Psycho-Babble Medication Thread 63758

Shown: posts 1 to 17 of 17. This is the beginning of the thread.

 

Cam and Effexor SR thoughts

Posted by Paige on May 20, 2001, at 21:19:03

Hi Cam,
I know you are real busy, so when and if you get time,
naybe you could answer some questions. I know
you mentioned you had been on Wellbutrin before and now
you are on Effexor SR. My pdoc has suggested Effexor by
itself and or augmented with WB. What are your thoughts?
Do you like Effexor? What are the big differences for
you? I also don't understand the difference in WB either
SR or the regular. Is there a better one between the two?
Would you combine Effexor and WB?? I am the one with the crying
spells that you have helped a lot.

When you get time. No rush.

thanks , Cam.


Paige

 

Re: Cam and Effexor SR thoughts

Posted by SalArmy4me on May 20, 2001, at 22:30:35

In reply to Cam and Effexor SR thoughts, posted by Paige on May 20, 2001, at 21:19:03

Effexor XR + Wellbutrin SR means that norepinephrine is boosted twice, serotonin is boosted once, and dopamine is boosted once. That's a nice combination.

Wellbutrin SR has less of the overstimulation, tremor, and nervousness of regular Wellbutrin. There is no difference between the antidepressant efficacy of the regular and the SR version.

 

Re: Cam and Effexor SR thoughts » SalArmy4me

Posted by Paige on May 21, 2001, at 4:29:00

In reply to Re: Cam and Effexor SR thoughts, posted by SalArmy4me on May 20, 2001, at 22:30:35

> Effexor XR + Wellbutrin SR means that norepinephrine is boosted twice, serotonin is boosted once, and dopamine is boosted once. That's a nice combination.
>
> Wellbutrin SR has less of the overstimulation, tremor, and nervousness of regular Wellbutrin. There is no difference between the antidepressant efficacy of the regular and the SR version.

Thanks Sal!

What do you think the side effects might entail? Given
that I am hyper sensitive to every med out there and
even the ones they're thinking about marketing.
I would make a lousy clinical trial person. I
guess they are volunteers right? Actually, I would
make a good one, but they might not see it that way.
Is there tons of weight gain from Effexor?

I might agree to go with the combo, but I need
as much ammunition with as possible with my pdoc.
He's a tough case to crack....
and so am I.

thanks for you help. You had mentioned something
like this to me before. What do you think it would do overall?

thanks,
paige

 

Re: thoughts on treatment of depression (long) » Paige

Posted by Cam W. on May 21, 2001, at 14:03:41

In reply to Cam and Effexor SR thoughts, posted by Paige on May 20, 2001, at 21:19:03

Paige - Unfortunately, everyone's body chemistry is different and we still do not have very many reliable &/or consistent rules of thumb for choosing antidepressants for different people (unless their depression is vastly different - eg. atypical depression). Many disease states and many medications can induce or exacerbate depression, as can many lifestyles. A depressed person's temperment and lifestyle also play a role in an efficient doctor trying to decide what antidepressant (or combination of meds) are needed to most likely produce the best results, with a minimum of unwanted effects (ie side effects). Unfortunately, many doctors in the Western world do not (or cannot) take the time necessary to fully explore all these avenues (and other avenues that I am not thinking of, at the moment). I believe that following is more important than any medication in the treatment of depression.

I believe that one of the best ways to overcome the above problem is to enter into a "therapeutic alliance" with your doc. This concept relies on a developing a "concordance" with your doc rather than just having you play a "compliance" role, with the doctor calling all the shots. Simply speaking, reaching a therapeutic alliance through concordance occurs when there is open, two-way dialogue between the depressed patient and the doc. Both sides (doc & pt) bring something to the alliance. The doc brings the clinical and scientific expertise, as well as personal prejudices. The patient brings their philosophies of medicine and disease states (in this case, depression) and personal prejudices. Both the patient and the doctor must find a happy medium, without bruising the egos of, or trivializing the philosophies of either party.

