+David Oesterle I'm glad the video was helpful. In theory, people with depression who have low energy, loss of interest in pleasurable things, and decreased alertness can benefit from SNRIs, as these symptoms of reduced positive affect are mediated in part by norepinephrine. I generally don't recommend SNRIs for someone with panic attacks, as I find SNRIs to be activating, which can lead to worsening anxiety symptoms and irritability. SSRIs are all for the most part effective and safe for depression and anxiety. But if I had to choose, my top 2 SSRIs would be Zoloft (sertraline) and Celexa (citalopram). To learn more about SSRIs, please go to the following link: anxietyboss.com/anxiety-treatments/ssris-selective-serotonin-reuptake-inhibitors/

No real difference...who cares if escitalopram only has the active isomer, while citalopram has both the inactive and active isomers. Pharmaceutical gimmick, and an excuse to extend patents. (Note: the original question was erased by the commenter- maybe they didn't like my answer. The original comment stated that escitalopram was more effective and had less side effects than citalopram.)

I'm a lexapro can you make please make a video on lexapro please

SSRIS are very dangerous for high anxiety depression

@@CarloCarandang i didnt find sertraline or citalopram to be useful for anxiety or panic attacks. ive been prescribed venlafaxine and heve been taking it for about 1 year i didnt find it helpful either. i found the CBT to be very useful in preventing extreme panic attacks, i have too many physical anxiety symptoms to list here. im currently taking 40mg propranolol 4 times a day, 150mg slow release venlafaxine, amlodipine, and recently gabapentin 2x100mg. i fight the adrenal fatigue to complete my daily tasks like eating washing cleaning shopping etc which gives me headaches, i appreciat any advice you can give (disclaimer: that i act upon at my own risk)

Thank you for your kind words Gill!

That's very kind of you...thanks for visiting!

@@CarloCarandang I taken meds before for about a week and for some reason I felt a little worse even a little suicidal don’t know why

Thanks for your feedback!

Thanks for visiting, fellow advocate!

Thanks for your kind feedback!

Glad you enjoyed it...thank you for watching!

Glad it was helpful!

Dustin Wallace thanks for the great feedback, and thanks for visiting!

Carlo Carandang no, thank you. Have you visited surviving anti depressants web site or any Facebook groups to get real live feed back from real patients suffering from withdrawls of ADs? I understand their a minority but I think it’s important to look at. Just curious from a doctors perspective who seems to be more productive and active in this regard.

Dustin Wallace thanks- I’ll look it up!

beeli same here! This video is exactly what I needed to understand what is going on with my brain and why many other drugs have not been effective for me in the past.

Thanks for visiting and for the kind feedback!

Yes, the withdrawal side effects from coming off of Effexor (venlafaxine) can last several weeks, if not months.

Beta blockers are good for situational anxiety, while SSRIs are good for constant anxiety. The following link has more information on beta blockers and SSRIs for anxiety: anxietyboss.com/anxiety-treatments/prescription-drugs/

Carlo Carandang, thank you I'll have a look

I will note, also, that at higher doses I find Prozac to be very stimulating -- which I think does go to show the complexity with which these drugs directly and indirectly effect specific and other neurotransmitters.

I'm glad you found a treatment that works for you. However, an informed patient is a doctor's nightmare, as docs historically had the monopoly on medical knowledge. But Dr. Google is now the most queried medical repository, and this is no longer in the exclusive realm of doctors. Good for you to stand up to your doctor, armed with medical knowledge!

Carlo Carandang I'm giving the Cymbalta a try but I am still being a brat and taking 20mg of Prozac. He only put me on 30mg of Cymbalta and wanted to pull me right off 60mg Prozac/100mg Wellbutrin. I told him it wasn't happening. I've been on the Prozac since 2012 -- pretty sure I'd feel just dropping that one!

That makes sense, as Prozac (fluoxetine) is an antidepressant...it improves energy, increases concentration, increases psychomotor functioning, elevates mood...too much of it can be over-stimulating

Please follow-up with your doctor, but if you don't agree, then please consider getting a second opinion from another doctor.

Desensitization may help you: anxietyboss.com/why-does-facing-your-fears-reduce-your-anxiety/

@@CarloCarandang the problem i never had these anxiety attacks before. I had social anxiety with little physical symptoms..slightly losing track of thoughts in new situations... and hot flashes. now its out of control During my previous years in college, and years i used to work in stimulating environments, it was all fine and overcome most of my fears... Now it doesn't matter whether it's a new situation or a situation i felt comfortable with. And do you recommend venlafaxine? All i read about is bad bad reviews regarding withdrawal symptoms

@@zombiedeutsch avoid venlafaxine as a first choice for anxiety, as I state in this video. Go back and study the video...I'm clear that venlafaxine should not be considered for anxiety disorders. Please see a psychiatrist for individual cases, as this channel is only for general advise.

@@CarloCarandang I disagree. I had MAJOR anxiety, panic disorder, depression and major OCD. Venlafaxine changed my life! I love it! I feel like I'm living normal again! I've been on it for 18 years. I went off it for about 3 months. Depression and all my other symptoms came back again. Went back on it and I feel normal again.

@@fordmustang5856 I’ve been prescribed venlafaxine for similar issues (OCD, panic attacks and depression) and am worried about potential side effects/ withdrawals. I was wondering how long it took for the medication to work? And what the main difference you noticed while taking it.

Not familiar with such test. Please follow your doctor's advice.

@@CarloCarandang thank you for responding! I tried to contact you via your website with a few questions but was unsuccessful. How can I email you? Thank you!

@@sara54501 you can contact me here: carlocarandang.com/

Fluvoxamine

Are you taking an antidepressant?

