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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by jerseygal111 on April 17, 2012, at 16:37:18
I was on prozac for 10 years before it pooped out on me. Since then, over a 2 year period, I have tried lexapro, pristiq, and viibryd. I am currently on remeron, 30 mg., mostly for sleep, klonopin 1 mg. 3x per day, zyprexa 5mg. as needed for anxiety, and lamictal. The lamictal did not do anything for me so I am tapering off of it. What I'm wondering is it worth it to try something I haven't such as zoloft or cymbalta? Any chance they would work if the others have not? Oh, I haven't been on an SSRI since about January so I have had a break from SSRI's and SNRI's.
Posted by Phillipa on April 17, 2012, at 18:42:12
In reply to Is it worth it to try another SSRI or SNRI?, posted by jerseygal111 on April 17, 2012, at 16:37:18
Worth a try as once apdoc said if a med stops working taking a time out from the med would restore the ability of the med to work. Now this is but one pdoc? Phillipa
Posted by phidippus on April 18, 2012, at 22:29:18
In reply to Is it worth it to try another SSRI or SNRI?, posted by jerseygal111 on April 17, 2012, at 16:37:18
Its doubtful the Prozac pooped out on you. Your symptoms worsened more likely. You may want to try two antidepressants-compliment the Remeron with Clomipramine. Two SSRIs together will probably not be helpful, but you can try Zoloft with amitryptaline.
Eric
Posted by bleauberry on April 19, 2012, at 5:24:19
In reply to Is it worth it to try another SSRI or SNRI?, posted by jerseygal111 on April 17, 2012, at 16:37:18
No, you do not want another ssri. That is, not one by itself anyway.
Cymbalta, my opinion is to stay away from it because I just do not see a good track record with it happening in the real world. They have to advertise the crap out of it to sell any. It is basically just another ssri. It is almost deceptive to call it a snri because its impact of NE compared to 5ht is miniscule.
What you want, and I say this as an ex 8-year prozac patient, and a ECT failure patient, is treatment that has balanced serotonin and norepinephrine. That means stuff like zoloft+nortriptyline, prozac+nortriptyline, ssri+ritalin, savella, parnate, nardil. If it isn't on that short list, I wouldn't even consider it. Face it, a 10 year prozac poopout is not going to get fixed by a garden variety approach.
Posted by creepy on April 19, 2012, at 10:54:22
In reply to Is it worth it to try another SSRI or SNRI?, posted by jerseygal111 on April 17, 2012, at 16:37:18
zoloft might be worth a try. Personally I would avoid the SNRIs. They can be very hard to discontinue.
Have you thought about adding or switching to another AAP? Or maybe trying a different AED like topamax?
Posted by jerseygal111 on April 19, 2012, at 16:52:49
In reply to Re: Is it worth it to try another SSRI or SNRI? » jerseygal111, posted by phidippus on April 18, 2012, at 22:29:18
Thanks everyone. I'm going to mention your suggestions to my pdoc at my next appointment. Something's gotta work soon as this has been going on too long.
Posted by crazyjoe on April 19, 2012, at 16:53:14
In reply to Re: Is it worth it to try another SSRI or SNRI?, posted by creepy on April 19, 2012, at 10:54:22
bleuberry why do you say is no good in the real world and it is not really an snri?
Posted by Phillipa on April 19, 2012, at 19:51:25
In reply to Re: Is it worth it to try another SSRI or SNRI?, posted by crazyjoe on April 19, 2012, at 16:53:14
I'd like to know same answer. Many times another SSRI can work and even two combined if not high doses of each. Phillipa
Posted by Alexei on April 20, 2012, at 13:59:50
In reply to Re: Is it worth it to try another SSRI or SNRI?, posted by crazyjoe on April 19, 2012, at 16:53:14
> bleuberry why do you say is no good in the real world and it is not really an snri?
I think because cymbalta claims to have balanced ratio of serotonin to norepinephrine... but it does not.
The ratio is roughly 90%-10% in favor of serotonin.
Posted by crazyjoe on April 21, 2012, at 9:21:28
In reply to Re: Is it worth it to try another SSRI or SNRI? » crazyjoe, posted by Alexei on April 20, 2012, at 13:59:50
alexie how the heck do you know this ratio on cymbalta are you a chemist?
Posted by Alexei on April 21, 2012, at 13:12:44
In reply to Re: Is it worth it to try another SSRI or SNRI?, posted by crazyjoe on April 21, 2012, at 9:21:28
> alexie how the heck do you know this ratio on cymbalta are you a chemist?
I was very respectful in my post to you, why cannot you show similar respect?
This website is excellent ...
Posted by crazyjoe on April 21, 2012, at 16:27:05
In reply to Re: Is it worth it to try another SSRI or SNRI? » crazyjoe, posted by Alexei on April 21, 2012, at 13:12:44
sorry to diss ....do you think then that a dr could automatically switch you over to an ssri immediately with no problem......thinking of switching to viibryd .....would a taper be necessary.....from 60 mg of cymbalta....maybe thats why i'm getting more anxious maybe cymbaltais not realyy as potent as thought.....my dr felt i should be on 90 ...but insurance wouldn't go for it
Posted by Phillipa on April 21, 2012, at 21:22:39
In reply to Re: Is it worth it to try another SSRI or SNRI?, posted by crazyjoe on April 21, 2012, at 16:27:05
I'm surprised as six years ago the doc wanted me on 120mg said it worked better he'd found. I ran from him as at the time prescribed dose was 30-60mg. Phillipa
Posted by crazyjoe on April 21, 2012, at 21:47:34
In reply to Re: Is it worth it to try another SSRI or SNRI? » crazyjoe, posted by Phillipa on April 21, 2012, at 21:22:39
in my case its all about what dose the insurance will cover...what do you think about cymbalta being a weak snri
Posted by Alexei on April 22, 2012, at 7:00:49
In reply to Re: Is it worth it to try another SSRI or SNRI?, posted by crazyjoe on April 21, 2012, at 16:27:05
> sorry to diss ....do you think then that a dr could automatically switch you over to an ssri immediately with no problem......thinking of switching to viibryd .....would a taper be necessary.....from 60 mg of cymbalta....maybe thats why i'm getting more anxious maybe cymbaltais not realyy as potent as thought.....my dr felt i should be on 90 ...but insurance wouldn't go for it
I agree with you, cymbalta was not a good med for me... and it left me with sedation and apathy. Not much help for depression. Felt better once I got off it.
It would still be better to taper off rather than just stop, even if going onto an ssri. It would be much smoother that way. Have you started vybrid yet?
Posted by crazyjoe on April 22, 2012, at 18:52:28
In reply to Re: Is it worth it to try another SSRI or SNRI? » crazyjoe, posted by Alexei on April 22, 2012, at 7:00:49
seeing my dr tomorrow
This is the end of the thread.
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