This scenario changes the role of the doctor from an authority figure (do-as-I-say-compliance model) to that of an educator (let's-arrive-at-a-compromise model). The patient must be fully honest and forthcoming with the doctor, disclosing all pertinent information of their life and illness, as well as doing the leg work to learn about depression (this board is one information source). This allows the patient to become an "informed consumer" and if one knows why a med causes a side effect and/or therapeutic effect, they are more likely to stay on that med through the start-up side effects and be better able to wait out the lag time until therapeutic effect.

The doctor needs to be able to assemble all pertinent information on depression and have the ability to 'shuffle' that information into a form that applies to that particular patient. The doctor then needs to be able simplify the information for the patient (tailored to their level of understanding). This informtion should include any pertinent treatment options, including those which are nonchemical (eg. psychotherapy, massage, etc.). The patient must provide feedback as to which treatment(s) best suits their philosophies and lifestyles. This feedback must be ongoing throughout therapy.

So, in your case, the doctor should tell you why he/she wants to try Effexor XR™ (venlafaxine) and why and when he/she is considering the addition of Wellbutrin SR (bupropion) and the reasoning for these choices. Also, nonchemical (non-drug) options and/or adjuncts should also be offered, justified, and encouraged.

Sorry, for the long-windedness of the above, but it sets up my answers to your questions.

1) Thoughts on augmentation of Effexor XR with Wellbutrin SR.
This combination is used quite often, usually to avoid or reverse the longterm sexual side effects that can occur with Effexor XR. These two antidepressants have different mechanisms of action. At higher doses (approx. >225mg), Effexor XR morphs from an SSRI (like Paxil or Zoloft) to an SNRI (where both serotonin- and norepinephrine-reuptake is blocked). The mechanism of action of Wellbutrin SR (I truly believe) is unknown. The block of norepinephrine- and dopamine-reuptake does not occur unless one takes very high doses of the drug ( >450mg daily), and the maximum recommended dose is 300mg daily (to avoid seizure potential). We do know that Wellbutrin is effective in some depressions, so there may be some other unknown reaction (adenosine-A1A block?, second messenger changes? ) occuring.

I would recommend a full trial of Effexor XR first. This includes slowly raising the dose up to approximately 300mg (or higher - 450mg to 600mg - in some cases of severely resistant depression). One should try a maximally tolerated dose of Effexor XR for a good 4 weeks before giving up on it. This means that one should take the Effexor XR at maximal dose for four weeks, thus an adequate trial of Effexor XR may be 10 to 12 weeks of treatment from the first dose (depending on the person's tolerability and the time it takes to reach maximal dose) before giving up on the drug.

2) Do I like Effexor XR?
Quite frankly, I do not like taking any medication, but this one (so far) doesn't have the side effects of Paxil or Zoloft. At about 10.5 weeks on the drug, I have not gained any weight (actually lost some), but weight gain usually does not occur with an SSRI until one has taken it for 12 to 20 weeks. Also, rather than the loss of libido and delayed ejaculation that I experienced with the Paxil and Zoloft, I am much more hypersexual, with thigh-weakening, explosive orgasms, taking the Effexor. Again, it is too early to know if this little bonus will last.

I am getting side effects with the Effexor XR, especially for a couple days upon each dosage increase. I find that I get 'fuzzy' thinking, insomnia, and diarrhea-constipation (believe it or not, at the same time). For me, these side effects do fade within a couple of increasing the dose and are not dibilitating. A constant thirst is the only side effect that has not gone away, but I have already become use to it. Anyway, I should be drinking more water.

Everyone's body is different and what is good for me and the effects that I experience will be different from yours. As it says at the top of the page, YMMV (your mileage may vary). So, saying which antidepressant is better for you is impossible for me to say. The Wellbutrin has worked for me in 3 past depressive episodes, but did not touch this current one. This depressive episode is slightly different than the others, which were triggered mainly by job/life stress. This episode was triggered by the death of my 18 year old daughter last June 5, while on holiday at Disney World. So, I now consider this depressive episode to be slightly different than my previous ones (ie. this depression is either more severe or a slightly different breakdown of my HPA axis - part of the body's stress control mechanism - has occurred).

