Psycho-Babble Medication Thread 13305

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Re: I hate to burst the Reboxetine Bubble...

Posted by JohnL on October 19, 1999, at 3:10:15

In reply to Re: I hate to burst the Reboxetine Bubble..., posted by saint james on October 18, 1999, at 17:02:50

Reboxetine delayed because of some snag? I didn't know that. That is disappointing. The option is still open to anyone who wants it though thru overseas mailorder pharmacies. It's been successfull in other countries with no problems, I don't know why the FDA has to make some big deal out of it. Pity.

 

Re: Reboxetine translation pls., Andrewb, JohnL,or

Posted by Elizabeth on October 19, 1999, at 12:32:27

In reply to Re: Reboxetine translation pls., Andrewb, JohnL,or, posted by dj on October 18, 1999, at 0:06:49

> Eliz, kindly responded to Bob's request however the jargon is still a bit thick for those of us who flunked chemistry, didn't study pharmacy and prefer english to scientific semi-mystic babble...

...whereas I'm just barely passing chemistry... (should spend less time online, eh?)

Sorry about that! Give me a chance to try again, at least : norepinephrine is a metabolite of epinephrine, aka adrenaline, a neurotransmitter (like serotonin). Norepinephrine is associated with alertness, in particular (though it seems to have a number of functions).

> And perhaps while you are at it you can clearly explain what exactly a "reuptake inhibitor" is and does, as I don't know enough about your politics to determine what Congress is doing to the country, though generally one hears that politicians of all types are screwing their counties, however I can't quite see the chemical interaction there (the seminal one, perhaps but I digress...;8^! )

Reuptake...well, okay, this requires some other stuff though. So the way neurons (nerve cells) talk to each other is, one of them "fires" a chemical (a neurotransmitter) and the second one, if it's in the right place at the right time, "receives" it (i.e., it binds to the appropriate receptor, a protein that is activated by the neurotransmitter, on the receiving cell). The gap in between the two cells is called a synapse (the first cell, the firing one, is sometimes called "presynaptic," while the second is the "postsynaptic" neuron.)

Not all of the neurotransmitter arrives at the receptor on the postsynaptic cell. Reuptake is the process whereby the neurotransmitter gets moved back into the cell via the transporter (a protein on the cell membrane). A reuptake inhibitor is a substance that blocks the transporter, thus increasing the amount of neurotransmitter outside the cell. Longer-term effects are more complicated, as the central nervous system will try to compensate for the increased concentration of neurotransmitter.

I hope this makes some sense.

(The thing about Congress was a paraphrase of a very old joke. It makes no sense otherwise. I must have been tired when I wrote that.)

> And is it possible that the recprtors affected are the same one's andrewb refers to in our earlier thread about the effects of various meds.

I'll have to read that thread to find out, I guess!

 

q for Mr. or Ms. Anon

Posted by Elizabeth on October 19, 1999, at 12:53:14

In reply to I hate to burst the Reboxetine Bubble..., posted by Anon on October 18, 1999, at 10:56:58

> Why? Well, the FDA is concerned enough about one of its side effects to ask for physician monitoring of this side effect while the patient is taking Reboxetine.

Since you seem to know so much about this, what is the side effect in question?

 

Re: q for Mr. or Ms. Anon

Posted by Adam on October 19, 1999, at 14:57:57

In reply to q for Mr. or Ms. Anon, posted by Elizabeth on October 19, 1999, at 12:53:14

I also am curious. I have thought for a couple months now that a combination of an MAOI and reboxetine might be a very potent
antidepressant therapy, if such a combination proves to be safe. Especially for those with the "endogenous" or "melancholic"
type of depression, with maybe some atypical features, I have a hard time thinking of a better way to enhance the noradrenergic
response whilst minimizing adverse side effects. One favorite coctail I have dreampt up in my head is selegiline plus reboxetine.
Selegiline is activating, highly dopaminergic, probably less robust in boosting NA and 5-HT than other MAOIs, but a good mood
elevator for me, and apparently others. Combine that with the supposedly drive-enhancing effects of reboxetine, and you might
just end up with a happier, more productive person. Parnate might do well in place of selegiline in this little scheme of mine.
I know plenty of other people have thought of the same thing, and all that remains is to test it.

