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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Phidippus on December 11, 2011, at 19:30:49
I have treatment resistant OCD and one strategy I've found helps is combining two ADs. I want to try Mirtazapine with Viibryd. Does anyone know their mechanisms of action well enough to supply an informed opinion?
Eric
Posted by Phillipa on December 11, 2011, at 20:42:05
In reply to Mirtazapine + Viibryd, posted by Phidippus on December 11, 2011, at 19:30:49
I don't but would love to hear those that do:) Phillipa
Posted by williamockham on December 12, 2011, at 8:19:46
In reply to Mirtazapine + Viibryd, posted by Phidippus on December 11, 2011, at 19:30:49
Not OCD, but I tried Cymbalta 180mg and 60mg Remeron for about six weeks. The Remeron certainly helped mitigate Cymbalta's side effects (at least the SRI ones), and theoretically would increase serotinergic transmission via alpha-2 antagonism. AFAIK, the jury is still out on whether 5HT2 antagonists help with OCD.
wo
Posted by ed_uk2010 on December 12, 2011, at 14:57:23
In reply to Mirtazapine + Viibryd, posted by Phidippus on December 11, 2011, at 19:30:49
What exactly are you OCD symptoms? What are your obsessions and what are your compulsions? What type of OCD is it? I don't recall you ever saying. Hope you don't mind me asking.
Posted by Phillipa on December 12, 2011, at 18:54:17
In reply to Re: Mirtazapine + Viibryd, posted by ed_uk2010 on December 12, 2011, at 14:57:23
A person can take 180mg of cymbalta? Never heard that before? Phillipa
Posted by williamockham on December 13, 2011, at 13:43:13
In reply to Re: Mirtazapine + Viibryd, posted by Phillipa on December 12, 2011, at 18:54:17
Yeah, 180 for a couple of weeks. Insurance was annoying, certainly. Can't say I saw much of a differences vs. 120.
Posted by Phidippus on December 13, 2011, at 16:53:49
In reply to Re: Mirtazapine + Viibryd, posted by ed_uk2010 on December 12, 2011, at 14:57:23
My OCD symptoms are pretty simple. I struggle with suicidal ideation. Then there's some negative thinking and basic ruminating-almost an inability to stop worrying that creates this baseline anxiety I can't shake.
I'm 'pure o', with no compulsions. Just intrusive and recurrent thoughts.
I appreciate you asking.
Eric
Ativan PRN
Dilaudid PRN
Latuda 80 mg
Lithium 1200 mg
Prazosin 15 mg
Rozarem 16 mg
Viibryd 40 mg
Vyvanse 60 mgso many meds...
Posted by Phidippus on December 13, 2011, at 17:57:28
In reply to Re: Mirtazapine + Viibryd, posted by williamockham on December 12, 2011, at 8:19:46
>theoretically would increase serotinergic >transmission via alpha-2 antagonism.
I take another medication which has been extremely helpful for my OCD, Prazosin. Prazosin is an alpha-adrenergic blocker, type 1. It is hypothesised that prazosin in combination with a Serotonin Reuptake Inhibitor (SRI) might possess an anti-obsessive compulsive disorder (OCD) modulating effect by raising dopamine (DA) levels in the synaptic cleft in the prefrontal cortex and inhibiting extracellular DA concentrations in the nucleus accumbens. I wonder if Mirtazapine does much the same thing.
>the jury is still out on whether 5HT2 >antagonists help with OCD.
Antagonism of 5-HT2C receptors results in an increase of dopamine and norepinephrine activity in the frontal cortex. 5-HT2C receptors significantly regulate mood, anxiety, feeding, and reproductive behavior.
Seems reward pathways benfit from 5ht2 antagonism.
Eric
This is the end of the thread.
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