Posted by pharmrep on August 3, 2002, at 11:00:24
In reply to Re: phil's combo, posted by pharmrep on August 3, 2002, at 0:20:36
> Well, I got some general answers since they dont know you. But the one commonality I heard was you have some pretty high doses, and the feeling sleepy yet not able to fall to asleep til 3am.
> Everyone thought 400mg Wellbutrin was too high (going to 1/2 was something I heard a couple of times) Adderall at 40 came up too (2x 20mg's). The Dr's thought this was your insomnia problem. I asked specifically if Celexa could be the "relaxed/tired" culprit...they didnt think so...they often go to 80+ without the "tired" effect, but everyone is different. There was the strong belief that more likely that there are both activating and relaxing meds in you at the same time...at the higher dosing, you could be getting adverse events as well. Your Dr. may have more experience with these meds at the higher doses than the pool I spoke with, but one thing I would recommend is to see how each one of these meds metabolizes in to make sure they are in fact doing that rather that fighting for the same pathway in you body and just floating around...this causes s/e and adverse events as well...I'll give you Celexa...it's a very mild inhibitor of the 2D6 and 1A2 pathways in the liver.These are the adverse events incidence in the clinical trials (listed in the package insert) for Celexa vs placebo. I'm only listing those at 10% or greater or interesting #'s. (this is 8wk study) celexa (1063 patients) placebo (446)
dry mouth 20%/ 14
increased sweating 11 / 9
nausea 21 / 14
fatigue 5 / 3
somnolence 18 / 10
insomnia 15 / 14
yawning 2 / 0
**in the 6mo-24mo trial the numbers stayed about the same. except for nausea..cx=6% and placebo=10%.So Phil, you seem to have somnolence with Cx, and .tabi, you get insomnia. I hate that the same drug
can contradict itself in different people. I will get you some ideas to help next week. (I cant remember
the Lexapro #, but I think it was about 5 or so...FDA is saying "similar to placebo")
poster:pharmrep
thread:109458
URL: http://www.dr-bob.org/babble/20020731/msgs/115066.html