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Dr. Bob is Robert Hsiung, MD,
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Posted by Bill L on August 29, 2003, at 12:07:07
Selective serotonin reuptake inhibitors combined with venlafaxine in depressed patients who had partial response to venlafaxine: four cases.
Gonul AS, Akdeniz F, Donat O, Vahip S.
Affective Disorders Unit, Department of Psychiatry, Ege University, School of Medicine, 35100, Izmir, Turkey
One third of depressive patients show partial or no response to antidepressant treatment. With partial or nonresponders, treatment strategies are as follows: switching to another antidepressant, augmenting with other psychotropic agents, or combining antidepressants. There are no data in the literature about the positive effect of combining venlafaxine with selective serotonin reuptake inhibitors (SSRIs). In this report, the presented cases had been on at least two different classes of antidepressant medication (or combination of antidepressants) for an adequate time and dose. They showed only a partial response to high dose of venlafaxine but improved after the addition of an SSRI (sertraline, citalopram, or paroxetine) to venlafaxine. The combination treatment was well tolerated in all of the cases.
PMID: 12921926 [PubMed - in process]
Posted by linkadge on August 29, 2003, at 15:00:56
In reply to Need some SSRI with your Effexor?, posted by Bill L on August 29, 2003, at 12:07:07
I think the problem is that we don't have the correct combination of serotonin and norepineprine in our antidepressants.
Even though Effexor has somewhat lesser effects on Serotonin than on norepinephrine, I still beleive its norephiniephrine effect is too strong. Many find it too stimulating, thats why they switch to a SSRI.
But SSRI's on the other hand can sometimes cause apathy because of norephinephrine downregulation.
This is perhaps why a combination of the two has proved to be so useful. Because you can boost the serotonin effect and still retain some norepinephrine effect.
Linkadge
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