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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Maximus on June 10, 2008, at 14:11:02
Hi,
After 3 months on Cymbalta, i'm now back with Effexor XR.
Based on my experience and a lot of reading (not just me), i can say now that Cymbalta is an inferior product for the treatment of *bipolar depression*, and here's why.
If you read here and there about bipolar depression, bipolars need this little extra boost that you can find with Mirapex, Modafinil, MAOI(s), bromocriptine, etc. and of course Effexor. Yes, that's right, i'm talking about this extra dopamine boost. The reuptake dopamine action of Effexor is small, indeed. But yet you can feel the difference. You feel a little sharper, more alive on it, though.
However, for the treatment of a major depression episode with or without anxiety, Cymbalta is or could be a better med than Effexor. Cymbalta is well tolerated and has generally less side effects than Effexor.
Good day!
Posted by Bob on June 10, 2008, at 15:10:45
In reply to Cymbalta -- Not so great for bp depression..., posted by Maximus on June 10, 2008, at 14:11:02
I assume you're referring to high dose Effexor? From what I understand, the dopamine effect does not become evident until quite high doses. Even the NE is less pronounced at lower doses, where the drug is heavily serotonergic.
Posted by Maximus on June 10, 2008, at 16:01:43
In reply to Re: Cymbalta -- Not so great for bp depression... » Maximus, posted by Bob on June 10, 2008, at 15:10:45
> I assume you're referring to high dose >Effexor? From what I understand, the dopamine >effect does not become evident until quite high >doses. Even the NE is less pronounced at lower >doses, where the drug is heavily serotonergic.
Not necessarily. I suspect that there are different observations/results between an in vitro and in vivo experiment. At 225 mg and higher you can feel the difference.
Although Cymbalta is a stronger NE reuptake drug than Effexor, the risk to trigger a mixed episode is lower with Cymbalta. You feel more flat on it.
Posted by Phillipa on June 10, 2008, at 16:38:45
In reply to Re: Cymbalta -- Not so great for bp depression... » Bob, posted by Maximus on June 10, 2008, at 16:01:43
Was on cymbalta when came to the states and took 60mg for about three months. Didn't help depression or anxiety. But back pain disappeared as didn't know I had it til off it. No trouble withdrawing either. Phillipa
Posted by Happyflower on June 12, 2008, at 0:32:59
In reply to Cymbalta -- Not so great for bp depression..., posted by Maximus on June 10, 2008, at 14:11:02
In my Cymbalta box, the long page of info says it is not recommended for BP.
Posted by Racer on June 12, 2008, at 9:42:12
In reply to Re: Cymbalta -- Not so great for bp depression..., posted by Happyflower on June 12, 2008, at 0:32:59
> In my Cymbalta box, the long page of info says it is not recommended for BP.
Generally speaking, NO antidepressant is recommended for Bipolar -- that's the official warning, that antidepressants can trigger manic episodes. In practice, sometimes bipolar responds well to an antidepressant in combination with a mood stabilizer.
Hope that helps.
This is the end of the thread.
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