Posted by SLS on November 7, 2000, at 21:28:18
In reply to Re:ATTENTION ANERGIC DEPRESSION SUFFERERS, posted by Anna P. on November 7, 2000, at 19:57:22
Hi again.
> Scott, I had chosen Viloxazine because of lack of choices.
Also, I was inspired by new book by Dr Stahl.> So I was looking for alternatives. Please pay attention that Viloxazine doesn't work by itself, only with Neurontin.
How did you discover that Neurontin was necessary? Was it through personal experience or did you read it in Dr. Stahl's book?
> I was also thinking about combining Viloxazine-Serzone or Reboxetine-Serzone. What do you think about those combos?
They seem like safe enough combinations to me. They are certainly complementary since they target different transmitter systems. You know, I don't think I remember reading of anyone combining Serzone with a potent NRI (tricyclics, reboxetine, maprotiline). I would like to know more about it. I brought up to my doctor the possibility of adding Serzone to the Parnate I am currently taking. However, I really don't like what I am feeling and not feeling on Parnate. I don't think there is enough there to work with. I would rather be on Nardil at this point.
> Dr Stahl in his last book "Psychopharmacology of depression and bipolar disorders" advises trying NDRI + NRI, such as Wellbutrin and Reboxetine. He calls it as double boosting of NE. He says some of the combos have synergistic action on the same monoamine neurotransmitter system. In a case of Bupropion and Reboxetine, NE actions of Bupropion are double-boosted by Reboxetine (also desipramine, maprotiline, nortriptiline or protriptiline).
Thank you for citing Dr. Stahl's book.
Not that I'm recommending it, but some have used yohimbine, a NE alpha-2 antagonist to boost the effects of tricyclics. Mirtazapine (Remeron) is also a NE alpha-2 antagonist (along with its ability to block 5-HT2 and 5-HT3 receptors). Blockade of the NE alpha-2 receptor leads to an increase in the synthesis and release of norepinephrine. The idea is that this works synergistically with the NE reuptake inhibition of the NRIs.
> Stahl says,(page 152)that boosting noradregenic neurotransmission may be useful in people with fatigue, apathy and cogniive slowing.
>
> Now, I thought Viloxazine is NDRI, just like Wellbutrin.No. I double checked Medline again, and there are no references to viloxazine other than its ability to selectively and fairly potently inhibit the reuptake of norepinephrine. Whatever you are doing, you are on the right track. Sometimes, one must forego the idea that they can choose drugs with precision based upon the *known* putative mechanisms of action they possess.
> Scott, what happens when combining two ADs working on nonadreline system only? (Viloxazine and Reboxetine)
> Is this not safe?I have no reason to believe that they aren't safe. My only concern would be to monitor for changes in cardiac function. Reboxetine alone can produce tachycardia (increased heart rate) and rhythym irregularities. Viloxazine is supposed to be less apt to evoke cardiac irregulators, but is not without effect.
I doubt cardiac function will be an issue to the same extent it would be if your were using a tricyclic. It might be worth getting an EKG at some point.
I wish you continued success.
- Scott
poster:SLS
thread:48258
URL: http://www.dr-bob.org/babble/20001102/msgs/48412.html