Posted by sowhysosad on April 24, 2009, at 22:06:05
In reply to Re: Remeron's now put my friend off meds for life., posted by metric on April 24, 2009, at 21:03:16
> Why is phenelzine preferred over tranylcypromine (Parnate in the U.S.)? I think the latter is more effective and with fewer side-effects. It is, however, more prone to dangerous (but still rare) hypertensive events. My guess is that's the reason for the preference of phenelzine.
I wondered that myself, given that phenelzine is hepatoxic and more likely to cause weight gain. I came to the same conclusion as you.
> > With SSRI's all being very different, there was a good chance that citalopram or sertraline would have worked where fluoxetine failed. But for some reason he decided to start her off on Cymbalta.
> >
>
> I disagree. I've taken them all (including venlafaxine and duloxetine) and none of them work. They all have horrible side-effects.
>
> Well, in defense of the psychiatrist (words you'll seldom hear from me), it's not like he had any effective alternatives to work with -- at least none that wouldn't jeopardize his license, if the UK is anything like the U.S.I still maintain another SSRI might have been worth a try. She wasn't very compliant when taking fluoxetine, and perhaps she might have an issue with 2D6 metabolism that interfered with its action. Plus fluoxetine also boosts dopamine and noradrenaline in some parts of the brain which she may not have tolerated. Why did he not try sertraline or citalopram for example? Or even an MAOI?
poster:sowhysosad
thread:891271
URL: http://www.dr-bob.org/babble/20090416/msgs/892653.html