Posted by psychobot5000 on May 30, 2012, at 14:03:11
In reply to Re: Helpful advice on NE and/or NE/DA medication?, posted by psychobot5000 on May 29, 2012, at 2:24:50
cymbalta/duloxetine is another one to try--similarish to effexor.
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> > From what I understand, Reboxetine would probably work just as well.
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> Straterra and reboxetine are, in my experience, very, very different medications, despite the fact that they act in (roughly) the same way. These ways we think about medications--what neurotransmitter they affect, what transporter they occupy--are really very crude. We have to think about other things, things largely unknown: what brain regions are affected by a given drug, what concentrations make it to the striatum as opposed to the nucleus accumbens, what down-the-line alterations in brain structure or chemistry occur. Even that is a pretty rough way to look at the intricacy of the central nervous system. ...And, in any case, every person's brain chemistry is different. Everyone reacts differently to a given drug. Which is a long way of saying: this theorizing only goes so far; you can only find out what works FOR YOU through some drug trials.
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> Bottom line: if effexor worked for you in a way that SSRIs didn't, then great! If you can't find a way to keep taking it (could you ask them to add a muscle-relaxant? I don't know...), then you may well get mileage by trying medications that affect noradrenaline (there's no reason to go immediately to dopaminergics--many aren't very good [or are illegal], and effexor has no direct effect on dopamine, anyway). In my experience, desipramine is a good NA medication, but I don't believe you have that in Australia. Nortriptyline is another good one. Reboxetine could be a good choice, but maybe not straterra for your purposes--it doesn't have a great reputation... Any tricyclic antidepressant, with the possible exception of clomipramine--which you seem to have already tried anyway (and if that one didn't work, you may wish to avoid imipramine as well)-- is probably worth trying. Wellbutrin has its flaws, but I think may also be worth your time. Milnaciprin, if you have it down there, is pretty similar to effexor, so that might be a place to go first, if they have it down there. That might be where I would go first.
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> Keep in mind that, if you end up going for drugs that affect dopamine as well, they can be difficult to get. Still, if you have ADD-like symptoms (if you have depression, then -technically- you don't have ADD also, at least according to official psychiatry. Mental illness classification is weird, that way. But, seriously, depression can cause the same symptoms, and what you call a thing doesn't matter), it may be a possibility.
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> Hope that's useful in some way.
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poster:psychobot5000
thread:1017923
URL: http://www.dr-bob.org/babble/20120522/msgs/1018922.html