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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by farshad on October 5, 2017, at 15:27:51
Has anyone used any of these medication and how was your experience? I have suffered from depressionn and social anxiety with Mild OCD for over 10 years. I have tried therapy and various other things including meds like SSRI/SNRI. How well do these help? I was thinking of taking all 3 together. Im just looking for anyone who maybe has used any of these together or alone and how it went for you?
Posted by linkadge on October 5, 2017, at 18:16:13
In reply to Wellbutrin , Abilify or Remeron?, posted by farshad on October 5, 2017, at 15:27:51
If you are currently not (nor have ever) taken either of these medications, then your first step is not to take all three together.
If you decide to try one of these meds, I would start with the med that best fits your symptoms.
If anxiety / insomnia are issues, the remeron or abilify might be a first choice. Wellbutrin can be good for depression (and possibly social phobia) but perhaps not as much for anxiety.
Neither of these meds has an approval for social anxiety.
I have only taken remeron which can be great for anxiety, and perhaps a bit less so for depression.
Linkadge
Posted by rjlockhart37 on October 5, 2017, at 23:28:06
In reply to Wellbutrin , Abilify or Remeron?, posted by farshad on October 5, 2017, at 15:27:51
the only one i've been on is wellbutrin, i took abiilify for a while they say that abilify is partly a dopamine agonist, so it gives you a small kick, but it blocks other receptors also....i've read abilify has been a great add-on antidepressant people here on babble have posted get them out the slumps
wellbutrin i took in 2004, then again in 2009, all i rerember was i took 300mgXL in mornings, and it would slightly wake me up and do things, i would take if before class, and i would slightly more motivated to do work, but nothing like stimulants - adderall, ritilin, etc ... I've taken 450mg XL for a while, and noticed i was more focused but also it gave me a little anxiety, i would think about things too long. But bupropion is a great alternative to low energy depression, it's a mild stimulant, but nothing like the others.....
it's cheap now with generic form, you'll be a little lifted but start out slow, too much is known for anxiety
Posted by SLS on October 6, 2017, at 4:38:04
In reply to Wellbutrin , Abilify or Remeron?, posted by farshad on October 5, 2017, at 15:27:51
Why Remeron? What illness and symptoms are to be treated?
For depression:
It has been my observation that Effexor and Pristiq are very effective complements to Wellbutrin. I don't know about Remeron. Abilify works well with serotonin reuptake inhibors. The only drug that I hear mentioned routinely as being a good augmenter to Remeron is Effexor.
If you experienced even a partial response to Effexor, I would consider combining it with Wellbutrin first and then add Abilify to that if necessary. Of course, there is the "California Rocket Fuel" strategy of combining Remeron with Effexor. As appealing as the name of this treatment is, I don't see people using it. I favor SNRI + Wellbutrin + Abilify if monotherapy has been ineffective. If bipolar depression is suspected, you can try using Lamictal in place of, or in addition to, the SNRI.
- Scott
Posted by farshad on October 6, 2017, at 5:29:40
In reply to Re: Wellbutrin , Abilify or Remeron? » farshad, posted by SLS on October 6, 2017, at 4:38:04
> Why Remeron? What illness and symptoms are to be treated?
>
> For depression:
>
> It has been my observation that Effexor and Pristiq are very effective complements to Wellbutrin. I don't know about Remeron. Abilify works well with serotonin reuptake inhibors. The only drug that I hear mentioned routinely as being a good augmenter to Remeron is Effexor.
>
> If you experienced even a partial response to Effexor, I would consider combining it with Wellbutrin first and then add Abilify to that if necessary. Of course, there is the "California Rocket Fuel" strategy of combining Remeron with Effexor. As appealing as the name of this treatment is, I don't see people using it. I favor SNRI + Wellbutrin + Abilify if monotherapy has been ineffective. If bipolar depression is suspected, you can try using Lamictal in place of, or in addition to, the SNRI.
>
>
> - Scott
>
how does lamictal work?
My thought process was abilify to increase dopamine.
