Posted by jrbecker76 on August 16, 2007, at 11:41:34
In reply to Re: Cymbalta vs Effexor-jrbecker76, posted by jhj on August 16, 2007, at 5:46:47
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> Hi
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> I have tried venlafaxine for three years for my depression,GAD & social phobia.I have been on 300 mg dose for quite some time.But,i have not felt any better in addition to side effect like stomach discomfort.Do you thing i should give duloxetine a try despite the failure of Venlafaxine despite the same mechanism of action? By the way,are you the same jrbecker76 who gives list of upcoming list on neurotransmitter.net? if yes,i would like to know which drugs of depression and anxiety are likely heat market by 2008 end? Thanks.
Yes, even though nausea might be an issue at start-up as well as higher doses, I think it's worth a shot to find out the cost-benefit ratio. I recall reading a study that compared Effexor to Cymbalta's side effects, and that Cymbalta rated slightly higher for nausea issues. However, hopefully, you can find an effective dosage window where this isn't a problem.Subjectively speaking, I'm not a good candidate to evaluate the typical side effects seen at standard dosage levels since I'm a med-sensitive individual. But back in the time when I was still taking higher doses of Effexor, I also recall nausea issues being a problem. I've had no such problems on Cymbalta. But once again, I'm not a typical case to be measured by.
The transition from Effexor to Cymbalta is not really a rough one in terms of the need for cross-titration. You could always give Cymbalta a try for 2-3 wks. If it's not working, you can re-initiate Effexor with very little cross-tolerance issues.
As for new drugs on the horizon... it's tough to prognosticate there. The FDA makes it harder than Vegas to bet on outcomes. However, we are likely to see drugs like Gepirone (a 5-HT1a partial agonist) be possibly approved by end of '07; Pristiq (a metabolite of Effexor, that like Cymbalta, has a slightly more noradrenergic-to-serotonergic balance) will probably be launched in early '08. Possible other candidates are Amibegron (a purely adrenergic [beta-3] drug) might have a chance of approval in late 08/09. More further down the line in '09 are be saredutant, a neurokin-2 antagonist and agomelatine a 5-HT2c antagonist/melatoninergic agonist. These drugs aren't exactly the next big leap in ADs, however, most of them are attractive because they represent newer classes of drugs and/or have more pin-pointed mechanisms of action (thus, perhaps heightening efficacy while limiting side effects). So, yes, some hopeful things on the horizon.
JB
poster:jrbecker76
thread:442711
URL: http://www.dr-bob.org/babble/20070815/msgs/776614.html