Antidepressants
Discussion
Hello All,
Just testing the water here. I'm going through a divorce that makes 'acrimonious' sound cuddly. This has been going on for 18 months and has unsurprisingly triggered a classic dose of reactive depression in me. I've already had some antidepressant medication but I'm seeing the doc tomorrow, in search of something more suitable. Here are some qualifiers...
I know it's a big ask but I'm effectively seeking an non-sedating antidepressant that has anxiolytic properties.
Interestingly, it would appear that Bupropion is a compound that makes patients wake up. Yes, it's Zyban but I understand it can be prescribed for depression - it's accepted use in the USA.
Any thoughts/experiences will be welcome.
Just testing the water here. I'm going through a divorce that makes 'acrimonious' sound cuddly. This has been going on for 18 months and has unsurprisingly triggered a classic dose of reactive depression in me. I've already had some antidepressant medication but I'm seeing the doc tomorrow, in search of something more suitable. Here are some qualifiers...
- I have 'previous' for anxiety problems. After 26 years with agoraphobia, I largely conquered it with the aid of a splendid therapist.
- Nevertheless, I still have the use of a small amount of Diazepam, which I use as a crutch but only very rarely. The dose is 2mg tablets.
- In the past, I've used numerous antidepressants, including Flouxetine and Amitryptaline. The best was Manerix (Moclobemide) but that eventually stopped working.
- For the current problem, I had Prozac (no real effect), Venlafaxine (risky - trying to nod off at the wheel) and Mirtazapine (made me sleep for Britain).
I know it's a big ask but I'm effectively seeking an non-sedating antidepressant that has anxiolytic properties.
Interestingly, it would appear that Bupropion is a compound that makes patients wake up. Yes, it's Zyban but I understand it can be prescribed for depression - it's accepted use in the USA.
Any thoughts/experiences will be welcome.
Edited by davhill on Monday 18th January 23:13
I'm sorry to hear about your situation
The first line for treatment of anxiety is Sertraline, which is an SSRI, similar to fluoxetine or citalopram, it's known to work well for anxiety, but most people need at least 100-150mg dose to achieve a substantial benefit. Sertraline has a few side effects, but sleepiness is not one of the more common ones.
An excellent adjunct for anxiety is Pregabalin. This Can however cause drowsiness, but usually it is well tolerated.
All the best for the future.
The first line for treatment of anxiety is Sertraline, which is an SSRI, similar to fluoxetine or citalopram, it's known to work well for anxiety, but most people need at least 100-150mg dose to achieve a substantial benefit. Sertraline has a few side effects, but sleepiness is not one of the more common ones.
An excellent adjunct for anxiety is Pregabalin. This Can however cause drowsiness, but usually it is well tolerated.
All the best for the future.
I was Sertraline for around 4 weeks before I stopped, the big issue for me was the insomnia, I was lucky to be getting a couple of hours a night usually not getting to sleep until around 2-3am now I'm off them I'm sleeping much better though still a bit broken.
Appreciate I didn't take them for long enough to them to take effect properly but they just weren't for me.
Appreciate I didn't take them for long enough to them to take effect properly but they just weren't for me.
It's a very personal thing. I've tried a lot of different types and they all bring their own benefits and side effects to each individual and it's just a case of weighing them up and working out what's best for you. Fluoxetine was my preferred AD, it was significantly better for me than the others I tried.
Thank you people.
The quack's given me Sertraline, starting at 50mg/day. It's new to me and she said it's good stuff.
So, I'll take it and see what transpires after a couple of weeks.
Incidentally, she wouldn't prescribe Bupropion off - label, despite its being the top choice in the US.
The quack's given me Sertraline, starting at 50mg/day. It's new to me and she said it's good stuff.
So, I'll take it and see what transpires after a couple of weeks.
Incidentally, she wouldn't prescribe Bupropion off - label, despite its being the top choice in the US.
My first thought was "A non-sedating antidepressant with anxiolytic properties........ good luck with that".
Not getting Bupropion, well I don't think that is a great loss really. Just because something is trendy in the US doesn't necessarily mean it is any good.
I've become highly cynical about antidepressants and their ability to treat depression and especially anxiety. However Sertraline is fine as far as SSRIs go, but do be prepared for an initial increase in anxiety - unless you go totally up the wall you need to stick it out a few weeks to see if it going to help. What dose of Manerix were you on - it can be used well above the recommended 600mg max, but again that is 'off label'.
I prefer lorazepam for situational anxiety but I appreciate most doctors won't prescribe it regularly these days due benzo-phobia and the view that nobody is capable of not getting addicted to the things.
Other options for anxiety are Gabapentin (off label) and Pregabalin. Both similar meds but the latter is actually licensed for general anxiety....... although it is expensive and both are increasingly controversial medications so not all doctors would prescribe them.
Not getting Bupropion, well I don't think that is a great loss really. Just because something is trendy in the US doesn't necessarily mean it is any good.
