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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 Anna Laura on January 17, 2002, at 1:42:11
I started Effexor last Summer (end of July).
Took a long time to kick in (a couple of months).
It got better so slowly that i didn't realized my mood improved. After four months on Effexor, i had to admit it did affect my motivation and negative thinking. My self confidence improved also.
Effexor didn't affect my anhedonia though, which is my "target symptom". I decided to discuss the subject with a pdoc : we both thought to give Parnate a try.
I started tapering Effexor the first week of December and i went down to 75 mg. in about ten days. As i reached 75 mg. dose, i grew worse but I held on, being confident Parnate was going to help me with anhedonia.
I was about to drop my 75 mg. dose when i found out the Parnate version in my country is not a pure compound, being mixed with an antypsicotic. There is no way you can find pure Tranycylpromine here, and i can't tolerate antypsycotic since they make my depression worse (possibly by blocking dopamine receptors).
So i decided to go back on 300 mg.: i slowly raised the dose and i was back on full dose a couple of days before Christmas.
The problem is that i'm still demotivated, kind of anxious, my sleep is lousy , my mood is not so bright anymore, i have ups and downs, pms is awful.
My question is: how long does it take for Effexor to wash out from your system?
I know it does have a very short half life. Is there a possibility that Effexor levels in my system got abruptely low as i tritated the dose down to 75 mg.? I almost felt like i was totally "uncovered" after a few days on 75 mg. dose. Does that mean i had to "start all over again" as i went back on my previous effexor dose? May be it washed out of my system almost completelly so that my body wasn't able to "catch up " effexor left overs in my blood.
Do i need to wait for Effexor to kick in a second time around because of that?
Hope i made myself understood. I can't think very clearly right now.
Posted by TSA West on January 17, 2002, at 23:40:36
In reply to Back on Effexor : need to kick in again?, posted by Anna Laura on January 17, 2002, at 1:42:11
-----------------TSA West------------------ :)
I'd give it one week to start being effective again at the 300 mg dose. Dose-response in Effexor is linear-- higher doses mean better efficacy in depression, anxiety, and anhedonia.
The antipsychotic in the Parnate could only help, not hurt: (http://www.dr-bob.org/tips/split/Antidep-effects-of-antipsy.html); Parnate is effective for a lot of people purely because it is related to a stimulant and produces refreshingly vigilant effects.
If not Parnate, look into moclobemide for a decent serotonergic/noradrenergic/dopaminergic medication with a benign side-effect profile(http://www.dr-bob.org/tips/split/Experience-with-moclobemid.html)
Posted by Anna Laura on January 18, 2002, at 1:37:33
In reply to 1 week » Anna Laura, posted by TSA West on January 17, 2002, at 23:40:36
> -----------------TSA West------------------ :)
>
> I'd give it one week to start being effective again at the 300 mg dose. Dose-response in Effexor is linear-- higher doses mean better efficacy in depression, anxiety, and anhedonia.
>
> The antipsychotic in the Parnate could only help, not hurt: (http://www.dr-bob.org/tips/split/Antidep-effects-of-antipsy.html); Parnate is effective for a lot of people purely because it is related to a stimulant and produces refreshingly vigilant effects.
>
> If not Parnate, look into moclobemide for a decent serotonergic/noradrenergic/dopaminergic medication with a benign side-effect profile(http://www.dr-bob.org/tips/split/Experience-with-moclobemid.html)West,
Thanks for answering . I appreciated it.
I have to disagree on the antypsychotic issue though; I've been tried four types of AP so far, atypical ones included (levosulpiride) and they
made my depression worse. I've been searching for a scientific explanation for this and i found a research study which showed that a class of depressed people with dopamine related depression with severe drop in the dopamine firing neurons are not going to benefit from AP even at low doses.
Moreover, women are more susceptible to APs, since they increase prolactin, an hormone involved in the neuroendocrine pathway, whose disregulation can cause depression in a class of people.
I wanted to ask you a question about Moclobemide: is it a more potent dopamine reuptake inhibitor compared to venlafaxine?Thanks again
Anna Laura
Posted by TSA West on January 22, 2002, at 23:47:49
In reply to Re: 1 week. APs are no panacea, posted by Anna Laura on January 18, 2002, at 1:37:33
Moclobemide and venlafaxine are weak inhibitors of the reuptake of dopamine even at the maximum doses. They are probably greater inhibitors of dopamine reuptake at higher than the legal limits of quantities that can be prescribed.
I wonder if you have tried Ziprasidone, the atypical neuroleptic that is also a dual reuptake inhibitor of norepinephrine and serotonin like venlafaxine.
Living life not as a dress rehearsal,
TSA West
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