3) Effexor v. Effexor XR / Wellbutrin v. Wellbutrin SR
Really, the XR (extended release) and SR (sustained release) are just the respective company's long-acting formulations. By ultimately extending the elimination half-life of a drug, one is able to take fewer doses of the drug per day, in a higher dosage. So, instead of taking Wellbutrin three times daily, you only need to take it twice daily for all day antidepressant activity.

The XR form of Effexor is a more important improvement. The regular Effexor has a very short elimination half-life of 4 to 6 hours and thus Effexor needs to be taken twice to three times daily. Regular Effexor is notorious for causing withdrawl symptoms, because when the increased serotonin levels fall too much, the characeristic serotonin withdrawl symptoms (flu-like symptoms, headache, light headedness, etc.) emerge. The elimination half-life of Effexor XR is 11 to 15 hours, and thus the XR version can be taken once or twice daily without serotonin levels falling too much. Taking the Effexor XR once daily, I have found that I do wake up a little anxious and this anxiety goes away within the hour after I take the drug. The elimination half-life of Effexor (& XR) does increase slightly as you stabilize on the drug.

4) Would I take Effexor XR and Wellbutrin SR together?
I guess, if I had to. Since Wellbutrin has worked for me in the past, if the Effexor XR were not to fully work (or stop working) I probably would consider adding Wellbutrin SR. This would be more an issue if I were extremely tired from the Effexor XR. As it was, I was only really tired on the Effexor XR for the first 6 weeks, so I think that the Effexor XR should be given a chance to resolve the tiredness on it's own.

Sorry for the long post, but now that I am getting more energy all the time, I am getting rather long-winded. I hope that this is of some help to you. - Cam

 

Wow! Thank you so much... » Cam W.

Posted by Paige on May 21, 2001, at 19:19:17

In reply to Re: thoughts on treatment of depression (long) » Paige, posted by Cam W. on May 21, 2001, at 14:03:41

Dear Cam,

You are great! Thank you so very much for all of
your info! To be printed !!!!! I am very
grateful for your post, very much so. Not long
winded at all, informative, concise and with
genuine concern. I could not have asked for
more. Very helpful indeed. Will take with me
to the pdocs and my therapist also.

I am deeply sorry for your loss. I was not aware.
I am sorry. I thought all day about certain
events triggering my responses and I go so far back
it's frightful. I hope that you are okay and
that what is working for you continues to work and
put some ease into your life.

Thank you for everything and for taking all that
time it took to write your post. Truly, I am very
grateful.

Best,
Paige

 

Re: thoughts on treatment of depression -cam

Posted by Kristi on May 22, 2001, at 0:52:33

In reply to Re: thoughts on treatment of depression (long) » Paige, posted by Cam W. on May 21, 2001, at 14:03:41

Cam..... I have been learking around here for a while.. and find you also wonderfully knowledgeable and helpful.... agree with paige there. You said you were 10 weeks now? Can I ask what dose? Kristi