I've become highly cynical about antidepressants and their ability to treat depression and especially anxiety. However Sertraline is fine as far as SSRIs go, but do be prepared for an initial increase in anxiety - unless you go totally up the wall you need to stick it out a few weeks to see if it going to help. What dose of Manerix were you on - it can be used well above the recommended 600mg max, but again that is 'off label'.
I prefer lorazepam for situational anxiety but I appreciate most doctors won't prescribe it regularly these days due benzo-phobia and the view that nobody is capable of not getting addicted to the things.
Other options for anxiety are Gabapentin (off label) and Pregabalin. Both similar meds but the latter is actually licensed for general anxiety....... although it is expensive and both are increasingly controversial medications so not all doctors would prescribe them.
Edited by VolvoT5 on Tuesday 19th January 19:18
Are you able to access private medicine?
One of the very best is Effexor made by Pfizer. Due to its costs it is rarely available via the NHS. Your doctor may tell you there are other venlafaxine drugs like Effexor. This is not true. Pfizer have the patent on Effexor, so only they make it. The difference is night and day.
Good luck. And keep talking about it
One of the very best is Effexor made by Pfizer. Due to its costs it is rarely available via the NHS. Your doctor may tell you there are other venlafaxine drugs like Effexor. This is not true. Pfizer have the patent on Effexor, so only they make it. The difference is night and day.
Good luck. And keep talking about it
The increased anxiety was also another side effect with the sertraline but it did calm down after a couple of weeks. Other issues I had were shooting pains down limbs,headaches and my knob lost all sensation!
Other big thing for me was I've never been on anything before and just couldn't get my head round what they actually did to help me.
Other big thing for me was I've never been on anything before and just couldn't get my head round what they actually did to help me.
The original Nick the Greek said:
Are you able to access private medicine?
One of the very best is Effexor made by Pfizer. Due to its costs it is rarely available via the NHS. Your doctor may tell you there are other venlafaxine drugs like Effexor. This is not true. Pfizer have the patent on Effexor, so only they make it. The difference is night and day.
Are you saying there is a difference between generic Venlafaxine and Pfizer made Venlafaxine branded as 'effexor'? Both contain the same drug, venlafaxine. There are plenty of manufacturers of it whether it is in the XL release format or not. One of the very best is Effexor made by Pfizer. Due to its costs it is rarely available via the NHS. Your doctor may tell you there are other venlafaxine drugs like Effexor. This is not true. Pfizer have the patent on Effexor, so only they make it. The difference is night and day.
I don't think you are right in saying it is 'rarely available' and it isn't that expensive either. It does have some more problematic side-effects than the SSRIs GPs usually like to prescribe though, so generally not used as a first line of attack.
OP certainly doesn't need to pay for private medical care to get Effexor given he has already tried it.
Citalopram works for me but with most pills it takes up to 6 weeks to be effective also as therapist will tell you only 50% of people on anti depressants are depressed and of thoes only 50% will benefit from the drugs. Basically I found I had to change my habits and accept limitations so for me no more drinking and no working 14 hour days. Once stable I did cbt and 6 years on in am food place and take the pills a
s an elective now. Oh an even 2mg of diazipan can have an effect that's kind of the point really. I think therapy and pills if you have time are best bet and of course draw a line under divorce if you can
s an elective now. Oh an even 2mg of diazipan can have an effect that's kind of the point really. I think therapy and pills if you have time are best bet and of course draw a line under divorce if you can
VolvoT5 said:
Are you saying there is a difference between generic Venlafaxine and Pfizer made Venlafaxine branded as 'effexor'? Both contain the same drug, venlafaxine. There are plenty of manufacturers of it whether it is in the XL release format or not.
I don't think you are right in saying it is 'rarely available' and it isn't that expensive either. It does have some more problematic side-effects than the SSRIs GPs usually like to prescribe though, so generally not used as a first line of attack.
OP certainly doesn't need to pay for private medical care to get Effexor given he has already tried it.
Venlafaxine is widely available on the NHS.I don't think you are right in saying it is 'rarely available' and it isn't that expensive either. It does have some more problematic side-effects than the SSRIs GPs usually like to prescribe though, so generally not used as a first line of attack.
OP certainly doesn't need to pay for private medical care to get Effexor given he has already tried it.
The "generic" copies of Effexor are just that, copies. Effexor is a "one and only". Even GPs make this mistake.
So you need Effexor by Pfizer, not venlafaxine.
The original Nick the Greek said:
Venlafaxine is widely available on the NHS.
The "generic" copies of Effexor are just that, copies. Effexor is a "one and only". Even GPs make this mistake.
So you need Effexor by Pfizer, not venlafaxine.
There is NO difference in efficacy between generic and branded venlafaxine. They both have exactly the same active ingredient. The "generic" copies of Effexor are just that, copies. Effexor is a "one and only". Even GPs make this mistake.
So you need Effexor by Pfizer, not venlafaxine.
