Psycho-Babble Medication Thread 101026

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

 

Is Reboxetine worth the wait?

Posted by Else on March 30, 2002, at 21:09:07

I have read that reboxetine has shown superior effectiveness over SSRIs in improving social functionning (it was compared to fluoxetine in one study and to citalopram in another.) Now, I do very poorly on SSRIs (I tried Zoloft and Prozac), and I practically explode with irritability on Effexor and Wellbutrin. Right now I am on Remeron and it has been the only AD that has proven both effective and tolerable for me so far. The only problem is that I sleep 12 hours a day even though I take plenty of Ritalin and coffee. Since social-functionning is definitely a problem for me and that SSRIs don't seem to do much, I was wondering if reboxetine is likely to be an adequate alternative to Remeron. Are the side effects similar to those of Effexor? From earlier posts I have read it doesn't seem all that great but I respond atypically to ADs (I don't gain weight on Remeron and Effexor/Wellbutrin make me feel like hell.) Has anyone had a particularly positive experience with the drug, especially with regards to social functionning, motivation and drive?

 

Re: Is Reboxetine worth the wait?

Posted by OldSchool on March 30, 2002, at 21:58:58

In reply to Is Reboxetine worth the wait?, posted by Else on March 30, 2002, at 21:09:07

> I have read that reboxetine has shown superior effectiveness over SSRIs in improving social functionning (it was compared to fluoxetine in one study and to citalopram in another.) Now, I do very poorly on SSRIs (I tried Zoloft and Prozac), and I practically explode with irritability on Effexor and Wellbutrin. Right now I am on Remeron and it has been the only AD that has proven both effective and tolerable for me so far. The only problem is that I sleep 12 hours a day even though I take plenty of Ritalin and coffee. Since social-functionning is definitely a problem for me and that SSRIs don't seem to do much, I was wondering if reboxetine is likely to be an adequate alternative to Remeron. Are the side effects similar to those of Effexor? From earlier posts I have read it doesn't seem all that great but I respond atypically to ADs (I don't gain weight on Remeron and Effexor/Wellbutrin make me feel like hell.) Has anyone had a particularly positive experience with the drug, especially with regards to social functionning, motivation and drive?


You wont ever see Reboxetine marketed in the USA. Forget about it...dont expend any mental energy thinking about it. As far as meds already available that work mostly on NE like Reboxetine, there is desipramine a tricyclic. Also, high dosage Effexor is similar to Reboxetine.


Old School

 

Re: Is Reboxetine worth the wait? OldSchool

Posted by Else on March 30, 2002, at 22:27:37

In reply to Re: Is Reboxetine worth the wait?, posted by OldSchool on March 30, 2002, at 21:58:58


> You wont ever see Reboxetine marketed in the USA. Forget about it...dont expend any mental energy thinking about it. As far as meds already available that work mostly on NE like Reboxetine, there is desipramine a tricyclic. Also, high dosage Effexor is similar to Reboxetine.
>
>
> Old School

Thanks Old (School),

Actually, I live in Canada and we do have moclobemide (even though my pdoc wont prescribe it because he insists it's useless) so this is not completely hopeless although Health Canada does tend to comply with FDA regulations. Not that it matters... If it does, indeed, feel like high dosage Effexor, I think I would pass anyway. But thank you for the info (I remember spending several consecutive nights awake while on 300mg Effexor, not manic, just excrutiatingly tired and too keyed-up to sleep. It was most unpleasant and I wouldn't want to go through that again.)

 

Re: Is Reboxetine worth the wait?