> Paige - Unfortunately, everyone's body chemistry is different and we still do not have very many reliable &/or consistent rules of thumb for choosing antidepressants for different people (unless their depression is vastly different - eg. atypical depression). Many disease states and many medications can induce or exacerbate depression, as can many lifestyles. A depressed person's temperment and lifestyle also play a role in an efficient doctor trying to decide what antidepressant (or combination of meds) are needed to most likely produce the best results, with a minimum of unwanted effects (ie side effects). Unfortunately, many doctors in the Western world do not (or cannot) take the time necessary to fully explore all these avenues (and other avenues that I am not thinking of, at the moment). I believe that following is more important than any medication in the treatment of depression.
>
> I believe that one of the best ways to overcome the above problem is to enter into a "therapeutic alliance" with your doc. This concept relies on a developing a "concordance" with your doc rather than just having you play a "compliance" role, with the doctor calling all the shots. Simply speaking, reaching a therapeutic alliance through concordance occurs when there is open, two-way dialogue between the depressed patient and the doc. Both sides (doc & pt) bring something to the alliance. The doc brings the clinical and scientific expertise, as well as personal prejudices. The patient brings their philosophies of medicine and disease states (in this case, depression) and personal prejudices. Both the patient and the doctor must find a happy medium, without bruising the egos of, or trivializing the philosophies of either party.
>
> This scenario changes the role of the doctor from an authority figure (do-as-I-say-compliance model) to that of an educator (let's-arrive-at-a-compromise model). The patient must be fully honest and forthcoming with the doctor, disclosing all pertinent information of their life and illness, as well as doing the leg work to learn about depression (this board is one information source). This allows the patient to become an "informed consumer" and if one knows why a med causes a side effect and/or therapeutic effect, they are more likely to stay on that med through the start-up side effects and be better able to wait out the lag time until therapeutic effect.
>
> The doctor needs to be able to assemble all pertinent information on depression and have the ability to 'shuffle' that information into a form that applies to that particular patient. The doctor then needs to be able simplify the information for the patient (tailored to their level of understanding). This informtion should include any pertinent treatment options, including those which are nonchemical (eg. psychotherapy, massage, etc.). The patient must provide feedback as to which treatment(s) best suits their philosophies and lifestyles. This feedback must be ongoing throughout therapy.
>
> So, in your case, the doctor should tell you why he/she wants to try Effexor XR™ (venlafaxine) and why and when he/she is considering the addition of Wellbutrin SR (bupropion) and the reasoning for these choices. Also, nonchemical (non-drug) options and/or adjuncts should also be offered, justified, and encouraged.
>
> Sorry, for the long-windedness of the above, but it sets up my answers to your questions.
>
> 1) Thoughts on augmentation of Effexor XR with Wellbutrin SR.
> This combination is used quite often, usually to avoid or reverse the longterm sexual side effects that can occur with Effexor XR. These two antidepressants have different mechanisms of action. At higher doses (approx. >225mg), Effexor XR morphs from an SSRI (like Paxil or Zoloft) to an SNRI (where both serotonin- and norepinephrine-reuptake is blocked). The mechanism of action of Wellbutrin SR (I truly believe) is unknown. The block of norepinephrine- and dopamine-reuptake does not occur unless one takes very high doses of the drug ( >450mg daily), and the maximum recommended dose is 300mg daily (to avoid seizure potential). We do know that Wellbutrin is effective in some depressions, so there may be some other unknown reaction (adenosine-A1A block?, second messenger changes? ) occuring.
>
> I would recommend a full trial of Effexor XR first. This includes slowly raising the dose up to approximately 300mg (or higher - 450mg to 600mg - in some cases of severely resistant depression). One should try a maximally tolerated dose of Effexor XR for a good 4 weeks before giving up on it. This means that one should take the Effexor XR at maximal dose for four weeks, thus an adequate trial of Effexor XR may be 10 to 12 weeks of treatment from the first dose (depending on the person's tolerability and the time it takes to reach maximal dose) before giving up on the drug.
>
> 2) Do I like Effexor XR?
> Quite frankly, I do not like taking any medication, but this one (so far) doesn't have the side effects of Paxil or Zoloft. At about 10.5 weeks on the drug, I have not gained any weight (actually lost some), but weight gain usually does not occur with an SSRI until one has taken it for 12 to 20 weeks. Also, rather than the loss of libido and delayed ejaculation that I experienced with the Paxil and Zoloft, I am much more hypersexual, with thigh-weakening, explosive orgasms, taking the Effexor. Again, it is too early to know if this little bonus will last.
>
> I am getting side effects with the Effexor XR, especially for a couple days upon each dosage increase. I find that I get 'fuzzy' thinking, insomnia, and diarrhea-constipation (believe it or not, at the same time). For me, these side effects do fade within a couple of increasing the dose and are not dibilitating. A constant thirst is the only side effect that has not gone away, but I have already become use to it. Anyway, I should be drinking more water.
>
> Everyone's body is different and what is good for me and the effects that I experience will be different from yours. As it says at the top of the page, YMMV (your mileage may vary). So, saying which antidepressant is better for you is impossible for me to say. The Wellbutrin has worked for me in 3 past depressive episodes, but did not touch this current one. This depressive episode is slightly different than the others, which were triggered mainly by job/life stress. This episode was triggered by the death of my 18 year old daughter last June 5, while on holiday at Disney World. So, I now consider this depressive episode to be slightly different than my previous ones (ie. this depression is either more severe or a slightly different breakdown of my HPA axis - part of the body's stress control mechanism - has occurred).
>
> 3) Effexor v. Effexor XR / Wellbutrin v. Wellbutrin SR
> Really, the XR (extended release) and SR (sustained release) are just the respective company's long-acting formulations. By ultimately extending the elimination half-life of a drug, one is able to take fewer doses of the drug per day, in a higher dosage. So, instead of taking Wellbutrin three times daily, you only need to take it twice daily for all day antidepressant activity.
>
> The XR form of Effexor is a more important improvement. The regular Effexor has a very short elimination half-life of 4 to 6 hours and thus Effexor needs to be taken twice to three times daily. Regular Effexor is notorious for causing withdrawl symptoms, because when the increased serotonin levels fall too much, the characeristic serotonin withdrawl symptoms (flu-like symptoms, headache, light headedness, etc.) emerge. The elimination half-life of Effexor XR is 11 to 15 hours, and thus the XR version can be taken once or twice daily without serotonin levels falling too much. Taking the Effexor XR once daily, I have found that I do wake up a little anxious and this anxiety goes away within the hour after I take the drug. The elimination half-life of Effexor (& XR) does increase slightly as you stabilize on the drug.
>
> 4) Would I take Effexor XR and Wellbutrin SR together?
> I guess, if I had to. Since Wellbutrin has worked for me in the past, if the Effexor XR were not to fully work (or stop working) I probably would consider adding Wellbutrin SR. This would be more an issue if I were extremely tired from the Effexor XR. As it was, I was only really tired on the Effexor XR for the first 6 weeks, so I think that the Effexor XR should be given a chance to resolve the tiredness on it's own.
>
> Sorry for the long post, but now that I am getting more energy all the time, I am getting rather long-winded. I hope that this is of some help to you. - Cam

