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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 Teresa on January 28, 2000, at 0:34:35
I am having some trouble with all day effectiveness on 225 mg. of effexor xr. We have tried several augmentations but none have worked. When i was on Paxil my doc prescribed 5 mg of protriptyline. does anyone know how this same prescript might work with the effexor xr or have any other suggestions?
Posted by saint james on January 28, 2000, at 16:08:09
In reply to Re: Effexor XR and Protriptyline, posted by Teresa on January 28, 2000, at 10:18:09
> > I am having some trouble with all day effectiveness on 225 mg. of effexor xr. We have tried several augmentations but none have worked. When i was on Paxil my doc prescribed 5 mg of protriptyline. does anyone know how this same prescript might work with the effexor xr or have any other suggestions?
James here....
Effexor + TCA is a good idea.
j
Posted by Cam W. on January 28, 2000, at 18:21:48
In reply to Re: Effexor XR and Protriptyline, posted by saint james on January 28, 2000, at 16:08:09
> > > I am having some trouble with all day effectiveness on 225 mg. of effexor xr. We have tried several augmentations but none have worked. When i was on Paxil my doc prescribed 5 mg of protriptyline. does anyone know how this same prescript might work with the effexor xr or have any other suggestions?
>
> James here....
>
> Effexor + TCA is a good idea.
>
> jTeresa - Protripyline has norepineephrine reuptake blocking properties, as well as serotonin reuptake blocking properties, whereas Effexor mainly blocks only serotonin reuptake (it does not have significant norepinephrine reuptake blocking properties as is usually believed according to receptor binding studies). The TCAs, like protriptyline, with their dual action are considered by European psychiatrists to be better antidepressants than SSRIs, like Effexor, but TCAs have more pronounced side effects.
This said, by augmenting Effexor with Protriptyline may give enhanced antidepressant action without causing the increased TCA side effects, because the protriptyline dose can be kept lower than it would be if it was used alone (without Effexor). Give it a try, it may work. Good luck. - Cam W.
Posted by Cindy W on January 29, 2000, at 10:00:55
In reply to Re: Effexor XR and Protriptyline, posted by Cam W. on January 28, 2000, at 18:21:48
> > > > I am having some trouble with all day effectiveness on 225 mg. of effexor xr. We have tried several augmentations but none have worked. When i was on Paxil my doc prescribed 5 mg of protriptyline. does anyone know how this same prescript might work with the effexor xr or have any other suggestions?
> >
> > James here....
> >
> > Effexor + TCA is a good idea.
> >
> > j
>
> Teresa - Protripyline has norepineephrine reuptake blocking properties, as well as serotonin reuptake blocking properties, whereas Effexor mainly blocks only serotonin reuptake (it does not have significant norepinephrine reuptake blocking properties as is usually believed according to receptor binding studies). The TCAs, like protriptyline, with their dual action are considered by European psychiatrists to be better antidepressants than SSRIs, like Effexor, but TCAs have more pronounced side effects.
>
> This said, by augmenting Effexor with Protriptyline may give enhanced antidepressant action without causing the increased TCA side effects, because the protriptyline dose can be kept lower than it would be if it was used alone (without Effexor). Give it a try, it may work. Good luck. - Cam W.Cam, what do you think about combining Effexor-XR and Serzone? I am taking Effexor-XR 225 mg/day but it makes me feel edgy, and keeps me awake sometimes...I used to sleep very well on Serzone. What about adding a tiny dose of Serzone, say, 30-40 mg/day, up to l50?--Cindy W
Posted by Cam W. on January 29, 2000, at 11:17:10
In reply to Re: Effexor XR and Serzone?, posted by Cindy W on January 29, 2000, at 10:00:55
> > > > > I am having some trouble with all day effectiveness on 225 mg. of effexor xr. We have tried several augmentations but none have worked. When i was on Paxil my doc prescribed 5 mg of protriptyline. does anyone know how this same prescript might work with the effexor xr or have any other suggestions?
> > >
> > > James here....
> > >
> > > Effexor + TCA is a good idea.
> > >
> > > j
> >
> > Teresa - Protripyline has norepineephrine reuptake blocking properties, as well as serotonin reuptake blocking properties, whereas Effexor mainly blocks only serotonin reuptake (it does not have significant norepinephrine reuptake blocking properties as is usually believed according to receptor binding studies). The TCAs, like protriptyline, with their dual action are considered by European psychiatrists to be better antidepressants than SSRIs, like Effexor, but TCAs have more pronounced side effects.
> >
> > This said, by augmenting Effexor with Protriptyline may give enhanced antidepressant action without causing the increased TCA side effects, because the protriptyline dose can be kept lower than it would be if it was used alone (without Effexor). Give it a try, it may work. Good luck. - Cam W.
