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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by former poster on August 6, 2015, at 18:26:26
My Pdoc put me on Fetzima because I had a good response to Savella. Wondering if it is more effective for depression/anxiety than Savella. I'm guessing its not judging by the huge number of free samples I was given.
Posted by phidippus on August 7, 2015, at 13:02:24
In reply to Anyone taking Fetzima?, posted by former poster on August 6, 2015, at 18:26:26
Why did you stop Savella?
Fetzima is similar (its an snri). It has a heavier norepenephrine profile.
Eric
Posted by former poster on August 8, 2015, at 0:48:26
In reply to Re: Anyone taking Fetzima? » former poster, posted by phidippus on August 7, 2015, at 13:02:24
I stopped savella 2 years ago because it was aggravating my prostate badly. This summer depression returned quite severe. Dr. wrote a prescription for savella but now insurance will pay for fetzima only. I'm stuck with fetzima for now.
Posted by SLS on August 8, 2015, at 6:41:52
In reply to Re: Anyone taking Fetzima? » phidippus, posted by former poster on August 8, 2015, at 0:48:26
> I stopped savella 2 years ago because it was aggravating my prostate badly. This summer depression returned quite severe. Dr. wrote a prescription for savella but now insurance will pay for fetzima only. I'm stuck with fetzima for now.
Fetzima might be better than Savella for depression. I haven't researched this thoroughly enough to say this with surety, though, but that's the claim being made. I don't see how it can be worse.
The relationship between the two drugs is analogous to:
Fetzima ~ Savella
Lexapro ~ CelexaAlso, the dosages used for Fetzima are generally lower than than those used for Savella. You might get more antidepressant effect at a dosage that doesn't aggravate a prostatic condition. BPH? Has prazosin been recommended to help with your prostate? If so, it might be interesting to give it a try. If childhood trauma or neglect contributed to the development of your depression, you might find prazosin helpful for mood and anxiety as well.
- Scott
Posted by former poster on August 8, 2015, at 22:32:30
In reply to Re: Anyone taking Fetzima? » former poster, posted by SLS on August 8, 2015, at 6:41:52
Thank you Scott for that very interesting tidbit. I'm really interested in studies that compare fetzima/savella efficacy.
I'm on my 5th day at 40mg I know its too early to make a comment other than the side effects. It may be a coincidence but my chronic pain is significantly less the last 3 days. E.D. started kicking in around the same time. Surprisingly my prostate gland was horrible on day 1 but almost normal now.
I just noticed the expiration date on the 20 sample boxes I was given says 7/15. Makes an impression that it's not in very high demand? Should I be taking these if they're expired?
Posted by former poster on August 12, 2015, at 12:11:16
In reply to Anyone taking Fetzima?, posted by former poster on August 6, 2015, at 18:26:26
Erectile dysfunction is severe on this med. How am I to get well worrying about my wife's sexual needs unfulfilled? What was my doc thinking when he put me on this? Medscape says its the most prevalent side effect. 10% of patients get E.D. on this med! Losing hope of ever feeling well.
Posted by SLS on August 12, 2015, at 15:09:43
In reply to Re: Anyone taking Fetzima? Bad E.D. » former poster, posted by former poster on August 12, 2015, at 12:11:16
> Erectile dysfunction is severe on this med. How am I to get well worrying about my wife's sexual needs unfulfilled? What was my doc thinking when he put me on this? Medscape says its the most prevalent side effect. 10% of patients get E.D. on this med! Losing hope of ever feeling well.
Do you lack libido?
Have you tried Viibrid (vilazadone) or Brintellix (vortioxetine)? These drugs should be free of sexual side effects. Personally, I had no problems with Effexor. Prazosin is a different story. It has squashed my libido, even though I can still achieve an erection and orgasm. However, when there is no sex drive, it is difficult to have enough interest or arousal response.
Buspar (buspirone) is supposed to help with sexual side effects, but I don't know specifically what aspect of sex response is improved. The same is true of Wellbutrin and Ritalin. The the problem with articles on sexual side effects with antidepressants is that they tend not to differenciate between libido, arousal, and orgasm. I believe cyproheptadine (Periactin) helps with erections and orgasm. You would have to check on that. It is a drug that you would take immediately before having sex before you begin to feel sedated. If your problem is strictly one of erectile dysfunction, perhaps Viagra or Cialis makes sense.
I would use a search engine and comb the Internet for answers to your questions. It might be premature to discontinue Fetzima. It would be nice to see if you obtain and antidepressant response. It will give you information, even if you ultimately decide not to take it. To respond to Fetzima may indicate that a combination of SSRI or SNRI with either desipramine or nortriptyline will produce an improvement in depression.
