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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by qbsbrown on December 10, 2006, at 23:51:27
This is what my PDOC says. Is this true?
Brian
Posted by polarbear206 on December 11, 2006, at 7:27:06
In reply to Effexor: 225 for Norepinephrine to kick in?, posted by qbsbrown on December 10, 2006, at 23:51:27
> This is what my PDOC says. Is this true?
>
> Brian
Yes, generally doses over 150mg will result in this.polarbear
Posted by qbsbrown on December 12, 2006, at 13:23:02
In reply to Re: Effexor: 225 for Norepinephrine to kick in?, posted by polarbear206 on December 11, 2006, at 7:27:06
Could have foiled us all, thinking the norepeniphrine was there all along.
Posted by linkadge on December 12, 2006, at 16:19:14
In reply to So Effexor is just an SSRI if under 150-225mgs,huh, posted by qbsbrown on December 12, 2006, at 13:23:02
For clarification, effexor will affect norepinephrine at ANY dose.
The molecule affects serotonin and norepinephrine uptake in a certain ratio, and that ratio is fixed nomatter what dose.
When doctors say that higher doses are needed for norepinephrine effects, generally, they are referring to the fact that norepinephrine effects are not prounounced for (some) peopled untill higher doses.
As a counterexample however, I was taken off 75mg of effexor when it gave me high blood pressure. This is a noradrenergically mediated side effect that I don't get on SSRI's. So, it depends on the individual too. How sensitive they are to the noradrenergic effects.
Linkadge
Posted by qbsbrown on December 12, 2006, at 20:00:03
In reply to Re: So Effexor is just an SSRI if under 150-225mgs,huh, posted by linkadge on December 12, 2006, at 16:19:14
With such a higher concentration of NE at much lower doses, is this going to be the new trend? I've finally heard even GP's and pharmacists talking about it
Posted by qbsbrown on December 12, 2006, at 20:30:23
In reply to Then why not just Cymbalta?, posted by qbsbrown on December 12, 2006, at 20:00:03
If i'm having probs w/ OCD, concentration, focus, and motivation, would u say effexor is the better direction than cymbalta? I see some benefit from Wellbutrin, but given my high idle anxiety, i don't think i could handle both. And we've already gone all the SSRI routes
Brian
Posted by linkadge on December 13, 2006, at 20:03:45
In reply to So Linkadge??? » qbsbrown, posted by qbsbrown on December 12, 2006, at 20:30:23
I would say that, in general, a medication with a substantial effect on norepineprine would be better for cogntition than a serotonin selective medication.
I don't know if cymbalta is necessarily any better. The ratio of serotonin to norepinehprine that works for a person is highly individual.
The TCA's for instance affect serotonin and norepinephrine in widely varing ratios. Some people respond well to one, but not the other.
Some people find cymbalta a bit more activating than effexor.
So, in the end, I don't know which one will be best for you.
Linkadge
This is the end of the thread.
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