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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Anna Laura on April 9, 2002, at 3:15:13
I'm currently taking 300 mg. Effexor + 8 mg. Reboxetine. Feeling better with Effexor then when i was on TCA's (Imipramine, Amytryptiline made anhedonia and lack of motivation worse). Moreover, i don't feel "medicated" (less numbed and dull) on Effexor even though i'm on a high dose (probably due to lack of anticholinergic effects). I feel more sleepy and extremely fatigued though. I'm taking supplements to battle fatigue and PMS (vitamin B6 and B12, vitamin C, minerals, acethil carnitine, NADH).
I've recently taken hormones testing wich came out normal. PMS is really awful as i start getting negative, suicidal thoughts and have crying spells when i hit the mid cycle phase. I feel much better the same day i get my period. feel decently well for about ten days and then i go down again. I've managed to get adafrinil to fight off Effexor induced fatigue and day time sleepiness. I'm afraid 300 mg. dose it's too high though, and i'm starting to doubt wether it can be safely combined with Adafrinil at that dose. Moreover, it could supposedly numb Adafrinil beneficial effects. Could 225-150 mg. Effexor a wiser augmenting strategy?Thanks for listening
Posted by TSA West on April 9, 2002, at 6:51:30
In reply to Effexor + Adafrinil?, posted by Anna Laura on April 9, 2002, at 3:15:13
I read your post with interest...
COMBINATIONS, SSRIs, CALCIUM, B6, ALPRAZOLAM, CHASTEBERRY
*COMBINATION(S): Since Effexor can be safely combined with Adrafinil's relative Modafinil, I assume judiciously that Effexor can be combined with Adrafinil. It is recommended that you have liver enzymes double-checked on Adrafinil though.
*SSRIs and FIGHTING FATIGUE: I assume you have tried SSRIs before, during, and after PMDD symptoms. So far, all studies but one have found that SSRIs as well as clomipramine decrease emotional and physical symptoms of PMDD and produce an overall moderate to marked improvement in up to 70% of patients compared with response rates of about 20% with placebo and 30% with reboxetine and TCAs--you mentioned imipramine and amitriptyline. If the side-effects from SSRIs were too much for you during every-day continuous therapy with them, you may be able to get away with just taking Fluoxetine (**which could provide the wakefulness you desire**) during the luteal phase of the menstrual cycle: Several recent preliminary studies have also shown that intermittent use of an SSRI-eg, during the luteal phase only-is at least as effective as continuous daily dosing.
THE B6 YOU TAKE IS GOOD: Vitamin B6 is about twice as likely as placebo to relieve symptoms of PMS (Wyatt KM, British Medical Journal 1999)
*ADD CALCIUM CARBONATE, if not already doing so: Calcium carbonate has been shown to decrease total symptom scores by 48% compared with a 30% reduction seen in the group on placebo (Thys-Jacobs S. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Am J Obstet Gynecol 1998).
*CHASTEBERRY: A formulation of chasteberry used in an appropriately designed study was well tolerated and more effective than placebo in decreasing symptoms of PMS. Most symptoms of PMS significantly improved with active treatment, and slightly more than half the women taking this herb experienced a substantial (>50%) decrease in overall symptoms {Journal of Family Practice, April 2001}.
*ALPRAZOLAM - Alprazolam, an antianxiety medication, may be potentially useful for some women with severe symptoms, but should be carefully considered because of side effects.
I wish you the best of happiness and health; in light of your only partial success with prescription medications, I recommend a combination of prescription and natural remedies.
--The Salvation Army A.R.C. Command: Producing quality Christians out of the most disadvantaged and destitute individuals--
Posted by IsoM on April 9, 2002, at 10:46:22
In reply to Effexor + Adafrinil?, posted by Anna Laura on April 9, 2002, at 3:15:13
Anna Laura, I'm really busy with work now that growing season has started but I've a couple of ideas. If you're patient enough, I'll e-mail you & describe more but I might not get the chance till this wkend as I want my facts to be straight & it'll be longer than I want to post here. Take care, pretty one.
Posted by johnj on April 9, 2002, at 16:14:44
In reply to Effexor + Adafrinil?, posted by Anna Laura on April 9, 2002, at 3:15:13
Are you bipolar or just unipolar? I am on nortryptline and want to get off. I need something for sleep but the sedating AD's are horrible to handle. thanks
Posted by Anna Laura on April 9, 2002, at 17:38:13
In reply to Question for you Anna, posted by johnj on April 9, 2002, at 16:14:44
> Are you bipolar or just unipolar? I am on nortryptline and want to get off. I need something for sleep but the sedating AD's are horrible to handle. thanks
I still don't know wether i am bipolar or not.
The last pdoc i've been consulting thought i was bipolar because of premorbid hyperthymic condition and treatment resistant depression with occasional anger outbursts.
I'm going to see a psychopharmacologist researcher next week, gonna have a throughout visit to find out
wether i could be bipolar or not.
As far as a sleeping aid is concerned, benzos could be an option; i'm personally not very fond of benzos 'cause i had developed a serious dependence years ago: i'd stay away from it, but everybody's different, each own of us possessing an unique physiological profile; may be benzos could be an option for you, who knows (if this is your case, i'd suggest temporary use, just to get a relief waiting for the next AD to kick in).