Posted by JohnX2 on March 30, 2002, at 22:34:10

In reply to Re: Is Reboxetine worth the wait? OldSchool, posted by Else on March 30, 2002, at 22:27:37

>
> > You wont ever see Reboxetine marketed in the USA. Forget about it...dont expend any mental energy thinking about it. As far as meds already available that work mostly on NE like Reboxetine, there is desipramine a tricyclic. Also, high dosage Effexor is similar to Reboxetine.
> >
> >
> > Old School
>
> Thanks Old (School),
>
> Actually, I live in Canada and we do have moclobemide (even though my pdoc wont prescribe it because he insists it's useless) so this is not completely hopeless although Health Canada does tend to comply with FDA regulations. Not that it matters... If it does, indeed, feel like high dosage Effexor, I think I would pass anyway. But thank you for the info (I remember spending several consecutive nights awake while on 300mg Effexor, not manic, just excrutiatingly tired and too keyed-up to sleep. It was most unpleasant and I wouldn't want to go through that again.)


Hi dose Effexor made me very irritable and anxious. Reboxetine was very tolerable except for the urinary retention and erectile dysfunction.

The two medicines beared no resemblence to me.

BTW, maybe some Zoloft added to the Remeron would help with the hypersomnia? Just a thought.

John

 

JOHNX2: re Reboxetine JohnX2

Posted by Janelle on March 30, 2002, at 23:34:27

In reply to Re: Is Reboxetine worth the wait?, posted by JohnX2 on March 30, 2002, at 22:34:10

Reading this thread (I was intrigued because I've seen this name Reboxetine bandied about on here) I just wonder how/where you got Reboxetine if it's not available in US? Don't worry, I'm not asking cuz I wanna run out and get some (NO WAY) I'm just curious. Thanks!

 

Re: Is Reboxetine worth the wait? OldSchool

Posted by Bob on March 31, 2002, at 0:25:37

In reply to Re: Is Reboxetine worth the wait?, posted by OldSchool on March 30, 2002, at 21:58:58


> You wont ever see Reboxetine marketed in the USA. Forget about it...dont expend any mental energy thinking about it. As far as meds already available that work mostly on NE like Reboxetine, there is desipramine a tricyclic. Also, high dosage Effexor is similar to Reboxetine.
>
>
> Old School

Why do you say this, Old School? I thought that Reboxetine was grinding its way through the FDA?

Bob

 

Re: Is Reboxetine worth the wait?

Posted by OldSchool on March 31, 2002, at 10:37:35

In reply to Re: Is Reboxetine worth the wait? OldSchool, posted by Bob on March 31, 2002, at 0:25:37

>
> > You wont ever see Reboxetine marketed in the USA. Forget about it...dont expend any mental energy thinking about it. As far as meds already available that work mostly on NE like Reboxetine, there is desipramine a tricyclic. Also, high dosage Effexor is similar to Reboxetine.
> >
> >
> > Old School
>
> Why do you say this, Old School? I thought that Reboxetine was grinding its way through the FDA?
>
> Bob


Well first of all, I totally admit I do not know for sure. Im giving my opinion, which is a calculated guestimation of sorts, based upon things Ive read. I turned down a chance to get into a reboxetine clinical trial at Duke University back in late 1998. The person running the trial told me rebox worked pretty good for young people, but not so much for older folks. Why I have no idea. It was a closed trial so there was a good chance I wouldnt get reboxetine that Id get placebo instead. So I didnt waste my time. If it had been an open trial, I probably would have gone for it.

Anyway, Reboxetine was up for FDA review a year or two ago and everybody was excited about it. Then it got shot down...rejected. The rumor going around was that Eli Lilly was trying to get some similar NE selective AD on the market and there was politics involved, so Reboxetine got blocked. However, this was just the rumor and I have no real idea why reboxetine wasnt FDA approved a while back.

Its been hashed and rehashed in the USA for years now and I seriously doubt we will ever see Reboxetine in the USA. I really dont. But I could be wrong, but I wouldnt hold your horses over this one.

Desipramine is the closest thing to Reboxetine we have in the USA. Try desipramine...its basically the same thing just more side effects like anti-cholinergic side effects.