 

Re: thoughts on treatment of depression » Kristi

Posted by Cam W. on May 22, 2001, at 2:54:38

In reply to Re: thoughts on treatment of depression -cam, posted by Kristi on May 22, 2001, at 0:52:33

Kristi - As of last week I am taking 262.5mg of Effexor XR. - Cam

 

Re: thoughts » Cam W.

Posted by Paige on May 22, 2001, at 18:27:29

In reply to Re: thoughts on treatment of depression (long) » Paige, posted by Cam W. on May 21, 2001, at 14:03:41

Hi Cam,

Might you be able to explain to me what an
agonist is? Does Klonopin (which i take) and
Buspar which the pdoc wanted me to take with
Wellbutrin activate serotonin? Meaning it realeases
more? I am trying to understand
more about the interplay between these drugs and
I don't know what agonist or antagonist mean.
No one seems to like Buspar and I would be willing
to give it a shot if I knew more and felt
better armed knowledge wise. The doctor said he
wanted to give me Buspar because I was having
difficulty making decisions and he thought I appeared
more agitated than usual. Buspar , I tried samples
and got headache, nausea and yawning, similar to
SSRI is it similar to that? Could Klonopin be better?
I have taken 0.5 during the day and klonopin does
calmme down when I am too anxious and I don't have
any side effects from klonopin. I am not anti-benzo
at all and they work, but I do notice a little memory
problem as of late (short term) and then I read it
can make depression worse.

