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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by floatingbridge on August 28, 2009, at 22:21:15
So I'm going down to 50 tonight, then no major changes till he comes back at the end of Oct.(!). He said he'll help me with withdrawals.
Something that first intrigued me, then disturbed me. He thought a possible course would be to dump the pristiq and add Strattera, for 'both anti-depressant properties and add.' Upon googling (and reading Scott's reply to Triedeverydrug) I see that Strattera is an snri and fails as an anti-depressant. And wellbutrin eventually ramped up to 450 did nothing but dull and fatigue me. I have no idea what his thoughts may be on this--does he think I am in less need of an anti-depressant? Cr*pes. I don't want anymore snri's! (Insert tantrum here.)
Had a good therapy session, though :)
fb
Posted by sam K on August 28, 2009, at 23:00:13
In reply to pdoc says: pristiq a bust, posted by floatingbridge on August 28, 2009, at 22:21:15
strattera works for my depression. its a good drug as far as i know. sounds like a good augment to your pristiq
Posted by Phillipa on August 28, 2009, at 23:38:07
In reply to pdoc says: pristiq a bust, posted by floatingbridge on August 28, 2009, at 22:21:15
fb October????? I sure hope he has a doc on call. Why do this when he's going away. Your symptoms are worse at 100 right so seems like a good idea. Now the straterra I have no idea. Hope you sleep well tonight. Love Phillipa
Posted by SLS on August 29, 2009, at 5:22:35
In reply to Re: pdoc says: pristiq a bust, posted by sam K on August 28, 2009, at 23:00:13
> strattera works for my depression. its a good drug as far as i know. sounds like a good augment to your pristiq
Do you have ADD?
- Scott
Posted by SLS on August 29, 2009, at 5:42:26
In reply to pdoc says: pristiq a bust, posted by floatingbridge on August 28, 2009, at 22:21:15
> So I'm going down to 50 tonight, then no major changes till he comes back at the end of Oct.(!). He said he'll help me with withdrawals.
>
> Something that first intrigued me, then disturbed me. He thought a possible course would be to dump the pristiq and add Strattera, for 'both anti-depressant properties and add.' Upon googling (and reading Scott's reply to Triedeverydrug) I see that Strattera is an snri and fails as an anti-depressant. And wellbutrin eventually ramped up to 450 did nothing but dull and fatigue me. I have no idea what his thoughts may be on this--does he think I am in less need of an anti-depressant? Cr*pes. I don't want anymore snri's! (Insert tantrum here.)
>
> Had a good therapy session, though :)
>
> fbStrattera is considered to be a NARI - noradrenaline (norepinephrine) reuptake inhibitor.
There is often a depressed mood component to ADD, which is different from having a combination of two separate disorders. If you effective treat the ADD, you often resolve the depressed mood at the same time. I have seen Strattera be extremely effective in treating ADD in this regard.
Another NARI is the TCA, desipramine. It, too, is used effectively to treat ADD, but is also effective to treat major depressive disorder (MDD). Since ADD can be comorbid with MDD - that is to say that they are two separate disorders occurring at the same time.
It's great that Sam K has found Strattera (atomoxetine) to be effective as an antidepressant in the absence of ADD. Strattera was originally researched as an antidepressant, but never made it. They even changed the name from tomoxetine to atomoxetine. You can try the Strattera first, and then switch over to desipramine if it doesn't work out.
- Scott
Posted by Phil on August 29, 2009, at 8:48:24
In reply to pdoc says: pristiq a bust, posted by floatingbridge on August 28, 2009, at 22:21:15
That sucks fb. I surely have no answers.
Pristiq was the one that gave me the mixed states episodes.
Sh*t in a bottle.
Posted by zana on August 29, 2009, at 10:08:17
In reply to pdoc says: pristiq a bust, posted by floatingbridge on August 28, 2009, at 22:21:15
Dear FB,
What a shame and the end of October is a long time to wait. It'a not clear why he would suggest strattera. I think of it as a stimulant used for ADD not an AD.
Well, maybe you'll feel better on less pristiq. But it sounds like its going to be a long wait to get moving on another plan.
Hope you're feeling OK with this.
Take care of yourself.
Zana
Posted by sam K on August 29, 2009, at 10:19:45
In reply to Re: pdoc says: pristiq a bust » sam K, posted by SLS on August 29, 2009, at 5:22:35
yea inattentive type, but it gave me some anxiety
Posted by linkadge on August 29, 2009, at 10:52:54
In reply to Re: pdoc says: pristiq a bust » sam K, posted by SLS on August 29, 2009, at 5:22:35
Suprisingly, Straterra worked for my depression too.
It has demonstrated antidepressant effects in previous animal/human trials.
It can be difficult sometimes to demonstrate the antidepressant of drugs sometimes as the placebo effect is often so marked.
I think if other drugs like fluoxetine had attempted approval with today's standards there would be more problems. Apparently there were tons of failed clinical trials with it.
