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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Lamdage22 on May 9, 2016, at 7:18:41
So Venlafaxine is partially effective for me. Is this to be explained solely by Serotonin/Noradrenalin reuptake inhibition or does Venlafaxin have any other actions?
Posted by SLS on May 9, 2016, at 8:02:32
In reply to Venlafaxin mode of action?, posted by Lamdage22 on May 9, 2016, at 7:18:41
> So Venlafaxine is partially effective for me. Is this to be explained solely by Serotonin/Noradrenalin reuptake inhibition or does Venlafaxin have any other actions?
While in development, it was claimed that venlafaxine (Effexor) produced significant dopamine reuptake inhibition. It was even first touted as being the non-MAOI MAOI. If it does do this at all, it would occur at higher dosages.
Venlafaxine may have additional pharmacological properties that I am unaware of - or even that researchers are unaware of. Sometimes you have to ignore the theory and pay more attention to the clinical properties. When first approved, venlafaxine was not to be prescribed at dosages above 225 mg/day. However, clinical practice indicated that this was too low, and the maximum recommended dosage was changed to 375 mg/day. Perhaps it is necessary to go higher than 225 mg/day in order for venlafaxine to exert a significant amount of dopamine reuptake inhibition.
To answer your question, I don't know what is the mode of action of venlafaxine to treat depression. I'm not sure that scientists are ready to declare with certainty an understanding of how venlafaxine works.
- Scott
Posted by Lamdage22 on May 9, 2016, at 8:04:12
In reply to Re: Venlafaxin mode of action?, posted by SLS on May 9, 2016, at 8:02:32
Thats what i thought. I just wonder wether or not i can replace Venla with Viibryd.
High dosages of Venla make me paranoid and i assume that Viibryd has the potential to do that as well.
Posted by Lamdage22 on May 9, 2016, at 8:07:36
In reply to Re: Venlafaxin mode of action?, posted by Lamdage22 on May 9, 2016, at 8:04:12
How long should i stay on 10mg of Viibryd until i can say for certain wether or not this dosage works and wether or not this dosage makes me paranoid? (The max is 40mg).
I want to be sure how 10mg affects me before i switch to 20mg.
THX
Posted by J Kelly on May 9, 2016, at 15:49:43
In reply to Viibryd, posted by Lamdage22 on May 9, 2016, at 8:07:36
> How long should i stay on 10mg of Viibryd until i can say for certain wether or not this dosage works and wether or not this dosage makes me paranoid? (The max is 40mg).
>
> I want to be sure how 10mg affects me before i switch to 20mg.
>
> THXhttp://reference.medscape.com/drug/viibryd-vilazodone-999620
Ultimately shouldn't your dose adjustments be based on any paranoia you feel? Good luck!
Jade
Posted by TriedEveryMedication on May 9, 2016, at 19:02:21
In reply to Venlafaxin mode of action?, posted by Lamdage22 on May 9, 2016, at 7:18:41
> So Venlafaxine is partially effective for me. Is this to be explained solely by Serotonin/Noradrenalin reuptake inhibition or does Venlafaxin have any other actions?
according to the binding affinity database, Venlafaxine only has notable binding affinities for SERT and NET.
here are the Ki values of 1000 and lower
Posted by SLS on May 9, 2016, at 20:07:42
In reply to Re: Venlafaxin mode of action?, posted by SLS on May 9, 2016, at 8:02:32
> > So Venlafaxine is partially effective for me. Is this to be explained solely by Serotonin/Noradrenalin reuptake inhibition or does Venlafaxin have any other actions?
> While in development, it was claimed that venlafaxine (Effexor) produced significant dopamine reuptake inhibition. It was even first touted as being the non-MAOI MAOI. If it does do this at all, it would occur at higher dosages.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802382/
I have also seen it proposed that venlafaxine-induced psychosis is due to serotonergic overexcitement.
For the moment, let us say that Stephen Stahl is right about venlafaxine being a DA reuptake inhibitor at higher dosages. Perhaps duloxetine would be a better drug for you.
Which SSRIs have produced psychosis in you?
Zoloft?
Celexa / Lexapro?
Luvox?- Scott
Posted by Lamdage22 on May 10, 2016, at 3:37:04
In reply to Re: Venlafaxin mode of action?, posted by SLS on May 9, 2016, at 20:07:42
> I have also seen it proposed that venlafaxine-induced psychosis is due to serotonergic overexcitement.
>
> For the moment, let us say that Stephen Stahl is right about venlafaxine being a DA reuptake inhibitor at higher dosages. Perhaps duloxetine would be a better drug for you.I have tried duloxetine. No psychosis, no effect.
>
> Which SSRIs have produced psychosis in you?
>
> Zoloft?
> Celexa / Lexapro?
> Luvox?Zoloft produced bad akathisia. I didnt get to a very high dosage because of that. However it worked very well for depression.
I never tried lexapro or luvox. However i am currently trialing Viibryd. No side effects at all.
Posted by SLS on May 10, 2016, at 5:50:58
In reply to Re: Venlafaxin mode of action?, posted by Lamdage22 on May 10, 2016, at 3:37:04
Hi Lamdage.
I wonder if you wouldn't mind making a list of the drugs that produced psychosis. Maybe we can find a common denominator.
By the way, Luvox is supposed to be the SSRI that is least liable to produce akathisia; Zoloft being the most liable.
I'm glad that Viibryd hasn't caused any untoward psychiatric side effects for you.
- Scott
Posted by Lamdage22 on May 10, 2016, at 6:38:20
In reply to Re: Venlafaxin mode of action?, posted by SLS on May 10, 2016, at 5:50:58
Nardil Parnate Moclobemide and Venlafaxin at medium to high dosage. Also st johns wort even at low dosage.
Posted by linkadge on May 13, 2016, at 19:37:45
In reply to Re: Venlafaxin mode of action?, posted by Lamdage22 on May 10, 2016, at 6:38:20
Venlafaxine does have some effect on opioid receptors.
Also, it can be more stimulating than its pharmacology would dictate.
There have been some studies that suggest it works in vivo differently than in vitro (i.e. stronger binding to the norepinephrine transporter) and possibly a stronger binding to NET in depressed patients.
It is chemically related to certain amphetamine derivatives like MDMA.
I would not at all be surprised if there are not alternative actions of venlafaxine that have not been fully determined.
For instance, it tends to supress appetite more than SSRIs.
Linkadge
Posted by TriedEveryMedication on June 4, 2016, at 11:32:21
In reply to Venlafaxin mode of action?, posted by Lamdage22 on May 9, 2016, at 7:18:41
> So Venlafaxine is partially effective for me. Is this to be explained solely by Serotonin/Noradrenalin reuptake inhibition or does Venlafaxin have any other actions?
venlaxfaxine has strong SERT binding affinity, weaker NET binding affinity, and then very weak affinities for a whole ton of other things.
(note that with Ki values, the lower the number the stronger the affinity)
here is a list of binding affinities discovered. I limited it to Ki of 2000:
This is the end of the thread.
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