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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by X-ray on January 29, 2009, at 7:18:21
From TheLancetcom:
117 randomised trials,
25,000 patients,
12 new-generation antidepressants:Mirtazapine, escitalopram, venlafaxine, and sertraline
were significantly more efficacious than
duloxetine, fluvoxamine, paroxetine and reboxetine.I'm all for Remeron.
What's your choice?X-ray
Posted by SLS on January 29, 2009, at 8:06:18
In reply to Remeron rules, posted by X-ray on January 29, 2009, at 7:18:21
> From TheLancetcom:
>
> 117 randomised trials,
> 25,000 patients,
> 12 new-generation antidepressants:
>
> Mirtazapine, escitalopram, venlafaxine, and sertraline
> were significantly more efficacious than
> duloxetine, fluvoxamine, paroxetine and reboxetine.
>
> I'm all for Remeron.
> What's your choice?
>
> X-ray
My choice?Spontaneous remission forever after.
:-)
It is a hard decision to make. Of the drugs you listed, I believe that Effexor is the most efficacious. I just wish it weren't so difficult to discontinue. My first two encounters with the drug, I suffered some wicked withdrawal effects. I have since learned how to come off of the SRI drugs without much discomfort.
Lexapro seems to have a good track record. I noticed that Prozac isn't up there.
- Scott
Posted by X-ray on January 29, 2009, at 8:27:06
In reply to Re: Remeron rules, posted by SLS on January 29, 2009, at 8:06:18
> > From TheLancetcom:
> >
> > 117 randomised trials,
> > 25,000 patients,
> > 12 new-generation antidepressants:
> >
> > Mirtazapine, escitalopram, venlafaxine, and sertraline
> > were significantly more efficacious than
> > duloxetine, fluvoxamine, paroxetine and reboxetine.
> >
> > I'm all for Remeron.
> > What's your choice?
> >
> > X-ray
>
>
> My choice?
>
> Spontaneous remission forever after.
>
> :-)
>
> It is a hard decision to make. Of the drugs you listed, I believe that Effexor is the most efficacious. I just wish it weren't so difficult to discontinue. My first two encounters with the drug, I suffered some wicked withdrawal effects. I have since learned how to come off of the SRI drugs without much discomfort.
>
> Lexapro seems to have a good track record. I noticed that Prozac isn't up there.
>
>
> - ScottMy mistake!
I had lost Prozac (fluoxetine).Here's a correct quatation:
Mirtazapine, escitalopram, venlafaxine, and sertraline were significantly more efficacious than duloxetine, fluoxetine, fluvoxamine, paroxetine and reboxetine.X-ray
Posted by desolationrower on January 29, 2009, at 12:15:35
In reply to Re: Remeron rules, posted by X-ray on January 29, 2009, at 8:27:06
can you ysi the fulltext? somewhat surprised reboxetine showed poorly.
-d/r
Posted by Phillipa on January 29, 2009, at 12:23:18
In reply to Re: Remeron rules, posted by desolationrower on January 29, 2009, at 12:15:35
What's wrong with luvox? Phillipa it's sedating more than others for me remeron at l5 did not sedate me or tire me.
Posted by X-ray on January 29, 2009, at 15:41:51
In reply to Re: Remeron rules, posted by desolationrower on January 29, 2009, at 12:15:35
> can you ysi the fulltext? somewhat surprised reboxetine showed poorly.
>
> -d/rHi,
It's an understatement to say that reboxetine showed poorly.
This drug was outclassed by the other drugs in the trials.Here's the verdict:
Reboxetine was significantly less efficacious than all the other antidepressants.I'm afraid that I can't give you the full text.
That would have cost me 31,50 dollars.I'll save that money for a night on the town.
Keep smiling,
X-rayP.S. I've always been crazy but it's kept me from going insane.
Posted by Maria3667 on January 29, 2009, at 16:56:45
In reply to Remeron rules, posted by X-ray on January 29, 2009, at 7:18:21
Oh sure. I'd be for Remeron too... Best AD ever, good for libido too... Only if it didn't such cause horrendous weight gain!
Maria
> From TheLancetcom:
>
> 117 randomised trials,
> 25,000 patients,
> 12 new-generation antidepressants:
>
> Mirtazapine, escitalopram, venlafaxine, and sertraline
> were significantly more efficacious than
> duloxetine, fluvoxamine, paroxetine and reboxetine.
>
> I'm all for Remeron.
> What's your choice?
>
> X-ray
Posted by SLS on January 29, 2009, at 18:43:48
In reply to Re: Remeron rules » X-ray, posted by Maria3667 on January 29, 2009, at 16:56:45
> Oh sure. I'd be for Remeron too... Best AD ever, good for libido too... Only if it didn't such cause horrendous weight gain!
What dosage are you taking?
- Scott
Posted by raisinb on January 29, 2009, at 18:53:08
In reply to Remeron rules, posted by X-ray on January 29, 2009, at 7:18:21
Remeron didn't work for me at all. I wish it had--my sex drive was *much* better.