If you have a moment to write I would appreciate it.
i don't understand allthis terminology and why
the mix would facilitate a positive response
according to my doc.

Thank you, Cam.

Paige

 

Re: BuSpar thoughts » Paige

Posted by Cam W. on May 23, 2001, at 0:36:36

In reply to Re: thoughts » Cam W., posted by Paige on May 22, 2001, at 18:27:29

Paige - I am really not sure if they have totally figured out BuSpar™'s (buspirone) mechanism of action. Mood is regulated by a complex mix of serotonin, norepinephrine, and (to a lesser extent, but no less important) dopamine receptors; of which there are several varieties of each receptor. There are other neuroactive peptides and molecules that are also involved in the regulation of mood and emotion.

There are 15 to 17 (or more) different serotonin receptors, depending on who you talk to. Serotonin is chemically called 5-hydroxytrytamine, hence the abbreviation 5-HT. BuSpar is an "agonist" at the "serotonin-1A" receptor or "5-HT1A" receptor. An agonist acts at the receptor like serotonin would. The difference is that BuSpar is selective only for the 5-HT1A receptor and does not have significant activity at other serotonin receptors. Hence, taking BuSpar is like injecting serotonin at only the sites containing 5-HT1A receptors.

The 5-HT1A receptors are primarily located on the serotonin nerve cell body. This is the bulgy, round part of the nerve cell, as opposed to where SSRIs work, which is at the end of the axon (long, thinner part of the nerve cell, down which the action potential or electrical signal travels) at the axon terminal (which is located across the synaptic gap from the nerve cell to be receiving the electrical signal in the form of a neurotransmitter).

The 5-HT1A receptors are called "somatodendritic autoreceptors" because they are located on the little nerve spines (dendrites), which are located on the bulgy, round part (soma) of the nerve cell. They allow crosstalk between nerve cell bodies. It is called an "autoreceptor" because these dendrites release serotonin to talk to other nerve cells in the close vicinity of the releasing nerve cell and since the 5-HT1A receptor is located on the serotonin releasing dendrite, the serotonin that the dendrite releases stimulates it's own receptor.

Why would there be a receptor for serotonin on a serotonin releasing (serotonergic) dendrite? The 5-HT1A receptor acts as a brake, shutting off the flow of serotonin out of the dendrite when the serotonin in the synaptic gap reaches a certain concentration. Thus, a 5-HT1A agonist slows the flow of serotonin out of the dendrites and decreases the crosstalk between serotnin nerve cells, making them less excitable.

Simple, you say; I wish that it were that easy. The above is an oversimplified version of what really happens and is not entirely the true story of what goes on. First, 5-HT1A receptors are also found on norepinephrine nerve cells where their stimulation modulates norepinephrine release, which also acts on mood. Second, the body tries to compensate for the change in serotonin (and norepinephrine) release, possibly by making fewer (downregulating) 5-HT1A receptors and/or making the receptors less sensitive. Third, the body will also change the numbers and concentration of other neurotransmitters and their receptors in response to the change in serotonin levels. Fourth, BuSpar also acts on a couple of the dopamine receptors and I am not sure of the implications of this. Fifth, I am too tired to think of any more problems (there are many).

The reason that you are getting the same start-up side effects as with the SSRIs is that these antidepressants also stimulate 5-HT1A receptors. This stimulation happens within hours of taking your first dose of an SSRI. These start-up side effects (headache, anxiety, etc.) do go away in 1 to 3 weeks, depending on how fast your body can downregulate (desensitize) the 5-HT1A receptors.