 

Re: Is Reboxetine worth the wait? JohnX2

Posted by Else on March 31, 2002, at 12:43:52

In reply to Re: Is Reboxetine worth the wait?, posted by JohnX2 on March 30, 2002, at 22:34:10


>
> Hi dose Effexor made me very irritable and anxious. Reboxetine was very tolerable except for the urinary retention and erectile dysfunction.
>
> The two medicines beared no resemblence to me.
>
> BTW, maybe some Zoloft added to the Remeron would help with the hypersomnia? Just a thought.
>
> John

Hey John,
Thanks for the reply. I was not aware that reboxetine caused sexual problems. Sexual difficulties are always presented as a rare side effect of the drug, not that they would keep me from trying it. Aside from this problem, did you find the drug more effective than serotonergic agents or was it similar?
I was on Zoloft for over a year and it didn't work too well. Like Prozac, it did make me less anxious but it also caused very unpleasant irritability and apathy so I prefer to rely on clonazepam for anxiety. Remeron works well for me. It's supposed to be less sedating in higher doses so I will consider asking my doctor to switch my prescription to 45mg instead of 30mg. Hopefully that will do the trick. Every other AD I've tried made me unbearably edgy, even when taken along with Depakote or Neurontin (except for Desyrel wich is definitely not an option, for other reasons). Do you know if a higher dosage of Remeron would help?

Thanks

 

Re: Is Reboxetine worth the wait?

Posted by turalizz on March 31, 2002, at 13:27:32

In reply to Is Reboxetine worth the wait?, posted by Else on March 30, 2002, at 21:09:07

> I have read that reboxetine has shown superior effectiveness over SSRIs in improving social functionning (it was compared to fluoxetine in one study and to citalopram in another.) Now, I do very poorly on SSRIs (I tried Zoloft and Prozac), and I practically explode with irritability on Effexor and Wellbutrin. Right now I am on Remeron and it has been the only AD that has proven both effective and tolerable for me so far. The only problem is that I sleep 12 hours a day even though I take plenty of Ritalin and coffee. Since social-functionning is definitely a problem for me and that SSRIs don't seem to do much, I was wondering if reboxetine is likely to be an adequate alternative to Remeron. Are the side effects similar to those of Effexor? From earlier posts I have read it doesn't seem all that great but I respond atypically to ADs (I don't gain weight on Remeron and Effexor/Wellbutrin make me feel like hell.) Has anyone had a particularly positive experience with the drug, especially with regards to social functionning, motivation and drive?

Hi there,
At the moment I am on 30 mg/day Remeron, and 2 mg/day Reboxetine. I started Remeron first, and then added reboxetine. This combo works perfect for me. But I must say that I get no sedation from Remeron. I added reboxetine, because Remeron could only be a partial solution to my basic problem, hypersomnia.

I tried Effexor as well. Upped to 300 mg/day with no results. I personally doubt Effexor has any noradrenergic property!

Did reboxetine helped with drive and motivation: Yes! Although I'm on quite a low dose, it works very well combined with Remeron. It is the most stimulating AD I have tried.

So, good luck! I think it is worth a try!

cem

 

Re: Is Reboxetine worth the wait? Else

Posted by JohnX2 on March 31, 2002, at 20:43:54

In reply to Re: Is Reboxetine worth the wait? JohnX2, posted by Else on March 31, 2002, at 12:43:52

>
> >
> > Hi dose Effexor made me very irritable and anxious. Reboxetine was very tolerable except for the urinary retention and erectile dysfunction.
> >
> > The two medicines beared no resemblence to me.
> >
> > BTW, maybe some Zoloft added to the Remeron would help with the hypersomnia? Just a thought.
> >
> > John
>
> Hey John,
> Thanks for the reply. I was not aware that reboxetine caused sexual problems. Sexual difficulties are always presented as a rare side effect of the drug, not that they would keep me from trying it. Aside from this problem, did you find the drug more effective than serotonergic agents or was it similar?

I don't think I gave the rebox a good trial to be honest. It didn't nullify my emotions like SSRIs, so that was a pro. Also, I didn't feel agitated like on Effexor. I do Okay on Remeron as you do also. In regards to the sexual dysfunction, this was not a libido issue, it was strictly a common side effect for males on NRIs that may be caused by stimulation of a particular noradrenaline receptor. There are medicines that may antidote this (like Flomax). Also it may just go away (I was only on the med for 3 weeks).