I sure hope reboxetine is the real deal. I also wish it would get approved ASAP. I'd much rather take such a combo than, say,
an MAOI plus desipramine. I have had horrible reactions to TCAs, and have basically concluded that I can't tolerate them.
Reboxetine just sounds like a great addition to the pharmacopia.

> > Why? Well, the FDA is concerned enough about one of its side effects to ask for physician monitoring of this side effect while the patient is taking Reboxetine.
>
> Since you seem to know so much about this, what is the side effect in question?

 

Re: Reboxetine translation pls., Andrewb, JohnL,or

Posted by dj on October 19, 1999, at 22:23:31

In reply to Re: Reboxetine translation pls., Andrewb, JohnL,or, posted by Elizabeth on October 19, 1999, at 12:32:27

Thanks Eliz! A bit clearer now -- seems I need some more of that norepinephrine at times...I think andrewb talked about dopamine binding with D1 & D2 pathways above...

> >. Norepinephrine is associated with alertness, in particular (though it seems to have a number of functions).
>
> I hope this makes some sense.
>
> > And is it possible that the recprtors affected are the same one's andrewb refers to in our earlier thread about the effects of various meds.
>
> I'll have to read that thread to find out, I guess!

 

Question for Elizabeth

Posted by Phil on October 23, 1999, at 6:55:52

In reply to Re: Reboxetine translation pls., Andrewb, JohnL,or, posted by dj on October 19, 1999, at 22:23:31

> > I just read on Medscape that Rebox will most likely be approved by years end as mentioned above. It's a little early in the morning here but the article seemed to suggest that it was similar in action to tricyclics w/o the anticholinergic side effects...that sound right?
If true, this could be a very good drug for me. I had great results with amitryp. for years except for SE. Thanks. Phil

 

SNRI Question for Anyone

Posted by Judy on October 23, 1999, at 10:02:31

In reply to Question for Elizabeth, posted by Phil on October 23, 1999, at 6:55:52

After a disappointing failure with Effexor SR (and Wellbutrin a several years ago) - both caused extreme aggitation, tremors, tachycardia, etc. - should that lead me to suspect that I can probably expect the same of Reboxetine and any other SNRI's that are on the road to approval?

 

Re: SNRI Question for Anyone

Posted by saint james on October 23, 1999, at 10:17:26

In reply to SNRI Question for Anyone , posted by Judy on October 23, 1999, at 10:02:31

> After a disappointing failure with Effexor SR (and Wellbutrin a several years ago) - both caused extreme aggitation, tremors, tachycardia, etc. - should that lead me to suspect that I can probably expect the same of Reboxetine and any other SNRI's that are on the road to approval?

James here....

I would say no. Effexor works with 3 neuro- transmitters while Reboxetine is only a SNRI.
Since this is not an apples to apples comparison.
You might look for euro studies on Reboxetine to see if these problems are mentioned.

j

 

Re: SNRI Question for Anyone

Posted by JohnL on October 23, 1999, at 13:33:41

In reply to SNRI Question for Anyone , posted by Judy on October 23, 1999, at 10:02:31

> After a disappointing failure with Effexor SR (and Wellbutrin a several years ago) - both caused extreme aggitation, tremors, tachycardia, etc. - should that lead me to suspect that I can probably expect the same of Reboxetine and any other SNRI's that are on the road to approval?

I don't think past experience on two different drugs has any predictive value at all. Even within the same class- like SSRIs -it's impossible to predict what response and what side effects will result from each. Or someone might handle one MAOI poorly but handle a similar one fine. I think all any of us can expect is that if we don't give it a fair trial we'll never know if it would have worked. And we'll never know if the side effects would have subsided or not.

 

Reboxetine vs. Wellbutrin?

Posted by Taryn on October 24, 1999, at 18:41:07

In reply to Re: SNRI Question for Anyone , posted by JohnL on October 23, 1999, at 13:33:41

It is my understanding that Wellbutrin mainly affects norepinephrine. Does that mean it's similar to Reboxetine? I currently take Zoloft, Ritalin, Levothroid and Wellbutrin, the Wellbutrin being added only a few months ago to help my fatigue and lack of motivation. It has helped somewhat but not as well as I had hoped. When I read about Reboxetine it sounded like just what I need. I was wondering if I should suggest to my Dr. a switch from Wellbutrin to Reboxetine when it becomes available. Or maybe I should just accept feeling so-so.

 

Re: Reboxetine vs. Wellbutrin?