So, you can expect your anxiety to get worse initially, but as your body adjusts to the BuSpar (or SSRI for that matter) the anxiety should decrease dramatically. On paper, BuSpar should be a much better anxiolytic (anti-anxiety agent) than it seems to be in clinical practice. There are many different psychological reasons for the seeming lack of effect of BuSpar, to go along with the physiological reasons given above. BuSpar's effects are subtle. There is no psychomotor slowing or "stoned" feeling with BuSpar, as is seen with benzodiazepines like Klonopin™ (clonazepam - Rivotril™ in Canada). On the upside, BuSpar has really no addictive potential and is safer in overdose than the benzodiazepines.

Benzodiazepines like Klonopin bind to a part of the GABA (gamma-amino butyric acid) receptor complex and facilitates the binding (allows easier binding) of GABA to this complex. GABA is an "inhibitory neurotransmitter" which means that it slows the action of other neurotransmitters (serotonin, norepinephrine, and dopamine are the main ones) by slowing their release from the nerve terminal. Benzodiazepines, while relieving anxiety in most people can actually cause more anxiety and aggression in some people. Also, benzodiazepines can cause memory problems in some people.

I hope that you can make sense of this. If you read it carefully, and perhaps rewrite it without the definitions, it might make more sense. Hey, you asked ;^)

- Cam

 

Re: BuSpar thoughts » Cam W.

Posted by Paige on May 23, 2001, at 4:28:28

In reply to Re: BuSpar thoughts » Paige, posted by Cam W. on May 23, 2001, at 0:36:36

Cam!

Thank you much! I could not re-write that you said
if I had. I will have to re-read a few times in
order to get the full scope though! It is very
interesting to me and it helps me become better
prepared when I do the doc talk thing. The memory
problem is not fun. I am talking mid sentence I
forget words. I know stress can do this, but I am
certain the Klonopin does not help. Problem is, it
helps in many other ways and is easier for me to stomach.

If Buspar had the potential to act somewhat like
Celexa did in terms of reduces social phobia
and a general overall happier feeling, I would
lunge at it, but I did not give it time,nor
have I read anything from anyone that even remotely
comes close. With WB and Buspar and Klonopin I
would think these receptors would be getting a bit of a
workout. My fear with Wellbutrin is being up
at 4am again every morning. I suppose I could make
good use of this time, but you tend to drag and
then I have to increase Klonopin more, not so good.

Well, I am off to read your post again. thank you very
much Cam. I truly appreciate it. -- oh, I read that
Buspar would not be as effective on people who have taken
Klonopin. This is something that made me wonder
why bother with it.

It helps alot.
Paige

 

Re: BuSpar thoughts » Paige

Posted by Cam W. on May 23, 2001, at 9:04:05

In reply to Re: BuSpar thoughts » Cam W., posted by Paige on May 23, 2001, at 4:28:28

Paige - Most of the literature regarding BuSpar not working after having taken Klonopin says that this phenomonon is psychological in nature, rather than having a physiochemical basis. Since BuSpar's anxiolytic action is subtle, is not associated with the physical side effects seen with Klonopin, and has a delayed onset of action, many people believe that BuSpar doesn't work. Most of these people haven't given the drug a chance to work (ie taken it for long enough, at an adequate dose for that person). Other times people believe that the start-up side effects (eg. increased anxiety) are long term effects, but these do disappear.

Just another thought - Cam

 

Re: BuSpar thoughts » Cam W.

Posted by Paige on May 23, 2001, at 19:35:47

In reply to Re: BuSpar thoughts » Paige, posted by Cam W. on May 23, 2001, at 9:04:05

Dear Cam,

Thank you for more Buspar info. I am very curious
if it could conceivably work as an SSRI would. I liked
certain aspects of Celexa...the ability to rid me
of my social ineptness or anxiety. I sure feel inept
because of it. I am going to talk over Buspar again
with pdoc. My wonder is if it can work all by its
lonesome without augmentation of any kind. I did not
feel jumpy on it, but I was not on very long. It
made me tired, nausea, headache as we upped dose
every 3 days. I have extreme levels of anxiety.
My brain runs full speed ahead around the clock. If
I am obsessing, I am reseaching or anything. There
is no shutoff valve unless I take klonopin at
night and during the day if I get that vice on my
head feeling. The problem I have (well, let's face
it , one of the problems!) is SSRIs make me feel
flat and I need my emotions to do some of my otherwork (writing
mostly and photography projects) Wellbutrin
was great for cognition, but I have alot of that, but
focus was good with WB. I am torn between staying
off all meds and just get to a point where I can take
Klonopin prn. It 's a goal, attainable , i don't know.
Thoughts?

