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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Sprat on November 9, 2014, at 23:44:14
Hi - I've been on SSRIs for over 15 years for agoraphobia - unfortunately they keep pooping out on me. Basically my last option (I've been through all the rest) is Effexor. My pdoc thinks that because Prozac made me really agitated and anxious, Effexor will probably do the same. Has anyone here not tolerated Prozac but was fine on Effexor?
Thanks
Sprat
Posted by Christ_empowered on November 10, 2014, at 8:47:39
In reply to For those with anxiety - Prozac + Effexor question, posted by Sprat on November 9, 2014, at 23:44:14
I did OK on Cymbalta (90mgs, even) but on Prozac.
Posted by kirkglen on November 10, 2014, at 11:51:27
In reply to Re: For those with anxiety - Prozac + Effexor question, posted by Christ_empowered on November 10, 2014, at 8:47:39
Sprat...........I got off Nardil and tried Prozac and Effexor. Both were terrible. I tried all the SSRI's and SNRI's same reaction.
The only drug that has ever helped is Nardil 60 mg and has never pooped out.
Posted by Phillipa on November 10, 2014, at 14:23:53
In reply to Re: For those with anxiety - Prozac + Effexor question, posted by kirkglen on November 10, 2014, at 11:51:27
I did take Cymbalta when new but with benzos had no problems with it. It helped me with back pain. I currently still take Luvox subtheraputic dose also with low dose benzos night for sleep Only. Phillipa
Posted by phidippus on November 10, 2014, at 20:24:36
In reply to For those with anxiety - Prozac + Effexor question, posted by Sprat on November 9, 2014, at 23:44:14
I couldn't tolerate either :P.
Why are you depending on antidepressants to treat agoraphobia? First line treatment for agoraphobia is always ERP.
Eric
Posted by Sprat on November 10, 2014, at 23:00:59
In reply to Re: For those with anxiety - Prozac + Effexor question » Sprat, posted by phidippus on November 10, 2014, at 20:24:36
> I couldn't tolerate either :P.
>
> Why are you depending on antidepressants to treat agoraphobia? First line treatment for agoraphobia is always ERP.
>
> Eric
I've had CBT, but what is ERP? For the record, I'm not just on an antidepressant, I'm also on an Risperdal and Clonazepam. If the antidepressant was working I shouldn't need either of the other two.Sprat
Posted by Christ_empowered on November 11, 2014, at 7:50:17
In reply to For those with anxiety - Prozac + Effexor question, posted by Sprat on November 9, 2014, at 23:44:14
can you take Pristiq? Some peoples' insurance has weird rules...
...I was just thinking...Effexor starts out as an SSRI (I think...) at low doses. Then you start hitting NE and at very high doses you hit dopamine.
If you could take Cymbalta or Pristiq, you could start at a therapeutic dose with dual reuptake inhibition. Cymbalta is generic now.
Just a thought. When you were on SSRI drugs and got agitated, did the AP and Klonopin help at all?
Posted by phidippus on November 11, 2014, at 12:51:11
In reply to Re: For those with anxiety - Prozac + Effexor question, posted by Sprat on November 10, 2014, at 23:00:59
> I've had CBT, but what is ERP?
ERP is exposure and response prevention therapy. You are exposed gradually to the subject of your phobia until you habituate to it. It is a very successful therapy for things like phobias and OCD.
What exactly are you afraid of so much that you need to be medicated?
Eric
Posted by Phillipa on November 11, 2014, at 20:11:34
In reply to Re: For those with anxiety - Prozac + Effexor question » Sprat, posted by phidippus on November 11, 2014, at 12:51:11
Doesn't work for me.
Posted by Sprat on November 11, 2014, at 23:08:07
In reply to Re: For those with anxiety - Prozac + Effexor question, posted by Christ_empowered on November 11, 2014, at 7:50:17
> can you take Pristiq? Some peoples' insurance has weird rules...
>
> ...I was just thinking...Effexor starts out as an SSRI (I think...) at low doses. Then you start hitting NE and at very high doses you hit dopamine.
>
> If you could take Cymbalta or Pristiq, you could start at a therapeutic dose with dual reuptake inhibition. Cymbalta is generic now.
>
> Just a thought. When you were on SSRI drugs and got agitated, did the AP and Klonopin help at all?Thanks for the idea, but I live in little ol' NZ where we have a much smaller selection of drugs to choose from! I'm pretty sure we have neither Cymbalta or Pristiq.
When I tried the Prozac I wasn't on the AP or klonopin, I was just switching from Paxil to Prozac. When the Paxil first worked, I didn't need any other medications with it.
Thanks
Sprat
Posted by burial on November 13, 2014, at 8:21:00
In reply to Re: For those with anxiety - Prozac + Effexor question » Christ_empowered, posted by Sprat on November 11, 2014, at 23:08:07
why did you switch to prozac? Paroxetine seems to be among the best for anxiety
Posted by Chris O on November 13, 2014, at 18:38:00
In reply to For those with anxiety - Prozac + Effexor question, posted by Sprat on November 9, 2014, at 23:44:14
I'm on the anxiety disorder axis as well. I've taken Prozac and Effexor (not together). I did not find these two drugs to be the least bit similar. I experienced little agitation on Prozac, even at 80-100mg a day. (I took Prozac for 1 year at that dose and 1 year at 20mg a day about 15 years ago.) On Effexor (which, admittedly, I only took for a couple of weeks), I experienced a lot of agitation, but also felt some antidepressant and anti-anxiety effects, even at the lower doses (75 mg/day). But I think Effexor is supposed to lose some of those agitating effects at higher doses. It certainly seems worth a try. Effexor is fast acting, so you'll get both the benefits and side effects right away. The only drawback would be the withdrawals (which I experienced even after taking it for two weeks). Good luck.
Chris
Posted by Christ_empowered on November 16, 2014, at 0:06:07
In reply to Re: For those with anxiety - Prozac + Effexor question, posted by Sprat on November 10, 2014, at 23:00:59
do you have remeron (mirtazapine) where you live? Its not the most popular thing here, but I read that US doctors are using it to boost other ADs...mostly Effexor, but also Wellbutrin and the various SRI drugs.
Weight gain can be an issue. Lower doses are more sedating.
Posted by Sprat on November 16, 2014, at 2:29:21
In reply to Re: For those with anxiety - Prozac + Effexor question, posted by Christ_empowered on November 16, 2014, at 0:06:07
Yes we do, and I did ask my pdoc about it, but he seemed to think that I wouldn't like it because of the weight gain. I think I'll just stay on my current med schedule for now and look into effexor if things start to get a bit tricky again.
Thanks
Sprat
> do you have remeron (mirtazapine) where you live? Its not the most popular thing here, but I read that US doctors are using it to boost other ADs...mostly Effexor, but also Wellbutrin and the various SRI drugs.
>
> Weight gain can be an issue. Lower doses are more sedating.
This is the end of the thread.
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