Lexapro + Zoloft are keeping me pretty stable, and I've had some tough blows in the last couple of weeks.
Posted by linkadge on January 29, 2009, at 19:30:31
In reply to Re: Remeron rules » X-ray, posted by raisinb on January 29, 2009, at 18:53:08
Remeron was good for a short period of time then I felt much worse. It is definately good if your sleep and appetite are all messed up.
As far as drug trials go I don't know if I'd let them make any definitive conclusions. It also depends on the way you look at the data. For instance, there are the paradoxes i.e. citalopram beats prozac, prozac beats luvox, and luvox beats citalopram.
Linkadge
Posted by theo on January 29, 2009, at 20:37:17
In reply to Re: Remeron rules, posted by SLS on January 29, 2009, at 8:06:18
I have since learned how to come off of the SRI drugs without much discomfort.
> - ScottHow?
Posted by SLS on January 29, 2009, at 21:06:39
In reply to Re: Remeron rules » SLS, posted by theo on January 29, 2009, at 20:37:17
> I have since learned how to come off of the SRI drugs without much discomfort.
> > - Scott
>
> How?You are the first person smart enough to ask that question. I wrote about it extensively while the Withdrawal board was new and fresh. I don't think I could reproduce here the contributions I made there. Maybe I can search for them.
Basically, I do not adhere to a fixed schedule of dosing as a traditional weaning process. I dose as needed, almost like a PRN.
I wish I had the wits about me to describe the whole thing for you here and now, but I really don't have the energy. Let me see what I can find.
- Scott
Posted by SLS on January 29, 2009, at 21:13:35
In reply to Re: Remeron rules » SLS, posted by theo on January 29, 2009, at 20:37:17
> I have since learned how to come off of the SRI drugs without much discomfort.
> > - Scott
>
> How?
Here are a few. There are more. I just don't recall which post has the most complete explanation.
http://www.dr-bob.org/babble/wdrawl/20050214/msgs/457546.htmlhttp://www.dr-bob.org/babble/wdrawl/20050228/msgs/469497.html
http://www.dr-bob.org/babble/wdrawl/20050712/msgs/537494.html
http://www.dr-bob.org/babble/wdrawl/20050424/msgs/494026.html
- Scott
Posted by SLS on January 29, 2009, at 21:35:59
In reply to Re: Remeron rules » SLS, posted by theo on January 29, 2009, at 20:37:17
> Here are a few. There are more. I just don't recall which post has the most complete explanation.
> http://www.dr-bob.org/babble/wdrawl/20050214/msgs/457546.html> http://www.dr-bob.org/babble/wdrawl/20050228/msgs/469497.html
> http://www.dr-bob.org/babble/wdrawl/20050712/msgs/537494.html
> http://www.dr-bob.org/babble/wdrawl/20050424/msgs/494026.html
Here is something else you may be interested in:http://www.dr-bob.org/babble/wdrawl/20050214/msgs/460726.html
- Scott
Posted by sam K on January 29, 2009, at 22:24:56
In reply to Re: Remeron rules, posted by SLS on January 29, 2009, at 18:43:48
I don't think studies really matter. I took celexa and it was so weak.. but to some other people it's the most potent. And you said fluoxitine was outclassed but yet it was the most remission I've ever had with depression. Luvox is great for me.
Posted by sam K on January 29, 2009, at 22:26:01
In reply to Re: Remeron rules, posted by sam K on January 29, 2009, at 22:24:56
im not being mean or anything.. Sorry if I come off like that.
Posted by psychobot5000 on January 29, 2009, at 22:56:27
In reply to Re: Remeron rules, posted by X-ray on January 29, 2009, at 8:27:06
> > > From TheLancetcom:
> Mirtazapine, escitalopram, venlafaxine, and sertraline were significantly more efficacious than duloxetine, fluoxetine, fluvoxamine, paroxetine and reboxetine.
>
> X-rayIn my experience Remeron was also somewhat more potent than other meds, venlafaxine included. Not that one experience is enough to draw conclusions from.
(digression warning)
One conclusion of this study I am suspicious of, though, is their conclusion that lexapro is more efficacious. You never can tell, of course, but I suspect that this is based in part on various studies the industry pushed through showing lexapro was faster-acting and slightly more potent than its parent, celexa. I view this conclusion as highly suspect, and possibly rigged up in some way, to help market lexapro. Are there another seven unpublished studies on celexa vs lexapro that failed to show similar conclusions?As far as I'm aware, lexapro is usually dosed at one-half the dose of its racemic parent, meaning that it's just Celexa without the inactive isomer. If this is true (and maybe the studies used differing doses...), and if the data shows lexapro more effective in some way (such as the much-touted study showing quicker AD onset)...then this would mean the other isomer in citalopram/celexa was not only completely ineffective, but actually counterproductive. It's hard to believe. Thus I suspect the lexapro data might be bent a little, (to produce a few more billions for its manufacturer after the parent drug expired), and further conclusions such as the ones this study comes to might be suspect.
