Psycho-Babble Medication Thread 17109

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reboxetine combo

Posted by drs on December 18, 1999, at 15:12:24

Hi,
I've been on Reboxetine at 8mg/day for 12 days now. I'm feeling no improvement and actually have been feeling much worse since I started taking it. The side effects haven't been very bothersome, but my mind is totally numb and I feel like a complete zombie. I know it's too early to quit but things are so shitty that I'm really tempted to drop it. Has anyone experienced anything similar?

Also, does anyone know anything about combining reboxetine with adrafinil?

Thanks.

 

Re: reboxetine combo

Posted by jamie on December 19, 1999, at 3:10:13

In reply to reboxetine combo, posted by drs on December 18, 1999, at 15:12:24

> Hi,
> I've been on Reboxetine at 8mg/day for 12 days now. I'm feeling no improvement and actually have been feeling much worse since I started taking it. The side effects haven't been very bothersome, but my mind is totally numb and I feel like a complete zombie. I know it's too early to quit but things are so shitty that I'm really tempted to drop it. Has anyone experienced anything similar?
>
> Also, does anyone know anything about combining reboxetine with adrafinil?
>
> Thanks.

A lot of times it is normal to actually feel worse before feeling better. But many times it is just over-sensitivity to a particular drug. Premature discontinuation is the primary cause of antidepressant failure, so it is extremely crucial to do whatever is needed to stay on the drug for a solid trial. For a lot of us that means starting at lower doses and taking more time to get up to higher levels. Our bodies will adjust, but a lot of us need more time.

It might be as simple as 8mg/day being too much in just 12 days. I think I can fairly accurately predict that I personally would not be able to get up to 8mg so fast. If I were you, I would cut the dose in half and stay there a while until I was comfortable with it before increasing it. Otherwise you risk premature discontinuation of a drug that, in a longer time frame, might have been the magic you were looking for. Do whatever it takes to stay with it, which probably means reducing the dose temporarily to a tolerable level. That's just what I would do. And I know from experience that's the approach my pdoc and my gp would take as well.

Reboxetine has already been tested in combination with ssris. So I'm pretty sure combining it with clomipramine would be safe, though we don't know how much plasma levels would be increased due to possible drug-drug interaction. Maybe some, maybe a lot, maybe none at all. In the meantime, I wouldn't be concerned with adding another drug. I would be more concerned about how to stay with the current drug for a fair trial first. With me that would mean lowering the dose to a tolerable level before making any other decisions. It just sounds to me like your situation is actually quite simple. That is, 8mg in 12 days is just too aggressive for you individually. Think about the hare and the turtle and who won the race. :-) jamie

 

Re: reboxetine combo

Posted by Stuck In The 60s on December 19, 1999, at 3:42:41

In reply to reboxetine combo, posted by drs on December 18, 1999, at 15:12:24

> I've been on Reboxetine at 8mg/day for 12 days now. I'm feeling no improvement and actually have been feeling much worse since I started taking it. The side effects haven't been very bothersome, but my mind is totally numb and I feel like a complete zombie. I know it's too early to quit but things are so shitty that I'm really tempted to drop it. Has anyone experienced anything similar?

We must have started the same day, but I spent nearly 1 week at 4mg before increasing to 8mg daily. Most side effects (especially the spaciness, zoned-out feeling) have improved (though not the sexual dysfunction), but the worst part is that I feel * more * intensely depressed than when I started Reboxetine. I still plan to give it a full month at the stated dose before evaluating success or failure. Good luck to both of us.

Stuck

 

Re: reboxetine combo

Posted by drs on December 19, 1999, at 15:11:27

In reply to reboxetine combo, posted by drs on December 18, 1999, at 15:12:24

thank you jamie and 'stuck' for the sound advice.

Is it possible that one would get results from a drug at a lower dose when a higher dose of that same drug previously proved ineffective?

dan

> Hi,
> I've been on Reboxetine at 8mg/day for 12 days now. I'm feeling no improvement and actually have been feeling much worse since I started taking it. The side effects haven't been very bothersome, but my mind is totally numb and I feel like a complete zombie. I know it's too early to quit but things are so shitty that I'm really tempted to drop it. Has anyone experienced anything similar?
>
> Also, does anyone know anything about combining reboxetine with adrafinil?
>
> Thanks.


 

Re: reboxetine combo

Posted by Stuck In The 60s on December 19, 1999, at 16:48:57

In reply to Re: reboxetine combo, posted by drs on December 19, 1999, at 15:11:27

> thank you jamie and 'stuck' for the sound advice.
>
> Is it possible that one would get results from a drug at a lower dose when a higher dose of that same drug previously proved ineffective?

I guess it's possible that we can respond at a lower dose, but not respond at a higher dose. But that question is out of my league.

BTW: I think a numb mind and zombie feeling are side effects. I had similar feelings, but I called them dizziness or lightheadedness. For example, you would not have wanted me driving a car in that state.

I think Jamie's point is that we often do better following the maxim: Start low, move slow. These antidepressants do weird things to our bodies, and it takes time for our bodies to adjust to the chemical assault. Starting at a lower dosage (2mg or 4mg daily), then ggggrrrrraaaaaddddduuuuaaaalllllyyyyyy working up to the recommended 8mg daily gives our bodies more time to adjust to smaller increments of chemicals.

I hope this is coherent. If you're going through the dizziness phase I had a few days ago...

Stuck

 

Re: reboxetine combo

Posted by Luke on December 19, 1999, at 18:18:50

In reply to Re: reboxetine combo, posted by Stuck In The 60s on December 19, 1999, at 3:42:41

Hang in there drs.

I have been taking reboxetine for almost 9 weeks.
I started at 8 mg a day, and it was overwhelming. I was totally impotent, distracted, agitated, had a lot of trouble peeing. After five days I cut the dose in half and immediately felt better. The sexual dysfunction took a while to go away. It slowly improved until week 7, when things made it back to normal.

I moved back up to 8 mg a day five days ago. The sex problems came back and the slow pee problem, but none of the agitation or zombie problems.

The side effects took a long time to go away at 4 mg, so I'm hoping they will just take a while to go away at 8 mg.

At 4 mg, I started noticing some subtle improvements in motivation and my willingness (though not desire) to socialize. During the past few days at 8 mg those subtle changes have intensified - I feel more motivated to do things, and the more I cash in on the motivation the more stable my mood becomes.

We'll see what happens. Good luck.

Luke

 

Re: reboxetine combo

Posted by Scott L. Schofield on December 30, 1999, at 7:59:23

In reply to reboxetine combo, posted by drs on December 18, 1999, at 15:12:24

> Hi,
> I've been on Reboxetine at 8mg/day for 12 days now. I'm feeling no improvement and actually have been feeling much worse since I started taking it. The side effects haven't been very bothersome, but my mind is totally numb and I feel like a complete zombie. I know it's too early to quit but things are so shitty that I'm really tempted to drop it. Has anyone experienced anything similar?
>
> Also, does anyone know anything about combining reboxetine with adrafinil?

This sounds very similar to the way I have felt early on during trials of imipramine and desipramine, both of which are rather potent reuptake inhibitors of norepinephrine. Reboxetine is also a potent and selective NE reuptake inhibitor. It may be that the zombie-effect is a shared side-effect among these noradrenergic drugs. Anyway, I experienced this side-effect for a week or more, and then it disappeared.

Of course, the side-effect that you are experiencing may not relate at all to my experiences with the tricyclics. Because there is a chance that it may abate over time, I would suggest hanging in there a little longer with it.


- Scott


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