Linkadge
Posted by SLS on August 29, 2009, at 10:54:32
In reply to Re: pdoc says: pristiq a bust, posted by sam K on August 29, 2009, at 10:19:45
> > > strattera works for my depression. its a good drug as far as i know. sounds like a good augment to your pristiq
> > Do you have ADD?
> yea inattentive type, but it gave me some anxiety
Your case provides more evidence that Strattera is effective for depression, but only if the depression is a component of ADD.This is, of course a generalization. I'm sure there will be exceptions.
- Scott
Posted by floatingbridge on August 29, 2009, at 11:41:58
In reply to Re: pdoc says: pristiq a bust » floatingbridge, posted by SLS on August 29, 2009, at 5:42:26
O.K. Scott, so NARI is different from snri--I will google this and find out more--good to know. I read in the Strattera literature last night about 'discontinuation syndrome' and I though, instantly, it will be as bad as effexor or (we'll see) pristiq. But if it's a different class, maybe not?
Thanks for the info on the tca--will remember that.
So you don't think my beloved pdoc/t is off his rocker?
And what about not responding to wellbutrin--two different animals?
You're a wealth of info, Scott. Hope today is a good one,
fb
Posted by floatingbridge on August 29, 2009, at 11:49:31
In reply to pdoc says: pristiq a bust, posted by floatingbridge on August 28, 2009, at 22:21:15
Thanks for the responses everyone. I do feel remarkably well today after halving my dose. I should really never have gone up, probably.
Phillipa, I see my pdoc three more times before he leaves in mid-september (the 18th). He'll be back for one week October 23 (I believe). Then gone week, then back for awhile. I gauge his age to be in the 70's--I feel he deserves the time off--and he doesn't want to initiate major change until he's back. And he wants me to make an appt. with his stand-in in case I may need it--he said i can always cancel. His call back stand-in was very prompt. So I'll be buckling in for a while. But on the 50 pristiq, I feel alright. Thanks for your concern, Phillipa, and everyone else who responded!
Posted by Maxime on August 29, 2009, at 11:51:17
In reply to pdoc says: pristiq a bust, posted by floatingbridge on August 28, 2009, at 22:21:15
I can't believe that you have to wait until the end of October to try something new. That doesn't seem right.
I took Strattera for depression, but it actually made it worse. I don't have ADD.
I hope you feel better on the 50mg of Pristiq.
Take care.
Posted by floatingbridge on August 29, 2009, at 11:55:52
In reply to Re: pdoc says: pristiq a bust » floatingbridge, posted by Maxime on August 29, 2009, at 11:51:17
Hi Maxime,
Our posts crossed each other on the board! Recap: I'm alright!
good to hear from you and
thanks,fb
Posted by SLS on August 29, 2009, at 12:14:21
In reply to Re: pdoc says: pristiq a bust » SLS, posted by floatingbridge on August 29, 2009, at 11:41:58
> O.K. Scott, so NARI is different from snri
Actually, "SNRI" was originally used to mean "selective norepinephrine reuptake inhibitor". However, its usage changed over time to mean "serotonin norepinephrine reuptake inhibitor". I think the acronym "NARI" was was coined in Britain.
I read in the Strattera literature last night about 'discontinuation syndrome' and I though, instantly, it will be as bad as effexor or (we'll see) pristiq. But if it's a different class, maybe not?
I don't think the withdrawal syndrome from discontinuing Strattera is particularly bad, and should be much more tolerable compared to Effexor. Personally, I don't remember having any withdrawal symptoms from Strattera.
Wellbutrin is a unique drug whose mechanism of action is still being debated. I think there is a growing opinion that it is a reuptake inhibitor of dopamine and norepinephrine. I'm not convinced. I do think that it does influence NE neurotransmission, I'm just not sure how. Wellbutrin has some effectiveness in treating ADD, but not as much as Strattera.
- Scott
Posted by floatingbridge on August 29, 2009, at 12:19:14
In reply to Re: pdoc says: pristiq a bust » floatingbridge, posted by SLS on August 29, 2009, at 12:14:21
Posted by Maxime on August 30, 2009, at 17:49:41
In reply to pdoc says: pristiq a bust, posted by floatingbridge on August 28, 2009, at 22:21:15
Hey FB, have you ever tried Desipramine? It's good for depression and ADD. Might be the right med for you.
Posted by floatingbridge on August 30, 2009, at 17:57:57
In reply to Re: pdoc says: pristiq a bust » floatingbridge, posted by Maxime on August 30, 2009, at 17:49:41
> Hey FB, have you ever tried Desipramine? It's good for depression and ADD. Might be the right med for you.
No, will google around. Thanks!
fb
Posted by Frustratedmama on August 30, 2009, at 21:26:41
In reply to Re: pdoc says: pristiq a bust » Maxime, posted by floatingbridge on August 30, 2009, at 17:57:57
Posted by floatingbridge on August 30, 2009, at 21:29:56
In reply to Re: pdoc says: pristiq a bust » Maxime, posted by floatingbridge on August 30, 2009, at 17:57:57
I reaaaally appreciate it!
hug back,fb
This is the end of the thread.
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