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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by meltingpot on March 24, 2010, at 8:18:34
Hi,
My psychiatrist was talking about adding Milnacipran to the Seroxat I'm taking the next time I go to see her (which will be next week).
However, as usually I've been researching Milnacipran on here and on google and have seen a message where somebody likens Milnacipran to Edronex (reboxetine).
I know all drugs are different and we all react in different ways but I have already tried Edronex along with Clomipramine and it didn't seem to do diddly squat. I'm a bit concerned I'll be put on milnacipran for another six weeks and have the same result.
Does anyone else have any experience with these two drugs?
Thanks.....Denise
Posted by SLS on March 24, 2010, at 10:47:51
In reply to Reboxetine (Edronex) vs Milnacipran, posted by meltingpot on March 24, 2010, at 8:18:34
> I'm a bit concerned I'll be put on milnacipran for another six weeks and have the same result.
Do you have any alternatives at this point?
> Does anyone else have any experience with these two drugs?
I tried reboxetine about 9 years ago. It immediately exacerbated my depression and produced anxiety such that I became suicidal.
I am currently taking milnacipran at a dosage of 100mg. I am on day 8. It has neither helped nor hurt so far. It is still too early to expect an improvement.
- Scott
Posted by ed_uk2010 on March 24, 2010, at 15:23:47
In reply to Reboxetine (Edronex) vs Milnacipran, posted by meltingpot on March 24, 2010, at 8:18:34
Hi Denise,
Milnacipran isn't normally used in combination with paroxetine (Seroxat). What country are you in?
> Hi,
>
> My psychiatrist was talking about adding Milnacipran to the Seroxat I'm taking the next time I go to see her (which will be next week).
>
> However, as usually I've been researching Milnacipran on here and on google and have seen a message where somebody likens Milnacipran to Edronex (reboxetine).
>
> I know all drugs are different and we all react in different ways but I have already tried Edronex along with Clomipramine and it didn't seem to do diddly squat. I'm a bit concerned I'll be put on milnacipran for another six weeks and have the same result.
>
> Does anyone else have any experience with these two drugs?
>
>
> Thanks.....Denise
Posted by Meltingpot on March 24, 2010, at 17:04:06
In reply to Re: Reboxetine (Edronex) vs Milnacipran » meltingpot, posted by SLS on March 24, 2010, at 10:47:51
Scott,
You have the patience of a Saint. As far as my options go, I don't think there are many other than ECT, VNS or DBS and none of them have been presented to me as options. Therefore I have none, oh the other option is suicide but I don't have the courage for that.
How long do you intend giving the milnacipran?
Denise
Posted by Meltingpot on March 24, 2010, at 17:05:13
In reply to Re: Reboxetine (Edronex) vs Milnacipran » meltingpot, posted by ed_uk2010 on March 24, 2010, at 15:23:47
Hi Ed,
I'm in the same country as you. You've posted me quite a lot in the past. I used to be DeniseUK1966 I think it was.
Denise
Posted by ed_uk2010 on March 24, 2010, at 17:30:08
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED, posted by Meltingpot on March 24, 2010, at 17:05:13
> Hi Ed,
>
> I'm in the same country as you. You've posted me quite a lot in the past. I used to be DeniseUK1966 I think it was.
>
> DeniseHi there,
I thought it might be you :) I was confused though because milnacipran is not marketed in the UK. I suppose it could be imported though.
Posted by SLS on March 24, 2010, at 17:37:31
In reply to Re: Reboxetine (Edronex) vs Milnacipran SLS, posted by Meltingpot on March 24, 2010, at 17:04:06
> You have the patience of a Saint.
Not really. I guess it depends on the situation. For now, I am willing to give milnacipran a minimum of 4 weeks. I will go longer if there is at least a subtle response. I hope my doctor is willing to go up to 150mg.
> As far as my options go, I don't think there are many other than ECT, VNS or DBS and none of them have been presented to me as options.
What drugs have you combined with paroxetine?