there's my longwinded recital....
by the way, I forwarded one of your posts to me onto
my therapist who found your counsel quite good and'useful to her!
You have been extremelyhelpful. Therapists and
lay people need and want to understand to the
best of their ability some of the inner workings
of all this stuff and it clarifies things, even
if I don't understand evrything, I get a much
greater picture that helps me cope. Thank you.

Paige

 

Re: BuSpar thoughts » Paige

Posted by Cam W. on May 24, 2001, at 9:39:43

In reply to Re: BuSpar thoughts » Cam W., posted by Paige on May 23, 2001, at 19:35:47

Paige - More accurately, the SSRIs act like BuSpar for the first couple of weeks, then the body desensitizes the 5-HT1A receptors and the major action of the SSRIs is at the nerve terminal. - Cam


 

Re: BuSpar thoughts » Cam W.

Posted by Paige on May 24, 2001, at 20:31:13

In reply to Re: BuSpar thoughts » Paige, posted by Cam W. on May 24, 2001, at 9:39:43

> Paige - More accurately, the SSRIs act like BuSpar for the first couple of weeks, then the body desensitizes the 5-HT1A receptors and the major action of the SSRIs is at the nerve terminal. - Cam

Thanks again, Cam. Looks like your pretty busy
on the above post re: bandage theory...looks like its
getting warm in there. Very well then, thanks much
for everything. I'll just tip toe out...

Paige

 

Re: BuSpar thoughts

Posted by Daveman on May 25, 2001, at 1:44:04

In reply to Re: BuSpar thoughts » Paige, posted by Cam W. on May 24, 2001, at 9:39:43

My PDoc tells me that Buspar is effective only for about 20% of patients. He would consider prescribing it more if it were not just about the most expensive drug out there, it's just not cost effective to try it. His opinion may change when it goes generic.

Dave

 

Re: BuSpar thoughts » Daveman

Posted by Paige on May 28, 2001, at 19:50:46

In reply to Re: BuSpar thoughts , posted by Daveman on May 25, 2001, at 1:44:04

Hi Dave,

Buspar is a tad pricey. Curious what dosage your
doc gets results from. I have heard it needs
to be fairly high 60mg or so? What are your thoughts?
Have you tried it? I guess my chronic
curiousity about it is because 1) awaiting visit
with doc on 6/14 and 2) could it be better to
just take this versus Wellbutrin and also
Klonopin? Weanign off Kolonopin now that I don't
take WB because it made me get up at 4am and
was not making me feel great to be honest.

Just curious.

Paige

 

Re: BuSpar thoughts-Paige

Posted by Daveman on May 28, 2001, at 23:44:56

In reply to Re: BuSpar thoughts » Daveman, posted by Paige on May 28, 2001, at 19:50:46

Paige: I don't know what he prescribes because he just doesn't do it very much (so he says). I didn't get into the details except for his explaining why he didn't consider it as an option for me.

Dave

> Hi Dave,
>
> Buspar is a tad pricey. Curious what dosage your
> doc gets results from. I have heard it needs
> to be fairly high 60mg or so? What are your thoughts?
> Have you tried it? I guess my chronic
> curiousity about it is because 1) awaiting visit
> with doc on 6/14 and 2) could it be better to
> just take this versus Wellbutrin and also
> Klonopin? Weanign off Kolonopin now that I don't
> take WB because it made me get up at 4am and
> was not making me feel great to be honest.
>
> Just curious.
>
> Paige


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