> I was on Zoloft for over a year and it didn't work too well. Like Prozac, it did make me less anxious but it also caused very unpleasant irritability and apathy so I prefer to rely on clonazepam for anxiety. Remeron works well for me. It's supposed to be less sedating in higher doses so I will consider asking my doctor to switch my prescription to 45mg instead of 30mg. Hopefully that will do the trick. Every other AD I've tried made me unbearably edgy, even when taken along with Depakote or Neurontin (except for Desyrel wich is definitely not an option, for other reasons). Do you know if a higher dosage of Remeron would help?
>
> Thanks

I think the higher dosage of Remeron may help, yes. This would be the 1st thing to try before switching meds, etc.

Also, the Remeron blocks serotonin receptors that cause agitation, so the addition of an SSRI like Zoloft may not add any agitation at all and may boost the AD effect.

Good Luck.
John

 

OLDSCHOOL: re drug trials, more: OldSchool

Posted by Janelle on March 31, 2002, at 21:17:58

In reply to Re: Is Reboxetine worth the wait?, posted by OldSchool on March 31, 2002, at 10:37:35

Well, first of all, where the heck is this Reboxetine available - Europe? Just curious. It apparently has gotten a lot of press here in the US, but the first I've heard of it is on this board.

Second, you spoke of drug trials - what is the difference between a CLOSED trial and an OPEN trial? You said that in a closed trial you probably wouldn't reboxetine but a placebo instead. And you said that if it had been an open trial, you probably would have gone for it (meaning you would have had a better chance of getting reboxetine or you definitely would have gotten it?) Can you please explain the difference between a CLOSED and an OPEN trial? Thanks.

Third, you said that when Reboxetine was up for FDA review a year or two ago and everybody was excited about it that but it got rejected and the rumor was that Eli Lilly was trying to get some similar NE selective AD on the market and there was politics involved, so Reboxetine got blocked.

I take it that Eli Lilly is NOT the manufacturer of Reboxetine, so which company is? Just curious.

Thanks for answering these questions.

 

Uh, JohnX2, did you miss my post above? JohnX2

Posted by Janelle on March 31, 2002, at 21:19:47

In reply to Re: Is Reboxetine worth the wait?, posted by JohnX2 on March 30, 2002, at 22:34:10

I had asked you: Reading this thread (I was intrigued because I've seen this name Reboxetine bandied about on here) I just wonder how/where you got Reboxetine if it's not available in US? Don't worry, I'm not asking cuz I wanna run out and get some (NO WAY) I'm just curious. Thanks!

If you would rather not say where you got the Rebox. just lemme know ... no problemo! Thanks.

 

Re: OLDSCHOOL: re drug trials, more:

Posted by OldSchool on March 31, 2002, at 22:20:52

In reply to OLDSCHOOL: re drug trials, more: OldSchool, posted by Janelle on March 31, 2002, at 21:17:58

> Well, first of all, where the heck is this Reboxetine available - Europe? Just curious. It apparently has gotten a lot of press here in the US, but the first I've heard of it is on this board.

yeah Europe. I know its available in the UK

>
> Second, you spoke of drug trials - what is the difference between a CLOSED trial and an OPEN trial? You said that in a closed trial you probably wouldn't reboxetine but a placebo instead. And you said that if it had been an open trial, you probably would have gone for it (meaning you would have had a better chance of getting reboxetine or you definitely would have gotten it?) Can you please explain the difference between a CLOSED and an OPEN trial? Thanks.

Sure. A closed trial is a clinical trial where you are "blinded." You dont know whether you are getting the real experimental drug (Reboxetine) or a placebo. This way the researchers supposedly get a more objective assessment of the effectiveness of Reboxetine. With a closed trial, usually you have about a one third chance of getting Reboxetine but you wont know if you got it til after the trial is over, where you are then "unblinded" and told what you got.