- Scott
Posted by former poster on August 13, 2015, at 0:40:56
In reply to Re: Anyone taking Fetzima? Bad E.D. » former poster, posted by SLS on August 12, 2015, at 15:09:43
I tried Vilazadone. Haven't tried Brintellix. Vilazadone actually gave me E.D. and didn't help my depression. Brintellix is the next one my doc wants me to try.
My libido is strong on fetzima but the day I started I noticed my usual nocturnal penile tumescence disappeared. This is very distressing for me. I have struggled intermittently with this demoralizing side effect for decades. Hopefully Brintellix will be better.
Posted by SLS on August 13, 2015, at 5:30:27
In reply to Re: Anyone taking Fetzima? Bad E.D. » SLS, posted by former poster on August 13, 2015, at 0:40:56
When was the last time that you tried a drug that does not inhibit the reuptake of serotonin?
Desipramine
Nortriptyline
Mirtazapine
Reboxetine
Agomelatine
Bupropion
Trimipramine
LamotrigineWhat has been your history of taking MAOIs?
What else are you taking right now?
- Scott
Posted by phidippus on August 13, 2015, at 19:49:59
In reply to Re: Anyone taking Fetzima? Bad E.D. » former poster, posted by SLS on August 12, 2015, at 15:09:43
Don't forget Mirapex and Requip-both supposedly help with libido....
Eric
Posted by former poster on August 14, 2015, at 11:15:45
In reply to Re: Anyone taking Fetzima? Bad E.D. » former poster, posted by SLS on August 13, 2015, at 5:30:27
>>
"When was the last time that you tried a drug that does not inhibit the reuptake of serotonin?Desipramine
Nortriptyline
Mirtazapine
Reboxetine
Agomelatine
Bupropion
Trimipramine
LamotrigineWhat has been your history of taking MAOIs?
What else are you taking right now?"
>>I have been on Emsam 6mg for 2 years. It improves motivation, mood and social anxiety. Recently the anxiety was gettting too severe. I asked the doc if I could go to 12mg patch, he said no and I agreed.
I was on Nardil from 1996 to 2006 with amazing results.
I was on Desipramine back in the 1980's for about a year. It gave a lot of side effects and little or no benefits.
Mirtazipine.. felt coma inducing. Took a 15mg tablet and slept nearly tht whole weekend. I'm terrified of this med!
Nortryptiline.. I tried back in the 1980's with some results. Can't remember, so long ago.
Bupropion.. I took for 2-3 years. Effective but at the cost of gritting my teeth, thining hair, horrific constipation that nothing could fix.
Lamotrigine.. Worked wonderful for social anxiety the first 2 weeks I took in combination with Nardil. Blunted feeling began to kick in so bad I couldn't do my job.Agomelatine sounds good but not available in USA.
Reboxetine.. I wanted to try but can't get doc to give me a Rx.
Trimimpramine I have not tried
I'm taking carvedilol for a heart condition.
also take 1-2 mg of clonazepam.
Posted by SLS on August 14, 2015, at 12:14:25
In reply to Re: Anyone taking Fetzima? Bad E.D. » SLS, posted by former poster on August 14, 2015, at 11:15:45
> I have been on Emsam 6mg for 2 years. It improves motivation, mood and social anxiety. Recently the anxiety was gettting too severe. I asked the doc if I could go to 12mg patch, he said no and I agreed.
What are your reasons for not wanting to increase the dosage of Emsam or returning to Nardil? Higher dosages of Emsam work on MAO-A more potently (and thus require diet restrictions), and might very well help with anxiety like Nardil would.
Have you discussed the use of clonazepam or Xanax XR in conjunction with Emsam? What about using an antipsychotic like low-dose Seroquel or Abilify?
Pregabalin is sometimes used for anxiety disorders. It works much like gabapentin, but is more anxiolytic.
- Scott
Posted by former poster on August 14, 2015, at 20:38:50
In reply to Re: Anyone taking Fetzima? Bad E.D. » former poster, posted by SLS on August 14, 2015, at 12:14:25
I'm on 2mg of clonz. Increasing that taxes my cognitive functions too much. I really would love to go back on nardil or increase the emsam dose but I can't travel safe internationally while on it. I'm really in a corner. My job or my sanity. Losing either one can result in losing the other. Taking pregabalin would likely result in the same hallucinations gabapentin gave. Trying to function at work on AP's would be a train wreck.
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