SSRIs versus SNRIs for Depression and Anxiety

[hstroller]

Has anyone had any success with SNRIs for their depression and anxiety? I don't understand how blocking norepinephrine would help at all. I had a report that says that I have short serotonin receptor genes and my psychiatrist wants me to try Pristiq which works 10-to-1 on serotonin versus norepinephrine. I tried one Effexor XR pill one time and I had the worse dry mouth and throat and sweated like crazy and that had a 30-to-1 serotonin versus norepinephrine reuptake ratio. Blocking norepinephrine would seem to want to increase anxiety and nervousness. I am scared to try the SNRI and go through all of that.

Would anyone like to share their experiences with desvenlafaxine (Pristiq) or venlafaxine (Effexor)? Could a benzodiazepine like clonazepam counteract or block the side effects, if they were to occur?

[XoxoFaith]

I take pristiq it did help me on the beginning but o think it stop working because I’ve been on it for 11 years now

[hstroller in reply to XoxoFaith]

I am sorry to hear that it stopped working for you. Can I ask some questions? I could use some advice as if you were talking to yourself 11 years ago. Were you satisfied with the drug while it was working? Did you have problems with side effects ever? If so, what were they? Were you trying to treat low energy, can't get out of bed depression, or depression with lots of anxiety?

[XoxoFaith in reply to hstroller]

Yes I was satisfied while it worked it has low side effects it’s great for motivation energy and feeling depressed and anxiety too it helped me. As I had depression as not being able to get out of bed and anxiety attacks it does take like 3 weeks to kick in though but it worked for me

[hstroller in reply to XoxoFaith]

I guess my biggest worry is that Pristiq will affect me like Effexor. I don't want to have sweating, insomnia, or dry mouth. Constipation, nausea, vomiting, jaw clenching, sleepiness, dizziness or bad sexual side effects would be awful also. What side effects did/do you experience?

[XoxoFaith]

I did have dry mouth and sweating that’s it

[hstroller in reply to XoxoFaith]

Did you have those problems only at the start, or was it an ongoing thing? I already have a dry mouth and my anxiety causes me to sweat sometimes or not tolerate hot or cold, so the though of making that worse is a problem. Any insomnia? Also, did you take anything else while on Pristiq? I am convinced benzodiazepines, which are sometimes prescribed when starting SSRIs/SNRIs, mask some of the side effects.

[XoxoFaith in reply to hstroller]

No it was only for like the first weeks now what I do expiriense still is sweating Iam hot all the time

[hstroller in reply to XoxoFaith]

How much do you take? Is it in the morning or evening? I would like to avoid the sweating issue, but it seem like it is a common problem. What kind of things do you do to deal with it?

[XoxoFaith in reply to hstroller]

I take 100 mg in the evening and I kind of just deal with the sweating

[hopingto]

Hi, how did you find out that you have short serotonin receptor genes ? I went on Paxil 25 years ago for PMS and been on it since for depression, it doesn't help much anymore but it is very hard to wean off. Started therapy, meditation and listen to subliminal utube videos which helps lessen the depression. My doctor hesitates to switch me to other types of medication for depression. Within the last year I developed GAD too, which is I feel is worse than a low grade depression.

[hstroller in reply to hopingto]

I am in the US. I talked to a new psychiatrist who recommended GeneSight, which is a DNA/gene testing service which looks to see if you have problems metabolizing certain common psychotropic medications (antidepressants, anxiety meds, hypnotics, antipsychotics medicines, sleep medicines, and mood stabilizers). They also check a few genes that are related to serotonin and drugs you might take. You could have Long/Long, Long/Short, or Short/Short (google SLC6A4 gene). Private insurance generally doesn't cover the test, although they claim most people pay $330 or less, or can apply for a Financial Assistance Program that can defer some or all of the cost. Your doctor or psychiatrist swabs your cheek, they send it in, and 2 or 3 days later you have a report.

I don't know if it is useful or not. It is theoretical / observational stuff. I took Paxil for 5 or 6 weeks (12.5 mg CR for 10 days, 25 mg CR for the rest of the period) and it did have an effect after 3 or 4 weeks, even though the report says my response could be limited and it also said I could have some intermediate problems metabolizing it.

I think the report can be helpful at the extremes if your liver might metabolize a medicine too quickly and render it unusable at a normal dose, or if you metabolize something poorly, which could cause it to build up in your body too strongly at a normal dose, causing adverse reactions.

I stopped Paxil after 6 weeks because of eye sight problems (couldn't focus clearly as the day progressed), sexual dysfunction, slight nausea, and feeling tired. I am debating starting again at 12.5 mg to fight ongoing depression and anxiety, but I am worried about never getting off of it. I was taking Klonopin while on Paxil also and another weird thing is that I seemed to lose the feeling of getting hungry and craving food. I don't know if that is the underlying depression, but I could eat food normally, but I didn't really get hungry around meal time.

How many years did the Paxil work for you before it stopped working? Did you have any side effects? What would your advice be to me about starting back up?

[hopingto in reply to hstroller]

I started 25 years ago at 10mg and it worked great for a few weeks, then I upped it to 20 mg for many years I managed because I was working, busy raising my son and I did not want to take a higher dosage ever. It probably stopped working many years ago and but I suppose I got the placebo effect. About 5 years ago, my insurance switched me to generic Paxil which I had to adjust to. Two years ago I tried Lexapro but couldn't sleep. So I started taking 30 mg of paxil. Doc said just keep taking it, as it was safe and I have no side effects, Now anxiety is an issue for the last year and depression is increasing. I have never used the controlled release formula so not sure if that would improve things. I was almost off paxil this past year with no withdrawal, but after a few weeks I hit depression again and started Paxil again. Paxil keeps me from sinking even deeper but doesn't alleviate the depression I already have. I will look into SNRIs though. Last year a bad 3 month episode of depression caused loss of appetite and I lost weight which I regained easily.

[Boyshape]

Hi Iv tried most antidepressants on the market for anxiety and depression. And have had most success with SNRI s. I currently take duloxetine, or cymbalta. IV noticed fewer side effects than SSRIs etc..... SNRIs appear far better at treating anxiety.... Certainly for me. Everyone is different though and one person's experience of the same medication can be very different to anothers....i would certainly recommend trying them... I suspect your fears of them enducing rather than treating anxiety are unfounded... Certainly in medical trials.

[hstroller in reply to Boyshape]

Do you take Cymbalta alone, or with any other medications?

[hstroller]

Have you had any side effects with the SNRIs? I know everyone reacts differently.