- Scott
Posted by Phillipa on March 24, 2010, at 22:03:35
In reply to Reboxetine (Edronex) vs Milnacipran, posted by meltingpot on March 24, 2010, at 8:18:34
Hi Denise been gone all day to docs. I'm glad to see you but sorry to hear all is not well. What do you think you will try? Phillipa
Posted by meltingpot on March 25, 2010, at 8:46:22
In reply to Re: Reboxetine (Edronex) vs Milnacipran SLS » Meltingpot, posted by SLS on March 24, 2010, at 17:37:31
Hi Scott,
I've combined Lamictal, Remeron, buspar, thyroid hormone, reboxetine and I take Zyprexa now and again (only when I'm really low). I also tried adding Wellbutrin to the Seroxat which funnily enough made me really, really tired, I could hardly keep my eyes open and it did nothing for my mood.
None of the above added to the Seroxat (Paxil) seemed to make a lot of difference. I feel like I've reached stalemate in a way. I guess you must feel the same. Which is why I'm wondering you aren't looking into more agressive treatments like DBS or VNS even?
Denise
Posted by meltingpot on March 25, 2010, at 8:47:48
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED » Meltingpot, posted by ed_uk2010 on March 24, 2010, at 17:30:08
Hi Ed,
Well this psychiatrist who I'm seeing at the Priory in Birmingham seemed to think I could try it. I'm not sure though if it's worth trying.
Denise
Posted by bleauberry on March 25, 2010, at 19:13:48
In reply to Reboxetine (Edronex) vs Milnacipran, posted by meltingpot on March 24, 2010, at 8:18:34
Reboxetine and milnacipran are not comparable, as I see it. Both strong on NE, but that is just table talk. Means nothing on predicting how they feel.
I can say this. Reboxetine immediately and profoundly made my depression tens times worse. Real bad. Milnacipran on the other hand felt positive right from the start.
It is commonly combined with Paxil or Luvox in Japan. It also goes especially well with Risperdal or Zyprexa.
Posted by meltingpot on March 26, 2010, at 8:25:19
In reply to Re: Reboxetine (Edronex) vs Milnacipran, posted by bleauberry on March 25, 2010, at 19:13:48
Hi Bleauberry,
Well that gives me a little bit of encouragement at least about Milnacipran. Funnily enough I never felt anything when I added Reboxetine to the Seroxat but then when I take Seroxat I can never notice the difference if I take anything else along with it. Apart from the Wellbutrin which just seemed to make me more tired.
Denise
I
Posted by ed_uk2010 on March 26, 2010, at 18:16:40
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED, posted by meltingpot on March 25, 2010, at 8:47:48
> Hi Ed,
>
> Well this psychiatrist who I'm seeing at the Priory in Birmingham seemed to think I could try it. I'm not sure though if it's worth trying.
>
> DeniseInteresting. It's extremely unusual for psych meds to be imported into the UK (except melatonin products), but I guess it does happen :)
Posted by Meltingpot on March 30, 2010, at 15:34:01
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED » meltingpot, posted by ed_uk2010 on March 26, 2010, at 18:16:40
Hi Ed,
It seems as though you were right :-) I went to see the psychiatrist on Saturday and she was talking about adding Mianserin not Milnacipran (I must have got confused). I'm not 100% convinced Mianserin will help but I'm not 100% convinced anything will ever get me to an "enjoying life" state.
I know we are not supposed to ask this but do you know if Milnacipran can be purchased online. Can you pbabble me?
Denise
Posted by ed_uk2010 on March 30, 2010, at 17:03:05
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED, posted by Meltingpot on March 30, 2010, at 15:34:01
> Hi Ed,
>
> It seems as though you were right :-) I went to see the psychiatrist on Saturday and she was talking about adding Mianserin not Milnacipran (I must have got confused). I'm not 100% convinced Mianserin will help but I'm not 100% convinced anything will ever get me to an "enjoying life" state.