Posted by Phil on October 24, 1999, at 19:22:09

In reply to Reboxetine vs. Wellbutrin?, posted by Taryn on October 24, 1999, at 18:41:07

Taryn,

Don't just accept so-so. I feel about a step below so-so lately and I don't recommend it. I sometimes think non-medicated depression is better than the numb zone. I think I'll be looking at other possibilities soon. Can't control my apathy. What to do? What to do?
Phil

 

Re: Reboxetine vs. Wellbutrin?

Posted by Taryn on October 26, 1999, at 8:18:10

In reply to Re: Reboxetine vs. Wellbutrin?, posted by Phil on October 24, 1999, at 19:22:09

> Taryn,
>
> Don't just accept so-so. I feel about a step below so-so lately and I don't recommend it. I sometimes think non-medicated depression is better than the numb zone. I think I'll be looking at other possibilities soon. Can't control my apathy. What to do? What to do?
> Phil

I know I won't give up looking for the miracle drug that works for me. That's really all we can do. At least now I can function. Just to feel like a normal person.....I wonder what it's like.

 

Re: Question for me

Posted by Elizabeth on October 26, 1999, at 19:26:22

In reply to Question for Elizabeth, posted by Phil on October 23, 1999, at 6:55:52

> > > I just read on Medscape that Rebox will most likely be approved by years end as mentioned above. It's a little early in the morning here but the article seemed to suggest that it was similar in action to tricyclics w/o the anticholinergic side effects...that sound right?

Yup! That's what has me psyched too. I'm just starting nortriptyline (a metabolite of amitriptyline, fewer side effects but still has some) but would like to switch to reboxetine if it becomes available.

 

Re: Question for me

Posted by Phil on October 27, 1999, at 7:38:16

In reply to Re: Question for me, posted by Elizabeth on October 26, 1999, at 19:26:22

>
> Yup! That's what has me psyched too. I'm just starting nortriptyline (a metabolite of amitriptyline, fewer side effects but still has some) but would like to switch to reboxetine if it becomes available.

Thanks Elizabeth. I'm so sick of SSRI's. My life is in meltdown and hope is a word for other's. I'm not suicidal but I can't see past each day. I'm really getting tired of 'changing personalities' with all the trials I've been through this past year.
I know I'm depressed when I only dream about getting in my little truck and driving til I can't drive anymore. I need a rest. Phil

 

My opinion regarding SSRIs, reboxetine, etc

Posted by malletheadoctober3 on September 28, 2001, at 18:38:09

In reply to Question for Elizabeth, posted by Phil on October 23, 1999, at 6:55:52

The tricyclics have barbaric side effects for most - take them only if nothing else works.

Some get great relief from the SSRIs. If the side effects are terrible then consider moving on to another drug (with a doctors agreement).

This leaves us with a few other alternatives:

1) Serzone
2) Wellbutrin
3) Effexor
4) Remeron
5) waiting for reboxetine

My opinion:

Try the first four (with a doctor's help) before waiting forever for reboxetine. Until you've tried them all one doesn't know if they work in their situation.

As an example I tried everything and nothing worked until I tried Serzone. My life isn't perfect, but Serzone has allowed me to enjoy life a little in this difficult world.

--mallethead

 

Re: My opinion regarding SSRIs, reboxetine, etc

Posted by PattyG on September 29, 2001, at 21:27:34

In reply to My opinion regarding SSRIs, reboxetine, etc, posted by malletheadoctober3 on September 28, 2001, at 18:38:09

So what IS the status of Reboxetine? Heck, I would have thought it would be available by now!
PattyG

 

Re: Reboxetine - No Go

Posted by galtin on October 6, 2001, at 14:55:29

In reply to Re: My opinion regarding SSRIs, reboxetine, etc, posted by PattyG on September 29, 2001, at 21:27:34

> So what IS the status of Reboxetine? Heck, I would have thought it would be available by now!
> PattyG


I think that the FDA turned Reboxetine down.If this is what happened, does anybody know why?


galtin


 

Re: Reboxetine - No Go Ľ galtin

Posted by SLS on October 7, 2001, at 10:48:52

In reply to Re: Reboxetine - No Go, posted by galtin on October 6, 2001, at 14:55:29

> > So what IS the status of Reboxetine? Heck, I would have thought it would be available by now!
> > PattyG
>
>
> I think that the FDA turned Reboxetine down.If this is what happened, does anybody know why?
>
>
> galtin


I don't know that it has been turned down for a second time. It was turned down over a year ago because the only clinical trial performed in the US found it to be no better than placebo. However, it was determined that this was a "failed" study (invalid) because it also found Prozac to be no better than placebo - which we know is certainly false. The FDA thus mandated that another series of clinical trials be conducted in the US before it would be granted approval. I have no idea where they are with any of that.