Wellbutrin for norheprine
and remeron for anxiety (since it blocks a lot of serotonin receptors and has an effect on the amygdala I belive I have an overactive amygdala with overactive serotonin receptors and because many ppl say remeron helps with anxiety)
Posted by beckett2 on October 6, 2017, at 16:43:30
In reply to Re: Wellbutrin , Abilify or Remeron?, posted by farshad on October 6, 2017, at 5:29:40
Guanfacine (or Tenex) can be helpful for anxiety. You might take a look at that as an adjunct. Maybe ask your doctor.
Posted by farshad on October 7, 2017, at 6:06:57
In reply to Re: Wellbutrin , Abilify or Remeron? » farshad, posted by beckett2 on October 6, 2017, at 16:43:30
> Guanfacine (or Tenex) can be helpful for anxiety. You might take a look at that as an adjunct. Maybe ask your doctor.
yeah always wanted to try Guanfacine . I have ordered something else called memantine it too is good for anxiety and I think its similar to guanfacine not sure.
Posted by linkadge on October 7, 2017, at 11:11:46
In reply to Re: Wellbutrin , Abilify or Remeron?, posted by farshad on October 6, 2017, at 5:29:40
>My thought process was abilify to increase >dopamine. Wellbutrin for norheprine
>and remeron for anxiety (since it blocks a lot of >serotonin receptors and has an effect on the >amygdala I belive I have an overactive amygdala >with overactive serotonin receptors and because >many ppl say remeron helps with anxiety)In my long experiences with many psychiatric meds, this type of logical reasoning rarely translates / correlates with clinical response.
Also, starting with 3 meds at once is overkill and you're not going to be able to distinguish one effect / side effect from the other.
Linkadge
Posted by linkadge on October 7, 2017, at 11:14:42
In reply to Re: Wellbutrin , Abilify or Remeron?, posted by farshad on October 7, 2017, at 6:06:57
Guanfacine and memantine have different mechanisms.
Guanfacine is mostly to lower adrenaline release (which can reduce anxiety). Memantine is a NMDA antagonist which modulates glutamate release. It can have antidepressant / antianxiety effects.
Guanfacine would likely do little / nothing for depression. Its actions are actually opposite to some antidepressants like mirtazapine (which enhances norepinephrine release via opposite activity at the same receptor).
Linkadge
Posted by farshad on October 7, 2017, at 11:15:02
In reply to Re: Wellbutrin , Abilify or Remeron?, posted by linkadge on October 7, 2017, at 11:11:46
> >My thought process was abilify to increase >dopamine. Wellbutrin for norheprine
> >and remeron for anxiety (since it blocks a lot of >serotonin receptors and has an effect on the >amygdala I belive I have an overactive amygdala >with overactive serotonin receptors and because >many ppl say remeron helps with anxiety)
>
> In my long experiences with many psychiatric meds, this type of logical reasoning rarely translates / correlates with clinical response.
>
> Also, starting with 3 meds at once is overkill and you're not going to be able to distinguish one effect / side effect from the other.
>
> Linkadgealright u already made ur point in the first post. I was gonna take 1 med at a time anyway.
Posted by farshad on October 7, 2017, at 11:16:56
In reply to Re: Wellbutrin , Abilify or Remeron?, posted by linkadge on October 7, 2017, at 11:14:42
> Guanfacine and memantine have different mechanisms.
>
> Guanfacine is mostly to lower adrenaline release (which can reduce anxiety). Memantine is a NMDA antagonist which modulates glutamate release. It can have antidepressant / antianxiety effects.
>
> Guanfacine would likely do little / nothing for depression. Its actions are actually opposite to some antidepressants like mirtazapine (which enhances norepinephrine release via opposite activity at the same receptor).
>
> Linkadge
>
>
both guanfacine and memantine decrease amygdala acitivity.
Posted by linkadge on October 7, 2017, at 15:13:16
In reply to Re: Wellbutrin , Abilify or Remeron?, posted by farshad on October 7, 2017, at 11:16:56
Do you have a reference for memantine decreasing amygdala activity? I can only find secondary references.
Also, decreasing amygdala activity isn't always good.
The amygdala is not just responsible for fear, it is responsible for fear learning / processing, and ultimately fear adaptation & extinction.
For example, I just read a study on how administering cortisol (the stress hormone, which increases amygdala activity) after a traumatic event, can actually prevent the incidence of PDSD.
Linkadge
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