Though of course, that doesn't rule out the potential that celexa and lexapro were both just better drugs than other ADs. I suppose that's possible. But 'es' drugs put me in a suspicious mood in the first place, since in most cases a drug developer who had the patients' best interests at heart would be developing a new drug with a new mechanism, rather than repatenting a portion of the old drug.
Interesting conclusions of the meta-analysis, though--thanks for posting them,
Psychbot
Posted by desolationrower on January 30, 2009, at 0:32:53
In reply to Remeron rules--but lexapro's data may be suspect, posted by psychobot5000 on January 29, 2009, at 22:56:27
> > > > From TheLancetcom:
>
> > Mirtazapine, escitalopram, venlafaxine, and sertraline were significantly more efficacious than duloxetine, fluoxetine, fluvoxamine, paroxetine and reboxetine.
> >
> > X-ray
>
> In my experience Remeron was also somewhat more potent than other meds, venlafaxine included. Not that one experience is enough to draw conclusions from.
>
> (digression warning)
> One conclusion of this study I am suspicious of, though, is their conclusion that lexapro is more efficacious. You never can tell, of course, but I suspect that this is based in part on various studies the industry pushed through showing lexapro was faster-acting and slightly more potent than its parent, celexa. I view this conclusion as highly suspect, and possibly rigged up in some way, to help market lexapro. Are there another seven unpublished studies on celexa vs lexapro that failed to show similar conclusions?
>
> As far as I'm aware, lexapro is usually dosed at one-half the dose of its racemic parent, meaning that it's just Celexa without the inactive isomer. If this is true (and maybe the studies used differing doses...), and if the data shows lexapro more effective in some way (such as the much-touted study showing quicker AD onset)...then this would mean the other isomer in citalopram/celexa was not only completely ineffective, but actually counterproductive. It's hard to believe. Thus I suspect the lexapro data might be bent a little, (to produce a few more billions for its manufacturer after the parent drug expired), and further conclusions such as the ones this study comes to might be suspect.
>
> Though of course, that doesn't rule out the potential that celexa and lexapro were both just better drugs than other ADs. I suppose that's possible. But 'es' drugs put me in a suspicious mood in the first place, since in most cases a drug developer who had the patients' best interests at heart would be developing a new drug with a new mechanism, rather than repatenting a portion of the old drug.
>
> Interesting conclusions of the meta-analysis, though--thanks for posting them,
> Psychbot
>supposedly the r-citalopram binds to a allosteric site on the sert which hinders its effect. still, the publication bias problems make me suspicious of these metaanlyses
-d/r
Posted by psychobot5000 on January 30, 2009, at 15:04:36
In reply to Re: Remeron rules--but lexapro's data may be suspect, posted by desolationrower on January 30, 2009, at 0:32:53
> > > > > From TheLancetcom:
> >
> > > Mirtazapine, escitalopram, venlafaxine, and sertraline were significantly more efficacious than duloxetine, fluoxetine, fluvoxamine, paroxetine and reboxetine.
> > >
> > > X-ray
> >
> > In my experience Remeron was also somewhat more potent than other meds, venlafaxine included. Not that one experience is enough to draw conclusions from.
> >
> > (digression warning)
> > One conclusion of this study I am suspicious of, though, is their conclusion that lexapro is more efficacious. You never can tell, of course, but I suspect that this is based in part on various studies the industry pushed through showing lexapro was faster-acting and slightly more potent than its parent, celexa. I view this conclusion as highly suspect, and possibly rigged up in some way, to help market lexapro. Are there another seven unpublished studies on celexa vs lexapro that failed to show similar conclusions?
> >
> > As far as I'm aware, lexapro is usually dosed at one-half the dose of its racemic parent, meaning that it's just Celexa without the inactive isomer. If this is true (and maybe the studies used differing doses...), and if the data shows lexapro more effective in some way (such as the much-touted study showing quicker AD onset)...then this would mean the other isomer in citalopram/celexa was not only completely ineffective, but actually counterproductive. It's hard to believe. Thus I suspect the lexapro data might be bent a little, (to produce a few more billions for its manufacturer after the parent drug expired), and further conclusions such as the ones this study comes to might be suspect.
> >
> > Though of course, that doesn't rule out the potential that celexa and lexapro were both just better drugs than other ADs. I suppose that's possible. But 'es' drugs put me in a suspicious mood in the first place, since in most cases a drug developer who had the patients' best interests at heart would be developing a new drug with a new mechanism, rather than repatenting a portion of the old drug.
> >
> > Interesting conclusions of the meta-analysis, though--thanks for posting them,
> > Psychbot
> >
>
> supposedly the r-citalopram binds to a allosteric site on the sert which hinders its effect. still, the publication bias problems make me suspicious of these metaanlyses
>
> -d/rInteresting--I hadn't heard that. It's good to know that at least someone has a reasonable theory that could explain the difference--it makes me somewhat less skeptical about it. Still does seem very convenient,but I suppose these things do happen.
Posted by theo on January 31, 2009, at 15:53:43
In reply to Re: Remeron rules » theo, posted by SLS on January 29, 2009, at 21:35:59
Thanks I'll look them over.
This is the end of the thread.
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