Posted by Ritch on March 4, 2003, at 23:02:16
In reply to Scott, Ritch--Questions, posted by Jack Smith on March 4, 2003, at 16:37:07
> > I think Mitch (Ritch) has focused on an important point - you ARE responsive to SSRIs. Effexor (venlafaxine) is sort of a like a combination of SSRI + TCA. That you are resonsive to SSRIs leads me to believe that Effexor has a pretty good chance of working without poop-out (tachyphylaxis). A recent study of over 2000 patients demonstrated that Effexor has a somewhat higher rate of producing an antidepressant response than SSRIs, and has a much lower rate of pooping-out than SSRIs (probably similar to TCA).
> >
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> Scott, Ritch (Mitch?) or others,
>
> I tend to agree with you guys that Effexor is probably the better alternative at this stage in the game. BUT do you guys think that the fact that an ssri worked and then pooped out means that other ssri's won't work (granted Effexor is an snri as well as an ssri) or do you think it means that another ssri has a better chance of working since I have previously responded well to one? I know that everyone is different but what are your thoughts/opinions? By the way, Mitch, the reason why I am not thinking of prozac is that its half life is too long so if I did switch to an MAOI, I'd probably have to wait quite a while.
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> Thanks in advance,
>
> JACKGiven that you don't want to wait a long time for a med washout it tends to tilt things to the short acting meds like Effexor for a trial. I felt the most alertness from Prozac and Celexa (out of the heavy serotonergic meds). Zoloft, Paxil, Luvox, and even Effexor tends to tire me quite a bit (at the low-doses I can tolerate). I just mentioned Prozac because it seems to be a different animal from the other SSRI's and there seems to be a significant alerting effect the others don't seem to have (it's the ONLY SRI that actually helps my ADD sx). It was my favorite-but it was just so harsh on my gut (but it isn't the only one). If you can tolerate fairly high doses of serotonergic AD's Effexor might be the best bet for you right now.----Mitch
poster:Ritch
thread:205524
URL: http://www.dr-bob.org/babble/20030301/msgs/206004.html