Personally, I have not been terribly impressed with reboxetine as far as the number of people who respond well to it, although, obviously, some do. I can think of no reason not to try it. However, be wary that this drug seems to have some liability to make depression dramatically worse for some people.

Good luck.


- Scott

 

Re: Reboxetine - No Go-- SLS

Posted by galtin on October 7, 2001, at 17:34:34

In reply to Re: Reboxetine - No Go Ľ galtin, posted by SLS on October 7, 2001, at 10:48:52

> > > So what IS the status of Reboxetine? Heck, I would have thought it would be available by now!
> > > PattyG
> >
> >
> > I think that the FDA turned Reboxetine down.If this is what happened, does anybody know why?
> >
> >
> > galtin
>
>
> I don't know that it has been turned down for a second time. It was turned down over a year ago because the only clinical trial performed in the US found it to be no better than placebo. However, it was determined that this was a "failed" study (invalid) because it also found Prozac to be no better than placebo - which we know is certainly false. The FDA thus mandated that another series of clinical trials be conducted in the US before it would be granted approval. I have no idea where they are with any of that.
>
> Personally, I have not been terribly impressed with reboxetine as far as the number of people who respond well to it, although, obviously, some do. I can think of no reason not to try it. However, be wary that this drug seems to have some liability to make depression dramatically worse for some people.
>
> Good luck.
>
>
> - Scott

Scott- The FDA rejection you mention is the one I was thinking of, though it doesn't seem like a year. I was not aware of round two. Since my depressions seem to involve primarily norepinephrine, I had been interested in the Reboxetine. But your comments throw a new light on things. I don't need to try any medications that WORSEN depression. Thanks for the info.


galtin

 

Re: Reboxetine - No Go Ľ galtin

Posted by SLS on October 7, 2001, at 23:19:18

In reply to Re: Reboxetine - No Go, posted by galtin on October 7, 2001, at 17:35:15


> Scott- The FDA rejection you mention is the one I was thinking of, though it doesn't seem like a year. I was not aware of round two. Since my depressions seem to involve primarily norepinephrine, I had been interested in the Reboxetine. But your comments throw a new light on things. I don't need to try any medications that WORSEN depression. Thanks for the info.
>
>
> galtin

Hi Gatlin.

I think it is important to note that every single antidepressant has the potential to exacerbate depression. Having posted here for about 2 years, I canít think of an antidepressant that I havenít seen do this (maybe trazodone). However, it has been my observation that reboxetine does this more often than the others. That said, I donít think it makes sense to forever cross it off your list. You will just have to determine how high up to place it based on your history of drugs tried.

Why do you feel that norepinephrine is involved in your case? What drugs have you tried (dosages and duration)?

Your answer may involve the use of multiple antidepressants that potentiate NE through different mechanisms. For instance, combining Effexor (NE reuptake inhibition) with Remeron (NE alpha-2 antagonism) would theoretically act synergistically to potentiate NE neurotransmission. Many experts consider this to be a highly effective treatment in difficult cases. Wellbutrin makes a good adjunct medication with just about everything. I guess it is the universal augmentor. I donít think researchers yet have a good handle on what this drug does. However, I think most feel that norepinephrine is somehow involved. I have seen more than one person respond well when Wellbutrin has been added to Effexor. Thyroid hormone and the amphetamines along with Ritalin are pro-noradrenergic. The stimulants are primarily NE releasers, although they do inhibit its reuptake to varying degrees. Thyroid hormones are thought to increase the sensitivities of NE receptors Ė primarily beta-1, I think.

Iím sure youíll strike gold if you keep digging.


- Scott

 

be careful with roboxetine!!!!