You could try Buspirone which seems to have sedating effects without benzos side-effects: it takes some time to kick in though.
I'd like to give you more options but i don't know much about sleeping aids unfortunately.
Posted by katekite on April 10, 2002, at 9:58:38
In reply to Effexor + Adafrinil?, posted by Anna Laura on April 9, 2002, at 3:15:13
I read somewhere that serotonin receptors are (I can't quite recall) either down-regulated or less sensitive to serotonin during that PMS time.
I occasionally take Paxil as a sleep aid, and notice that 5 mg will do it any day but the 3 days before my period. Then I need much more.
I have had excellent success with moclobemide for the irritable tired symptoms of PMS....taking it only for a few days when its the worst. I find it effective within a couple hours at a high dose allowing me to have a normal day, and no side effects (for me). Caution against taking maoi with any other drug without really getting your psychiatrist's attention about interactions.
So you may find you need higher serotonin stimulation during PMS than the rest of the time. There aren't too many drugs that are effective quickly enough.
kate
Posted by Anna Laura on April 10, 2002, at 23:23:35
In reply to Re: Effexor + Adafrinil?, posted by katekite on April 10, 2002, at 9:58:38
> I read somewhere that serotonin receptors are (I can't quite recall) either down-regulated or less sensitive to serotonin during that PMS time.
>
> I occasionally take Paxil as a sleep aid, and notice that 5 mg will do it any day but the 3 days before my period. Then I need much more.
>
> I have had excellent success with moclobemide for the irritable tired symptoms of PMS....taking it only for a few days when its the worst. I find it effective within a couple hours at a high dose allowing me to have a normal day, and no side effects (for me). Caution against taking maoi with any other drug without really getting your psychiatrist's attention about interactions.
>
> So you may find you need higher serotonin stimulation during PMS than the rest of the time. There aren't too many drugs that are effective quickly enough.
>
> kate
Thank you Kate: i'll keep that in mind.
Posted by disney4 on October 21, 2002, at 7:54:49
In reply to Effexor + Adafrinil?, posted by Anna Laura on April 9, 2002, at 3:15:13
> I'm currently taking 300 mg. Effexor + 8 mg. Reboxetine. Feeling better with Effexor then when i was on TCA's (Imipramine, Amytryptiline made anhedonia and lack of motivation worse). Moreover, i don't feel "medicated" (less numbed and dull) on Effexor even though i'm on a high dose (probably due to lack of anticholinergic effects). I feel more sleepy and extremely fatigued though. I'm taking supplements to battle fatigue and PMS (vitamin B6 and B12, vitamin C, minerals, acethil carnitine, NADH).
> I've recently taken hormones testing wich came out normal. PMS is really awful as i start getting negative, suicidal thoughts and have crying spells when i hit the mid cycle phase. I feel much better the same day i get my period. feel decently well for about ten days and then i go down again. I've managed to get adafrinil to fight off Effexor induced fatigue and day time sleepiness. I'm afraid 300 mg. dose it's too high though, and i'm starting to doubt wether it can be safely combined with Adafrinil at that dose. Moreover, it could supposedly numb Adafrinil beneficial effects. Could 225-150 mg. Effexor a wiser augmenting strategy?
>
> Thanks for listening
I am curiuos about the NADH. I was going to try it to increase my energy level, which is depleted from depression, but the previous poster mentioned something about impotence which scared me off. WHat was your experience with it?
Posted by Anna Laura on October 25, 2002, at 0:17:07
In reply to Re: Effexor + Adafrinil?NADH » Anna Laura, posted by disney4 on October 21, 2002, at 7:54:49
> > I'm currently taking 300 mg. Effexor + 8 mg. Reboxetine. Feeling better with Effexor then when i was on TCA's (Imipramine, Amytryptiline made anhedonia and lack of motivation worse). Moreover, i don't feel "medicated" (less numbed and dull) on Effexor even though i'm on a high dose (probably due to lack of anticholinergic effects). I feel more sleepy and extremely fatigued though. I'm taking supplements to battle fatigue and PMS (vitamin B6 and B12, vitamin C, minerals, acethil carnitine, NADH).
> > I've recently taken hormones testing wich came out normal. PMS is really awful as i start getting negative, suicidal thoughts and have crying spells when i hit the mid cycle phase. I feel much better the same day i get my period. feel decently well for about ten days and then i go down again. I've managed to get adafrinil to fight off Effexor induced fatigue and day time sleepiness. I'm afraid 300 mg. dose it's too high though, and i'm starting to doubt wether it can be safely combined with Adafrinil at that dose. Moreover, it could supposedly numb Adafrinil beneficial effects. Could 225-150 mg. Effexor a wiser augmenting strategy?
> >
> > Thanks for listening
>
>
> I am curiuos about the NADH. I was going to try it to increase my energy level, which is depleted from depression, but the previous poster mentioned something about impotence which scared me off. WHat was your experience with it?
>I didn't have any sexual dysfunction on NADH; it 's a mild energy booster. I took it for the transient fatigue i experienced during Spring months; i don't know if it'd be sufficient for depression fatigue though; in my opionion SAME would be a better option.
This is the end of the thread.
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