>
> Cam, what do you think about combining Effexor-XR and Serzone? I am taking Effexor-XR 225 mg/day but it makes me feel edgy, and keeps me awake sometimes...I used to sleep very well on Serzone. What about adding a tiny dose of Serzone, say, 30-40 mg/day, up to l50?--Cindy WCindy - I have not seen that combination (yet), but Serzone is similar in structure to Desyrel (trazodone) and I have seen Desyrel used, in low doses (25-100mg) as a sleeping aid in combination with the SSRIs, Wellbutrin and Effexor. The effects have generally been good, with little morning "hangover" effect. Ask your doctor about adding low dose Desyrel, rather than Serzone, for sleep. It is non-addicting and also works well and safely in seniors. I am only staying away from recommending Serzone because I have not seen that combination and do not like asking people to be guinea pigs. Desyrel (or if there is a generic) will be cheaper than Serzone. Good luck - Cam W.
Posted by Noa on January 29, 2000, at 11:36:02
In reply to Re: Effexor XR and Serzone?, posted by Cindy W on January 29, 2000, at 10:00:55
I take both Effexor XR (375 mg) and Serzone (225 mg). The serzone was added for two purposes--to augment the effexor, but mainly, to help me sleep, ie, counteract the jitteriness and sleep problems of effexor. I take the serzone in the evening. I used to take it around 5-6 pm, and it would start to be sedating at 10 or so, just in time for bed. Now that I take lithium, which potentiates the effects of all my meds, I take the serzone much closer to bed time, about 30-60 minutes before bed, and it is very sedating by the time I go to sleep.
Posted by Noa on January 29, 2000, at 11:39:54
In reply to Re: Effexor XR and Serzone - to Cindy, posted by Cam W. on January 29, 2000, at 11:17:10
I used to take Desyrel(Trazodone) for sleep, in a small amount (25 mg.). After a couple of years, it stopped working as well, especially with an increased dose of effexor xr. So I started to take 50 mg, but after a while, when I needed to augment my cocktail anyway, my doc suggested switching from trazodone to serzone. The differences are: 1) as Cam said, the trazodone is a generic so it costs a lot less, and you need less as a sedative/sleep agent. 2) trazodone, for me, was faster acting and more intensely sedating, but also wore off quicker.
Posted by Cam W. on January 29, 2000, at 14:25:32
In reply to Re: Effexor XR and Serzone - to Cindy, posted by Noa on January 29, 2000, at 11:39:54
> I used to take Desyrel(Trazodone) for sleep, in a small amount (25 mg.). After a couple of years, it stopped working as well, especially with an increased dose of effexor xr. So I started to take 50 mg, but after a while, when I needed to augment my cocktail anyway, my doc suggested switching from trazodone to serzone. The differences are: 1) as Cam said, the trazodone is a generic so it costs a lot less, and you need less as a sedative/sleep agent. 2) trazodone, for me, was faster acting and more intensely sedating, but also wore off quicker.
Noa - Thanks for the insight. Much appreciated.
- Cam W.
Posted by Cindy W on January 31, 2000, at 20:38:07
In reply to Re: Effexor XR and Serzone - to Noa, posted by Cam W. on January 29, 2000, at 14:25:32
> > I used to take Desyrel(Trazodone) for sleep, in a small amount (25 mg.). After a couple of years, it stopped working as well, especially with an increased dose of effexor xr. So I started to take 50 mg, but after a while, when I needed to augment my cocktail anyway, my doc suggested switching from trazodone to serzone. The differences are: 1) as Cam said, the trazodone is a generic so it costs a lot less, and you need less as a sedative/sleep agent. 2) trazodone, for me, was faster acting and more intensely sedating, but also wore off quicker.
>
> Noa - Thanks for the insight. Much appreciated.
> - Cam W.
Noa and Cam, thanks for the info about combining Effexor and Serzone! Am going to try combining Effexor-XR (was on 225 mg/day, now going to 300 mg/day) with the tiny amount of Serzone I have started taking at night (about 25-30 mg/day...a fourth of a 150 mg/day tablet). Think this will work.--Cindy
Posted by Noa on January 31, 2000, at 21:16:09
In reply to Re: Effexor XR and Serzone - to Noa, posted by Cindy W on January 31, 2000, at 20:38:07
Cindy, good luck and let us know how it goes.
Posted by Cam W. on January 31, 2000, at 21:28:38
In reply to Re: Effexor XR and Serzone - to Noa, posted by Noa on January 31, 2000, at 21:16:09
> Cindy, good luck and let us know how it goes.
Cindy - Ditto from me. I am very interested to see how it will turn out. - Cam W.
Posted by STEPH on February 1, 2000, at 12:37:15
In reply to Re: Effexor XR and Protriptyline, posted by saint james on January 28, 2000, at 16:08:09
WAS TAKING EFFEXOR AND WAS SWITCHED YO PAXIL AND SEEM TO BE GAINING WEIGHT LIKE CRAZY. ANYONE EXPERIENCED THIS PROBLEM?
This is the end of the thread.
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