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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by MorganW on May 14, 2001, at 1:22:23
Hi
I just came across this board and am very glad I found it. You seem very knowledgable and I was hoping you can answer a question for me. I have been on effexor xr 150 mg. for about 5 months. It's working well for me except the nasty side effect of fatigue. I just can't seem to get motivated. What are some drugs you can recommend that I can bring up to my psychiatrist to help me get through the day? I have to tell you, I am slightly afraid of addiction and stimulants. Any advice you have would be appreciated. Thanks, Morgan
Posted by SalArmy4me on May 14, 2001, at 5:57:02
In reply to SalArmy4Me....., posted by MorganW on May 14, 2001, at 1:22:23
Howdy Morgan,
1) If you are taking the Effexor XR in the morning, you may want to switch to taking it all at bedtime.
2) Buproprion (an NDRI) can often alleviate symptoms of fatigue induced by antidepressants. Dr. Stephen Stahl says that boosting noradrenergic neurotransmission with buproprion is useful especially to those with fatigue, apathy, and cognitive slowing on antidepressants {Further, venlafaxine + NDRI = one of Stahl's "Heroic Combos" of two ADs (boosting both serotonin and norepinephrine) for treatment-resistant depression}:
Stahl, Stephen M. Essential psychopharmacology of depression and bipolar disorder. p. 152 Cambridge University Press; Cambridge: 2000.3. If the fatigue does not resolve, and your doctor elects to keep you on Effexor, adding a psychostimulant may not be such a bad idea--assuming you have no prior history of a drug- addiction disease. High-dose venlafaxine plus a stimulant means serotonin and norepinephrine are single-boosted and dopamine is double-boosted. The stimulants could include d-amphetamine, methylphenidate, phentermine, or diethylproprion. It could also include direct-acting dopamine agonists such as pramipexole: Stahl p. 157
This is the end of the thread.
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