GPs don't make that mistake, because there is no 'mistake' to make
You should work for pfizer
there are differences between generic and brand but the molecular properties of generic can differ from brand by no more than 4% (FDA)
different manufacturers use different binding/filling agents and there can also be some variations in dose of active ingredient.
not all generics are that different though - manufacturer can make difference. as an example, Teva produced Effexor under patent for Pfizer. Once off patent, they also sold their own generic under their own identity. not altogether clear how different their version would be from the original, given that they were producing both at the same time.
paul
different manufacturers use different binding/filling agents and there can also be some variations in dose of active ingredient.
not all generics are that different though - manufacturer can make difference. as an example, Teva produced Effexor under patent for Pfizer. Once off patent, they also sold their own generic under their own identity. not altogether clear how different their version would be from the original, given that they were producing both at the same time.
paul
The original Nick the Greek said:
Venlafaxine is widely available on the NHS.
The "generic" copies of Effexor are just that, copies. Effexor is a "one and only". Even GPs make this mistake.
So you need Effexor by Pfizer, not venlafaxine.
No it is the same. Drugs once out of patent can be made by anyone and are sold by the drug name not the brand name. In this case Venlafaxine is the drug and Effexor the brand name, both are exactly the same thing containing the same active ingredient which is Venlafaxine. The "generic" copies of Effexor are just that, copies. Effexor is a "one and only". Even GPs make this mistake.
So you need Effexor by Pfizer, not venlafaxine.
This level of misunderstanding really gets on my tits. It is caused by the same marketing BS that gets people paying £3.50 for Nurofen tablets when you can buy supermarket Iburprofen for £0.50.... they are exactly the same only one is £3 more expensive and in a prettier box.
Edited by VolvoT5 on Tuesday 19th January 20:34
VolvoT5 said:
No it is the same. Drugs once out of patent can be made by anyone and are sold by the drug name not the brand name. In this case Venlafaxine is the drug and Effexor the brand name, both are exactly thing containing the same active ingredient as Venlafaxine.
This level of misunderstanding really gets on my tits. It is caused by the same marketing BS that gets people paying £3.50 for Nurofen tablets when you can buy supermarket Iburprofen for £0.50.... they are exactly the same only one is £3 more expensive and in a prettier box.
No.This level of misunderstanding really gets on my tits. It is caused by the same marketing BS that gets people paying £3.50 for Nurofen tablets when you can buy supermarket Iburprofen for £0.50.... they are exactly the same only one is £3 more expensive and in a prettier box.
You're wrong.
100%.
I speak from experience.
Don't let them fob you off with venlafaxine. It's NOT the same as Effexor.
The original Nick the Greek said:
No.
You're wrong.
100%.
I speak from experience.
Don't let them fob you off with venlafaxine. It's NOT the same as Effexor.
You're a fYou're wrong.
100%.
I speak from experience.
Don't let them fob you off with venlafaxine. It's NOT the same as Effexor.
king moron. edit:
incidentally ignoring the fact that you are factually wrong, the listed price difference between generic XL version and Pfizer Effexor XL is bugger all, so no financial reason why anyone would be 'fobbed off' anyway.
Edited by VolvoT5 on Tuesday 19th January 20:40
RobM77 said:
It's a very personal thing. I've tried a lot of different types and they all bring their own benefits and side effects to each individual and it's just a case of weighing them up and working out what's best for you. Fluoxetine was my preferred AD, it was significantly better for me than the others I tried.
I'd agree with that a and the other poster who suggested citalopram or sertaline, both of which have been recommended for anxiety / panic related stuff as well as depression.The original Nick the Greek said:
And you're a wrong fking moron.
You lost. Your ignorance offends me. Do you work in education?
Educate yourself http://www.nhs.uk/chq/pages/1003.aspx?categoryid=7...king moron.You lost. Your ignorance offends me. Do you work in education?
NHS said:
Medicines sold under their generic name are usually cheaper, because the research and development costs are lower. However, they contain the same active ingredient as the equivalent branded medicines.
........
generic medicines are as effective as branded versions
List of other sources that will back this up is virtually endless as well, FDA for one. ........
generic medicines are as effective as branded versions
there are a couple of anti eplieptics which can be prescribed by brand, ditto lithium salt ( by salt and brand) becasue the minisculedifferences in bioavailability do make an impact - and i nthe case of the anti -epileptics can mean people loosing their job and driving licence for up to 5 or 10 years on the basis of one fit ...
mph1977 said:
there are a couple of anti eplieptics which can be prescribed by brand, ditto lithium salt ( by salt and brand) becasue the minisculedifferences in bioavailability do make an impact - and i nthe case of the anti -epileptics can mean people loosing their job and driving licence for up to 5 or 10 years on the basis of one fit ...
I'm not disputing that there are rare exceptions though wouldn't apply to venlafaxine and in any case his argument was that it was too expensive and that is why the nhs would 'fob off' the patient with something else, which is not the case. Its not that expensive and despite the conspiracy theories doctors don't 'fob off' patients on cost grounds alone. No point trying to reason with some people. Anyway I don't want to be hijacking OPs thread any further so I will leave it there.
Edited by VolvoT5 on Tuesday 19th January 20:59
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