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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by James Donivan Justice II on January 5, 2001, at 16:21:59
Has anyone used all these drugs together or know if there are any contraindications involved when all are at high dosages?
Thanks for your response.
Posted by JohnL on January 6, 2001, at 5:36:17
In reply to Wellbutrin, Effexor XR, Remeron Combo?, posted by James Donivan Justice II on January 5, 2001, at 16:21:59
> Has anyone used all these drugs together or know if there are any contraindications involved when all are at high dosages?
>
> Thanks for your response.They can go fine together. The thing to watch out for though is the seizure risk of Wellbutrin. The risk is really overstated most of the time, but it will be increased with drug combinations. Just something to be aware of.
All three of these drugs however assume that neurotransmitter levels are inadequate. That may or may not be the real cause of your symptoms. If these drugs don't work completely, then the problem is something else other than low neuro levels. It would then be warranted to forget antidepressants and instead look at stimulants, antipsychotics, benzos, or mood stabilizers. The combination of drugs you asked about is big-guns, but like I said, it assumes that the problem is related to low neurotransmitter levels. If your symptoms are not caused by low neuro levels, then you could combine all the antidepressants you want and continually be disappointed with the results.
John
Posted by stjames on January 9, 2001, at 19:31:38
In reply to Wellbutrin, Effexor XR, Remeron Combo?, posted by James Donivan Justice II on January 5, 2001, at 16:21:59
Seritonin syndrome comes to mind. Polydrug augmentation means levels are often exponantally
larger and rapid spikes in levels can occur. The
info on SS is scetchy but it does happen when just on SSRI is taken. I'm not saying don't take this combo but just know the signs of SS. SS can have significant morbidity.Having read other posts of yours I would like to know if any SSRI's or other seritonin agents do anything. Seems you respond to noradergeneric AD's, only. If this is the case Effexor + Remeron or the new SNRI, Endronax (sp?) with or without another agent might be an option.
james
Posted by Andre Allard on January 10, 2001, at 13:32:16
In reply to Wellbutrin, Effexor XR, Remeron Combo?, posted by James Donivan Justice II on January 5, 2001, at 16:21:59
I do not think wellbutrin would be of any benefit since it will work on neurotransmitters that are already being stimulated by the remeron and effexor.
With this trio noradrenergic systems are being stimulated 3 times. I know that pdoc do not like to concurrently use 2 ADs that work on the same neurotransmitter let alone 3.
If max dosages of effexor and remeron are not doing the job you should be looking into other classes of meds.
Good luck!
This is the end of the thread.
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