An "open" trial is where everything is out in the open from the beginning and you are guaranteed the real experimental drug or treatment. There are no placebos given. You have a 100% chance of getting the real experimental drug.

Most of the time in drug trials, they start out closed and blinded and as it progresses they start opening up open trials, where they test large numbers of people.

Like when I was in the rTMS clinical trials, initially I was in a closed trial, had no idea if I was getting real rTMS or not. Turned out I got placebo which I learned when I was unblinded. Not many months after I did my closed trial, the FDA gave permission to start "open" rTMS trials where you were guaranteed real rTMS.

Obviously open trial is the ideal situation if you want to try a new experimental drug or treatment.

>
> Third, you said that when Reboxetine was up for FDA review a year or two ago and everybody was excited about it that but it got rejected and the rumor was that Eli Lilly was trying to get some similar NE selective AD on the market and there was politics involved, so Reboxetine got blocked.
>
> I take it that Eli Lilly is NOT the manufacturer of Reboxetine, so which company is? Just curious.

I cant remember, I think its some British company if I remember right. No its definitely not Eli Lilly.

Old School

 

Re: Uh, JohnX2, did you miss my post above? Janelle

Posted by JohnX2 on April 1, 2002, at 4:40:00

In reply to Uh, JohnX2, did you miss my post above? JohnX2, posted by Janelle on March 31, 2002, at 21:19:47


Sorry, these types of subjects are not discussed on this newsgroup.

John

> I had asked you: Reading this thread (I was intrigued because I've seen this name Reboxetine bandied about on here) I just wonder how/where you got Reboxetine if it's not available in US? Don't worry, I'm not asking cuz I wanna run out and get some (NO WAY) I'm just curious. Thanks!
>
> If you would rather not say where you got the Rebox. just lemme know ... no problemo! Thanks.

 

Re: Is Reboxetine worth the wait?

Posted by Else on April 1, 2002, at 14:22:39

In reply to Re: Is Reboxetine worth the wait? Else, posted by JohnX2 on March 31, 2002, at 20:43:54


>
> I don't think I gave the rebox a good trial to be honest. It didn't nullify my emotions like SSRIs, so that was a pro. Also, I didn't feel agitated like on Effexor. I do Okay on Remeron as you do also. In regards to the sexual dysfunction, this was not a libido issue, it was strictly a common side effect for males on NRIs that may be caused by stimulation of a particular noradrenaline receptor. There are medicines that may antidote this (like Flomax). Also it may just go away (I was only on the med for 3 weeks).

Well I am a girl so I never really know for sure if low-libido is a consequence of the meds I'm taking or whether I'm just not in the mood because of the depression.
>
> I think the higher dosage of Remeron may help, yes. This would be the 1st thing to try before switching meds, etc.
>
> Also, the Remeron blocks serotonin receptors that cause agitation, so the addition of an SSRI like Zoloft may not add any agitation at all and may boost the AD effect.
>
> Good Luck.
> John


Thanks ,I don't remember Zoloft very fondly and I doubt I would ever go back on it. I am feeling kind of blah but one thing I haven't done is to try cutting down on the Klonopin. I think that might also help with the hypersomnia but I am afraid of the anxiety coming back. Anyhow, thanks a lot for your help and good luck to you too.

 

Re: OLDSCHOOL: re drug trials, more:

Posted by Cmatt on April 1, 2002, at 20:53:32

In reply to OLDSCHOOL: re drug trials, more: OldSchool, posted by Janelle on March 31, 2002, at 21:17:58

The company now known as Pharmacia is the manufacture of Reboxetine.

Cmatt

 

Re: OLDSCHOOL: re drug trials, more:

Posted by JGm on April 10, 2002, at 18:44:25

In reply to Re: OLDSCHOOL: re drug trials, more:, posted by Cmatt on April 1, 2002, at 20:53:32

Reboxetine is on the market in Europe by Pharmacia & Upjohn and under the brand names of Edronax and Davedax.


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