Posted by ed_uk on January 9, 2005, at 11:07:41
In reply to Re: Reboxetine?/day2, posted by borderliner on January 8, 2005, at 22:54:10
Hi Mr. B!
It sounds like you're doing well!
>Perhaps u know, if i was to 'taper on' to the perscribed dose, just to check out and see how it feels, how many days would u recommend between each step up? Im on 4mg a day and am perscribed 8mg. the only dose available in between is 6mg and that would mean quartering tablets.
How quickly you decide to step up depends on what you are trying to acheive....
1) From a safety point of view it would probably be ok to go up to the prescribed dose now, most people initiate treatment with 8mg/day in two divided doses.
2) If you want to find out whether your current dose will be adequate you'll need to wait at least four weeks before considering whether you actually need a dose increase or not.
3) If you want to be sure that you can tolerate the side effects of your current dose before you increase, I'd suggest waiting a few more days. With reboxetine, most side effects seem to appear quickly- within the first week or so.
>Im on 4mg a day and am perscribed 8mg. the only dose available in between is 6mg and that would mean quartering tablets.
You could always buy a tablet cutter from a pharmacy. I expect that it would be fine to take 2mg three times a day, rather that 3mg twice daily, if that was more convenient for you.
>Negative Effects - slight constipation, pain after ejaculation and an un motivated 'member' so to speak he has become very lazy and contricted.
You could treat the painful ejac with tamsulosin (Flomax) if it becomes a problem. Flomax has side effects of its own though eg. fatigue.
Here is a list of reboxetine side effects, you may already have been given this list by the pharmacy.........Common adverse events causing withdrawal at least twice as often on reboxetine than placebo include insomnia, dizziness, dry mouth, nausea, sweating, sensation of incomplete bladder emptying (males only), urinary hesitancy (males only) and headache.
The information below refers to short-term controlled studies. Very common or common adverse events that are at least two times higher on reboxetine than placebo are listed below.
[Very common ( 1/10, Common ( 1/100, < 1/10)]
Nervous system disorders:Very common: insomnia, Common: vertigo
Cardiac disorders:
Common: tachycardia, palpitation, vasodilation, postural hypotension
Eye disorders:
Common: abnormality of accommodation
Gastrointestinal disorders:
Very common: dry mouth, constipation
Common: lack or loss of appetite
Skin and subcutaneous disorders:
Very common: sweating
Renal and urinary disorders:
Common: urinary hesitancy, sensation of incomplete bladder emptying, urinary tract infection
Reproductive system and breast disorders:
Common: erectile dysfunction (males only), ejaculatory pain (males only), ejaculatory delay (males only), testicular disorder-primarily pain (males only)
General disorders and administrative site conditions:
Common: chills
In addition there have been spontaneous reports of aggressive behaviour, cold extremities, nausea, vomiting and allergic dermatitis/rash.
As for long-term tolerability, 143 reboxetine-treated and 140 placebo-treated adult patients participated in a long term placebo controlled study. Adverse events newly emerged on long term treatment in 28% of the reboxetine treated patients and 23% of the placebo-treated patients and caused discontinuation in 4% and 1% of the cases respectively. There was a similar risk of the development of individual events with reboxetine and placebo. In the long term studies, no individual events were seen which have not been seen on short term treatment.
In short-term controlled studies of patients with depression, no clinically significant between-gender differences were noted in the frequency of treatment emergent symptoms, with the exception of urologic events (such as the sensation of incomplete bladder emptying, urinary hesitancy and urinary frequency), which were reported in a higher percentage of reboxetine-treated male patients (31.4% [143/456]) than reboxetine-treated female patients (7.0% [59/847]). In contrast, the frequency of urologic-related events was similar among male (5.0% [15/302]) and female (8.4% [37/440]) placebo-treated patients.
In the elderly population, frequency of total adverse events, as well as of individual events, was no higher than that reported above.
Signs and symptoms newly reported on abrupt discontinuation were infrequent and less frequent in patients treated with reboxetine (4%) than in those treated with placebo (6%).
In those short-term studies in depression where heart rate was assessed with ECG, reboxetine was associated with mean increases in heart rate, compared to placebo, of 6 to 12 beats per minute.
In all short-term controlled studies in depression, the mean change in pulse (in beats per minute) for reboxetine-treated patients was 3.0, 6.4 and 2.9 in the standing, sitting and supine positions respectively, compared with 0, 0, and –0.5 for placebo-treated patients in the corresponding positions. In these same studies, 0.8% of reboxetine-treated patients discontinued the drug because of tachycardia compared with 0.1% of placebo-treated patients.
Ed.
PS. What country do you live in?
poster:ed_uk
thread:438440
URL: http://www.dr-bob.org/babble/20050108/msgs/439717.html