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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by xbunny on December 14, 2004, at 13:18:20
It seems the manufacturers of reboxetive (edronax, vestra) are having a major screw up here in the UK and none of my local pharmacies have any idea when any will available. So I am fielding for advice on another drug I might take which might be similar. I cannot take SSRI's as they badly worsen my psychosis. I already take mirtazapine (zispin, remeron) and have tried venlafaxine (effexor) unsuccessfully. I have tried tricyclics before and would rather not go there again though if there are any that markedly different than clomipramine or dothiepin I would be interested in hearing. I find benzos have no effect on me atall (I can take 20mg valium and still be a wreck). Ideally I am after a drug which mostly or only affects NA and is good for anxiety and depression with mid to no sedative effect. I already find mirtazapine and flupenthixol (depixol), which I take for the psychosis, more than sedating enough.
Thanks for any ideas and greetings, Bunny
Posted by ed_uk on December 14, 2004, at 13:35:32
In reply to reboxetine alternatives available in the uk, posted by xbunny on December 14, 2004, at 13:18:20
Hi,
Lofepramine (Gamanil) is a tricyclic antidepressant which acts as a NA uptake inhibitor, as does reboxetine. It is quite popular in the UK. The side effects are generally much less than with dothiepin (yuck) or clomipramine. It is not sedating. It is good for depression but usually has little effect on anxiety. It may, however, be effective in preventing panic attacks.
Ed.
Posted by xbunny on December 14, 2004, at 14:02:23
In reply to Re: reboxetine alternatives available in the uk, posted by ed_uk on December 14, 2004, at 13:35:32
> Hi,
>
> Lofepramine (Gamanil) is a tricyclic antidepressant which acts as a NA uptake inhibitor, as does reboxetine. It is quite popular in the UK. The side effects are generally much less than with dothiepin (yuck) or clomipramine. It is not sedating. It is good for depression but usually has little effect on anxiety. It may, however, be effective in preventing panic attacks.
>hey thanks for posting back so quickly. Yeah I tried lofepramine right after dothiepin (since dothiepin did help but was waaaay to sedating) and it had no effect whatsoever on me. So I went onto clomipramine after that and was on that for about a year with olanzapine til my psychosis got out of control and they completely switched my meds to my current regiem (flupenthixol and zispin) which is the best I have had but still lacks in the area of anxiety and depression (which is alot better but not quite there if you know what I mean). Im kinda out of ideas (and so are they). I have tried heavier doses of antipsychotics but I get eps, sleeplessness and jitteryness and the rest I already said. :-(
Posted by ed_uk on December 14, 2004, at 14:07:59
In reply to reboxetine alternatives available in the uk, posted by xbunny on December 14, 2004, at 14:02:23
So have you tried reboxetine or were you hoping to start it soon?
Ed.
Posted by ed_uk on December 14, 2004, at 14:09:57
In reply to reboxetine alternatives available in the uk, posted by xbunny on December 14, 2004, at 14:02:23
From the pharmaceutical journal......
'Edronax tablets
Edronax (reboxetine) tablets are currently out of stock (Pfizer). The company expects stock to be available from the week commencing 29 November.'Ed.
Posted by xbunny on December 14, 2004, at 14:27:47
In reply to Re: reboxetine alternatives available in the uk, posted by ed_uk on December 14, 2004, at 14:07:59
>So have you tried reboxetine or were you hoping to >start it soon?
was hoping to start it but the pharmacy have suggested that it might be mid jan before they come in.
Posted by ed_uk on December 14, 2004, at 14:30:06
In reply to Re: reboxetine alternatives available in the uk » ed_uk, posted by xbunny on December 14, 2004, at 14:27:47
Hi,
If you'd like to try another NA reuptake inhibitor you could always try nortriptyline (Allegron in UK). It's more tolerable than dothiepin and clomipramine.
Ed.
Posted by xbunny on December 14, 2004, at 14:43:19
In reply to Re: reboxetine alternatives available in the uk, posted by ed_uk on December 14, 2004, at 14:30:06
> If you'd like to try another NA reuptake >inhibitor you could always try nortriptyline >(Allegron in UK). It's more tolerable than >dothiepin and clomipramine.
hey thanks Ed that sounds like just what Im looking for. Any idea if its safe to take with mirtazapine?
Posted by ed_uk on December 14, 2004, at 14:49:38
In reply to Re: reboxetine alternatives available in the uk, posted by xbunny on December 14, 2004, at 14:43:19
Hi,
As far as I know, no interaction with mirtazapine has been reported. UK docs are very awkward/afraid/suspicious about prescribing two antidepressants at once though. What side effects did you have with dothiepin, lofepramine and clomipramine?
Ed.
Posted by ed_uk on December 14, 2004, at 14:52:12
In reply to Re: reboxetine alternatives available in the uk, posted by xbunny on December 14, 2004, at 14:43:19
PS. Flupenthixol may increase the effect of tricyclics though, so you'd need to start nort at a low dose and increase gradually.
Ed.
Posted by xbunny on December 14, 2004, at 15:19:44
In reply to Re: reboxetine alternatives available in the uk, posted by ed_uk on December 14, 2004, at 14:49:38
>What side effects did you have with dothiepin, lofepramine and clomipramine?
nothing from the lofepramine. Dry mouth from the clomipramine. That and constipation and heavy drowsiness from the dothiepin.
Posted by Larry Hoover on December 14, 2004, at 22:24:43
In reply to Re: reboxetine alternatives available in the uk, posted by ed_uk on December 14, 2004, at 13:35:32
> Hi,
>
> Lofepramine (Gamanil) is a tricyclic antidepressant which acts as a NA uptake inhibitor, as does reboxetine. It is quite popular in the UK. The side effects are generally much less than with dothiepin (yuck) or clomipramine. It is not sedating. It is good for depression but usually has little effect on anxiety. It may, however, be effective in preventing panic attacks.
>
> Ed.Is atomoxetine available in UK? Branded Strattera in US.
Lar
Posted by ed_uk on December 15, 2004, at 6:39:39
In reply to Re: reboxetine alternatives available in the uk » ed_uk, posted by Larry Hoover on December 14, 2004, at 22:24:43
Hi Larry,
Yes it is, the brand name is the same. It doesn't seem that popular though. Another NE/NA reuptake inhibitor!
Posted by don_bristol on January 5, 2005, at 11:20:50
In reply to Re: reboxetine alternatives available in the uk » ed_uk, posted by xbunny on December 14, 2004, at 14:27:47
> >So have you tried reboxetine or were you hoping to >start it soon?
>
> was hoping to start it but the pharmacy have suggested that it might be mid jan before they come in.===================
Late posting.
That shortage of Edrinax which you refer to seems plain crazy. Many meds are nowadays imported from other European countries. In fact I often get foreign-market meds from my UK pharmacy.
I am not sure what is going on where you are but I think someone in the supply chain is not properly pulling their weight in terms of getting the meds for you.
Maybe they all use the same wholesaler and he has come up with this idea that because he can't get any from his usual source then there is none to be had.
However, I would be very surprised if there isn't some requirement for registered pharmacies to get the meds from whereever they need to (or maybe it is the wholesaler's duty).
I agree that it is possible that a particular med could run out right across Europe especially if there is a batch problem in one of the few plants making it. But I can't easily accept that "Edronax is out of stock and that is all there is to it, guv".
Don
This is the end of the thread.
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