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Dr. Bob is Robert Hsiung, MD,
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Posted by nancy on August 9, 1998, at 14:04:32
My husband has been on Effexor (now at 450mg) since 7/9. His psychiatrist upped his synthroid last week by 50%-no effect so far. He has suggested that the addition of Ritalin may help.
I have read that the combination of Effexor and bupropion may have a broader antidepressent effect because all three amine systems are affected. (Serotonin and noradrenergic reuptake inhibition - Effexor and dopaminergic effects for the bupropion.) This interests me because the effect of these two is compared to an MAOI and Marplan has been the only drug that worked.My question: do the odds favor the addition of Ritalin or bupropion or simply increase the Effexor more?
Anyone with experience with this stuff?
Posted by Toby on August 13, 1998, at 16:09:03
In reply to advice/help, posted by nancy on August 9, 1998, at 14:04:32
The Effexor probably should not be increased any further due to the risk of hypertension at high doses.
Synthroid doesn't tend to work as well as an augmentor of antidepressant as Cytomel does. On the other hand, thyroid medications don't tend to work as well in men as in women.
Ritalin is a pretty good choice, but keep in mind the hypertensive risk and just monitor his blood pressure pretty closely.
Adding Wellbutrin is a really good choice, provided he has no history of seizures.
Some other augmentation strategies that work well include: Serzone plus Wellbutrin; adding Remeron to just about any antidepressant; adding Buspar; adding Pindolol (if it's going to work you see results in less than 7 days).
Unfortunately, there is no way to "lay odds" on which one will work. Science just hasn't found a way to determine just which receptor isn't getting properly stimulated. So it's done by chance, but it's less complicated to start with the medications that last in the system the shortest amount of time so that if it doesn't work, you don't have to wait long for it to clear out of the system before trying something else.
Posted by Mary K on May 10, 1999, at 11:35:17
In reply to Re: advice/help, posted by Toby on August 13, 1998, at 16:09:03
> I would appreciate some feedback.
I am 49yr.old female, l mo. on Zoloft &
still feeling some lower tones & wondering if
the sadness & hopelessness will lift.Has anyone taken Zoloft & then started Effexor
how do you switch & was it successful for you
plse. contact me soon as I go to dr. tomorrow
May 11/99.May email is: marykauf@hotmail.com
Thks. mary k canada
This is the end of the thread.
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