other alternatives to curb these side effects and still have the desired AD effect? I've read about remeron, effexor, edronax, etc -- any suggestions? the effexor addiction horror stories scare me, but I am willing to try it if that's what it takes. I appreciate your input, and thanks for readingScott
Posted by King Vultan on September 1, 2004, at 7:48:12
In reply to Alternatives to Lexapro, posted by wyzeguy on September 1, 2004, at 0:20:25
> Hello everyone,
>
> I've been reading this board for quite some time now, but this is my first post. After quietly suffering from some form of depression for roughly 9 years, I finally had enough and sought therapy roughly 8 months ago. I was diagnosed with borderline moderate/severe clinical depression, although my humble opinion (I'm working towards a career in medicine) is that I have more of a dysthymia set of symptoms for the past few years. Since then I have been prescribed several antidepressants, each with negative effects. First was Lexapro, which had the greatest AD effect but nausea and very frustrating sexual side effects. I then tried a Wellbutrin supplement, but that did nothing but cause my appetite to go through the roof (weird huh?). I tried fluoxetine, paroxetine, and Wellbutrin separately with no avail.
> My question is this: what are some other alternatives to curb these side effects and still have the desired AD effect? I've read about remeron, effexor, edronax, etc -- any suggestions? the effexor addiction horror stories scare me, but I am willing to try it if that's what it takes. I appreciate your input, and thanks for reading
>
> Scott
You might want to try an antidepressant in a different class, such as nortriptyline, which is a tricyclic AD with relatively low side effects (for a tricyclic). It selectively blocks norepinephrine reuptake rather than serotonin as the drugs you've tried do (other than Wellbutrin, which primarily works on dopamine). I found nortriptyline to very much lack sexual side effects, at least negative ones, and it's really not known for causing nausea, either. Alternatively, you could also try this new AD Cymbalta, which works on both serotonin and norepinephrine, but nortriptyline is cheaper and has a more proven track record. Nortriptyline also seems to lack the bad withdrawal effects sometimes associated with the SSRIs and Effexor.Todd
Posted by chess on September 1, 2004, at 14:11:24
In reply to Re: Alternatives to Lexapro, posted by King Vultan on September 1, 2004, at 7:48:12
Have you ever tried Remeron?
I never have, but my understanding is that 5ht1-receptor stimulation has an anti-anxiety and anti-depression effect, 5ht2-receptor stimulation causes anxiety and agitation and insomnia and sexual dysfunction, and 5ht3-receptor stimulation causes nausea.
Remeron supposedly increases the amount of both norepinephrine and serotonin released into the synapse, but it also blocks postsynaptic 5ht2 and 5ht3 receptors, thus leaving 5ht1 receptors to be stimulated.
Like the older tricyclic antidepresants but much more moderately it blocks histamine, alpha andrenergic, and muscarinic receptors, so it more mildly could cause similar tricyclic side effects of sleepiness, hunger, weight gain, dry mouth, and constipation. Of these I've heard histamine is hit the most which causes some to find it sedating (which some actually find helpful for their insomnia as they take it at bedtime).
Posted by Rick on September 2, 2004, at 17:56:39
In reply to Alternatives to Lexapro, posted by wyzeguy on September 1, 2004, at 0:20:25
> Hello everyone,
>
> I've been reading this board for quite some time now, but this is my first post. After quietly suffering from some form of depression for roughly 9 years, I finally had enough and sought therapy roughly 8 months ago. I was diagnosed with borderline moderate/severe clinical depression, although my humble opinion (I'm working towards a career in medicine) is that I have more of a dysthymia set of symptoms for the past few years. Since then I have been prescribed several antidepressants, each with negative effects. First was Lexapro, which had the greatest AD effect but nausea and very frustrating sexual side effects. I then tried a Wellbutrin supplement, but that did nothing but cause my appetite to go through the roof (weird huh?). I tried fluoxetine, paroxetine, and Wellbutrin separately with no avail.
> My question is this: what are some other alternatives to curb these side effects and still have the desired AD effect? I've read about remeron, effexor, edronax, etc -- any suggestions? the effexor addiction horror stories scare me, but I am willing to try it if that's what it takes. I appreciate your input, and thanks for reading
>
> ScottNefazodone (generic Serzone), assuming you are in the U.S. But some doctors (and patients) shy away from it since it can cause very serious, sometimes fatal, liver dysfunction. But this is extremely rare despite all the negative hype. I wouldn't hesitate for a moment to go back to nefazodone if I needed it. The lack of sexual side effects was so welcome after dealing with the SSRI's. It would have made me sleepy without concurrent low-dose Provigil, though. Some people can take it all at night to avoid the daytime sleepiness.
It continues to be a godsend for a friend with persistent GAD and possible dysthymia. She has no side effects of any kind from it, not even sleepiness. Conversely, others can't tolerate it...everyone reacts differently. Might be worth a try.
Rick
Posted by Sad Panda on September 3, 2004, at 13:21:53
In reply to Alternatives to Lexapro, posted by wyzeguy on September 1, 2004, at 0:20:25
> Hello everyone,
>
> I've been reading this board for quite some time now, but this is my first post. After quietly suffering from some form of depression for roughly 9 years, I finally had enough and sought therapy roughly 8 months ago. I was diagnosed with borderline moderate/severe clinical depression, although my humble opinion (I'm working towards a career in medicine) is that I have more of a dysthymia set of symptoms for the past few years. Since then I have been prescribed several antidepressants, each with negative effects. First was Lexapro, which had the greatest AD effect but nausea and very frustrating sexual side effects. I then tried a Wellbutrin supplement, but that did nothing but cause my appetite to go through the roof (weird huh?). I tried fluoxetine, paroxetine, and Wellbutrin separately with no avail.
> My question is this: what are some other alternatives to curb these side effects and still have the desired AD effect? I've read about remeron, effexor, edronax, etc -- any suggestions? the effexor addiction horror stories scare me, but I am willing to try it if that's what it takes. I appreciate your input, and thanks for reading
>
> Scott
>
>Hi Scott,
I would go back to Lexapro & then add Remeron to it slowly. Remeron will counteract the side effects, but it is VERY sedating when you first start taking it.
Cheers,
Panda.
This is the end of the thread.
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