>
> I know we are not supposed to ask this but do you know if Milnacipran can be purchased online. Can you pbabble me?
>
>
> DeniseMianserin is related to mirtazapine (Zispin, Remeron). Have you tried mirtazapine?
I'm not sure about buying milnacipran online. Your pharmacy may be able to have it imported if your doctor prescribes it. Certain companies such as IDIS specialise in imports.
Posted by Meltingpot on April 1, 2010, at 15:25:55
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED, posted by ed_uk2010 on March 30, 2010, at 17:03:05
Hi Ed,
Yes I tried adding Mirtazapine to Seroxat but it didn't work that well. I know Mianserin is chemically similar to Mirtazapine but the Psychiatrist seems to think they are slightly different in the way they act.
I don't really know what to do next. I've had enough of this. I thought it was possible to get Milnacipran on line.
I can't get a prescription for it.
How are you anyway?
Denise
Posted by ed_uk2010 on April 1, 2010, at 16:21:40
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED, posted by Meltingpot on April 1, 2010, at 15:25:55
Hi Denise,
Have you tried bupropion? Although it is one of the most widely prescribed antidepressants in the US, your psychiatrist may not be familiar with its use an an AD since it's only approved for smoking cessation here. We don't have the Wellbutrin brand but we do have Zyban. Have you ever taken Zyban?
Unfortunately, you can't take Zyban with Seroxat due to the interaction. Although Zyban is officially contra-indicated with all SSRIs in the UK, combining Zyban with citalopram appears to be safe. Citalopram + bupropion was used in the STAR*D trial. No unexpected side effects occured. Perhaps you could switch from Seroxat to citalopram and then add Zyban? Alternatively, you could taper off Seroxat and try Zyban on its own.
Just a thought.
> Hi Ed,
>
> Yes I tried adding Mirtazapine to Seroxat but it didn't work that well. I know Mianserin is chemically similar to Mirtazapine but the Psychiatrist seems to think they are slightly different in the way they act.
>
> I don't really know what to do next. I've had enough of this. I thought it was possible to get Milnacipran on line.
>
> I can't get a prescription for it.
>
> How are you anyway?
>
>
> Denise
Posted by SLS on April 1, 2010, at 18:52:06
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED » Meltingpot, posted by ed_uk2010 on April 1, 2010, at 16:21:40
Hi Ed.
> Unfortunately, you can't take Zyban with Seroxat due to the interaction.
What is the interaction?
- Scott
Posted by ed_uk2010 on April 2, 2010, at 13:45:48
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED » ed_uk2010, posted by SLS on April 1, 2010, at 18:52:06
> Hi Ed.
>
> > Unfortunately, you can't take Zyban with Seroxat due to the interaction.
>
> What is the interaction?
>
>
> - ScottI was under the impression that bupropion inhibits the metabolism of paroxetine by CYP 2D6. I'm sure I've read about this before but I've just had a look in some books an there doesn't seem to be much information available.
Posted by Meltingpot on April 4, 2010, at 5:58:07
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED » SLS, posted by ed_uk2010 on April 2, 2010, at 13:45:48
Hi Ed,
I have tried adding Wellbutrin on a number of occasions. I tried adding Wellbutrin 350mg to Seroxat (Paxil) for over a week and it was making me really, really tired so I stopped it.
Thanks anyway.
Denise
Posted by ed_uk2010 on April 4, 2010, at 6:25:51
In reply to Re: Reboxetine (Edronex) vs Milnacipran - ED, posted by Meltingpot on April 4, 2010, at 5:58:07
> Hi Ed,
>
> I have tried adding Wellbutrin on a number of occasions. I tried adding Wellbutrin 350mg to Seroxat (Paxil) for over a week and it was making me really, really tired so I stopped it.
>
> Thanks anyway.
>
>
> DeniseI wonder whether the tiredness was because of an interaction. If bupropion did substantially increase the level of paroxetine, that could cause tiredness. Just a thought.
This is the end of the thread.
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