Posted by krista on October 9, 2001, at 12:09:53

In reply to Re: Reboxetine , posted by Elizabeth on October 17, 1999, at 20:56:47

If you have depression that is also plauged with occasional agitation or anxiety, I would be VERY careful with the Roboxetine. I only took it for 2 days It made me completly mental. I could not hold still was very agitated and anxious. And one of the nights I took it I ended up screaming like a crazed person in the middle of the street at 2:00 in the morning. I then proceeded to run down the street and spend the rest of the night hiding in the bushes. This is something I had NEVER done before before taking it and something I haven't done since. It also lead to severe thoughts of suicide and frustration. I have heard it works ok for people who have fatigued depression (only) who need a boost of energy. My depression however alternates between extreme fatigue and occaissional irratibily and anxiety. just wanted to warn those trying Roboxetine (vestra) to be very careful! It almost cost me my life!

 

Re: be careful with roboxetine!!!!

Posted by dreamer on October 9, 2001, at 19:48:16

In reply to be careful with roboxetine!!!!, posted by krista on October 9, 2001, at 12:09:53

> If you have depression that is also plauged with occasional agitation or anxiety, I would be VERY careful with the Roboxetine. I only took it for 2 days It made me completly mental. I could not hold still was very agitated and anxious. And one of the nights I took it I ended up screaming like a crazed person in the middle of the street at 2:00 in the morning. I then proceeded to run down the street and spend the rest of the night hiding in the bushes. This is something I had NEVER done before before taking it and something I haven't done since. It also lead to severe thoughts of suicide and frustration. I have heard it works ok for people who have fatigued depression (only) who need a boost of energy. My depression however alternates between extreme fatigue and occaissional irratibily and anxiety. just wanted to warn those trying Roboxetine (vestra) to be very careful! It almost cost me my life!

Rebox aggggghhh! anger.
First 3 days shouting abusive then stopped taking it. Pdoc couldn't understand why it had this effect so he insisted I'd try again so I did.
Another 3 days of hell then I calmed down a bit but couldn't go out without getting angry at the world.
Aquired some xtreme obbsessive compulsions about cleanliness, contamination etc and night sweats and bad dreams for 1.5 years I eventually made the desision to quit and discovered it was making me more tired and my poor heart was in constant overdrive.
Now feel much better. Docs sometimes don't listen well mine didn't anyway.

dreamer lab rat.

 

Re: be careful with roboxetine!!!! Ľ krista

Posted by MB on October 14, 2001, at 15:28:09

In reply to be careful with roboxetine!!!!, posted by krista on October 9, 2001, at 12:09:53

My depression/anxiety is like that too. Isn't it a weird combination? It's weird to be totally anxious, restless, and agitated, while at the same time feeling completely fatigued and drained. It's like I want to go running down the street screaming, but I can't get off the couch without tachycardia and lightheadedness overcomming me. Bad combo of symptoms!


< snip >

>My depression however alternates between extreme fatigue and occaissional irratibily and anxiety. just wanted to warn those trying Roboxetine (vestra) to be very careful! It almost cost me my life!

 

Re: be careful with roboxetine!!!!

Posted by pedr on October 23, 2001, at 9:03:18

In reply to Re: be careful with roboxetine!!!! Ľ krista, posted by MB on October 14, 2001, at 15:28:09

I've been on surmontil [a tricyclic called trimipramine] for several months after having had disasterous reactions to sertraline, lustral and st.john's wort.

I still have severe depression though and a "PDoc" I saw recently started me on reboxetine to take aswell as the surmontil. I didn't quite see the point as surmontil affects noradrenaline already. Anyhow, I've been on it for 2 weeks now [just]. I've been blighted for several days by persistent thoughts of suicide and bouts of crying my eyes out. Thing is, I have had suicicidal feelings&thoughts before when just on surmontil so I can't tell if it's the reboxetine or not.

I'd like to hear people's opinions on this combination of drugs. I'd also love to hear from someone who's got something positive to say about reboxetine!!!

Cheers,
pedr.

 

Re: positive about Reboxetine

Posted by Anna P. on October 23, 2001, at 12:13:40

In reply to Re: be careful with roboxetine!!!!, posted by pedr on October 23, 2001, at 9:03:18

In my opinion, Reboxetine feels very similar to Desipramine. Anyway, my experience was the positive one because I have the anergic depression. For me, Reboxetine provided the energy, and took away the negative thoughts.
I increased the doze gradually. Too bad, it's not working anymore by itself. I'm taking now
Reboxetine and Perphenazine.

Anna P.


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