Posted by Reggie BoStar on January 15, 2009, at 19:17:48
In reply to Duloxetine ineffective?, posted by Pete1968 on January 15, 2009, at 17:29:26
I was put on Effexor (Duloxetine) for a while about 4 or 5 years ago, and it didn't really do much of anything for me - nothing I was aware of, at any rate. I was pretty sick with a lot of migraines, increased depression, constant sleeping, and various other problems. If the Effexor did something for me, I didn't notice it with all those other things going on.
Anyway, I was put on other things for some time and nothing really worked. Finally I was put on Cymbalta (Venlafaxine) just about when it first came out and I've been on it since. It had been working better for me in terms of depression until last Fall. Then it started losing effectiveness. The first few times I tried any SSRIs, starting with Prozac, the same thing happened, only a lot faster. The drug would improve things somewhat for a while, then stop working.
Cymbalta has lasted the longest so far. Now I'm on a mix of Cymbalta (lower dose than before) and Pristiq. The first sentence for Pristiq on Wikipedia is "Desvenlafaxine succinate, marketed under the name Pristiq, is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class from Wyeth. It is a metabolite of venlafaxine (Effexor). Pristiq is also being targeted as the first non-hormonal based treatment for menopause."
I was told that Pristiq is similar to Effexor XR, i.e. a time-release formula, but is supposed to have fewer side effects. I looked up "metabolite" and Wiki says that it is an intermediate of metabolism. Thus it seems that Pristiq is something like Effexor after the body has partially metabolized it. Maybe that's the theory behind the fewer side effects; those may have been caused during the initial stages of metabolozing Effexor. Those stages are now gone, ergo...
I went into that litany about Pristiq because you're now having negative experiences with Effexor. Who knows, maybe the "metabolite" form, Pristiq, might work better for you.
Of course it's all up to you and your pdoc. I don't even play either one of you on TV, so I can't be called qualified in any respect.
Besides, I'm a bad spokesperson for Pristiq anyway. I've been on it for almost 8 weeks now and so far it's done nothing. On the other hand, that also means it hasn't done anything negative. For what it's worth, I'm at least tolerating it.
I was on Lexapro (Escitalopram) for a very short time. It worked like Prozac: some improvement for a month or two, then nothing.
So, in summary (as usual), in order of application:
Effexor (Duloxetine): no effect I know of, but I was very sick and couldn't tell.
Lexapro (Escitalopram): some improvement for a month or two, then nothing.
Cymbalta (Venlafaxine): some improvement for 2-3 years, now wearing off.
Pristiq (Desvenlafaxine succinate, metabolite of Effexor): ???? Nothing after 8 weeks (so far).
Current doses: Cymbalta 30mg/day, Pristiq 50mg/day.
BTW I was never bothered by gastro problems on any of the SSRIs or SNRIs. What always got me was that they turned me into a mental and physical eunuch. I also had some problems with urinary retention. Cymbalta was the worst offender in that respect.
It almost seems as though the ED effect of these drugs affects my urethra sphinctor as well, rendering it very unresponsive. Fortunately for me, the default state is "closed". As bad as being catheterized is, I'd rather deal with that than incontinence.
I hope you can figure out whether or not I answered your question, because I sure can't.
Pristiq (Desvenlafaxine succinate, metabolite of Effexor): Memory problems, confusion.
Best wishes,
Reggie BoStar
poster:Reggie BoStar
thread:874178
URL: http://www.dr-bob.org/babble/20090104/msgs/874200.html