Effexor can work in some people, so if that worked for you, then talk to your doctor (I can't give advise for individual cases- otherwise, I would charge you for the consultation).

The reason why SSRIs are effective for anxiety and depression is that it causes psychic numbness, where it helps you to not care about your thoughts and worries so much.

A 24 hour urine test for cortisol tells you nothing about your current state of anxiety, as cortisol is released immediately after an anxiety event. However, over the course of a day, the cortisol levels decrease and increase, depending on the stressor, but the 24 hour urine for cortisol may stay in the normal range. And SSRIs do suppress the amygdala, and hence suppress the release of cortisol: kzfaq.info/get/bejne/mdV5i9uVv5ipo3U.html

I'm the patient myself not a doctor & only share my experience, not diagnose or treat anyone. If nothing works for me I try Ativan 1 mg and the pain killer synthetic opiate the Tramadol (Ultram) that has SSRI side effect. Slowly 1 ×50 mg then 2×50mg every hour , until calming down . I must take Tramadol anyway for many pains I live with. Then search for the right kind of SSRI , some can make a person feel worse. Effexor, Cymbalta, Citalopram made me feel worse & Citalopram horribly bad ! For some people or a few they work OK. Friend told me to discuss with my doctor Citraline or Mitrazapine , they do work for him & the same that didn't help myself, also didn't help himself. Guess all depends on individuals biochemistry. Tramadol interacts with Dexmorphan(spelling?) in cough syrups! Ginseng! So best to start low & slow. I hope working with right doctor will help you. Histamine intolerance , inflammations were also the cause of my anxiety, DAO & Qurcetin helped myself. Some new generation of doctors are very good.

you sleep everyday?

Harry Callahan how are you doing now?

I would recommend a referral to a psychiatrist before proceeding with treatment.

Ask your Derm about low dose Doxycycline for rosacea if you are not allergic. Also Ivermectin. Please use with doctors recommendations.

If you have melancholic depression, then an SNRI may be a good choice, as detailed in the following article: anxietyboss.com/study-shows-two-different-types-of-depression-may-be-addressed-with-different-antidepressants/

Thanks for sharing.

In general, yes, but sounds like you had the opposite response.

Medicines work differently for females due to the fact we have our cycles and bunch of hormones that are too busy with setting up our three phase cycles per month. I am on the pill and I have seen claims saying that most medications will work more effectively if you have immune disorders/hormone disfunction if they are on the pill. 95% of medication catered for men do not work very well on woman since we have extra hormones that will be unbalanced or block those chemicals from working, so you can get the bad reaction instead. My adhd medication will not work great unless I am on the pill. My BP goes too high without being on the pill, but why should I miss out? The benefit out way for me to be on the pill and it regulates medications a lot better then chemicals that fluctuates. I do not think one anti depressant alone will fix the problem if you have pmdd, adhd or mixed anxiety. My depression comes co morbid, lack of stimulation since I'm on medications that make me too focused, it kills the fun out of the limbic system so I'm looking into the alternative of adding the SNRI with my other medications. I could just get a boyfriend but nah I'll pass. 😂 too much trouble for me! I'm happy with what I know today, it works. Better then being 120kg with binge eating disorders that all went away so maintaining it, my energy levels have improved, but it is hard when you are still restricted recreationally by the medication itself.

Your Propranolol is likely decreasing the sympathetic nervous response to anxiety, not the effexor

Thanks for visiting! Fetzima is effective for depression, as it is an SNRI.

The jury is still out on this one...

Pristiq basically has no value over Effexor...it is the same drug, except that Pristiq has only the active metabolite desvenlafaxine. Pristiq only serves to extend the patent of the drug manufacturer, as Effexor (venlafaxine) is now generic. Please follow-up with your psychiatrist to explain why they prescribed Pristiq over Effexor.

Karla Cisneros PRISTIQUE is not addictive!!!

Strattera has been known to help for anxiety when prescribed for ADHD. You will have to confer with your doctor on the last part of your question.

Please go see a psychiatrist- you may need combination treatment.

It's not a good idea to mix phentermine with antidepressants, as phentermine releases the same neurotransmitters into the synapses of your brain, and the antidepressants block the reuptake of these same neurotransmitters. It is a set-up for drug-drug interactions. Please follow-up with your doctor, or follow-up with a psychiatrist who knows what they are doing. Effexor can be associated with weight gain, but it is rare.

Oh my...what is the reason for prescribing 2 antidepressants at the same time? You may need a second opinion from a psychiatrist regarding the numerous medications you are taking.

I'm on same zopiclone 7.5 mirtazapine 30mg cocodomol and pregabalin 350mg and just started 75mg venlafaxine but it making me so nausea and can't eat can't keep food down without wanting to throw up. Hope you're well.

M Goldey 50mg of venlafaxine is sub therapeutic, and doses above 75mg are needed. But it has so many side effects, as I discussed in the video.

Carlo Carandang thank you for your response. Which minute of the video did you mention the dosages? Thanks for your info!

Thanks for visiting!

This channel is only for general advise- please see a psychiatrist for a psychiatric evaluation. For self-help topics, please visit AnxietyBoss.com

I hope you got it sorted out, but goid cold tukey from most of these meds, especially benzos is a very bad idea.

As from the video, I don't like SNRIs as first line for anxiety disorders. Ask your doctor to refer you to a psychiatrist who specialized in treating anxiety disorders.

Thanks for sharing.

Thanks for visiting!

Not recommended.

Thanks for your comment! Regarding your question, there is currently no direct way to address the adrenal secretions that is used clinically, although the methods to reduce anxiety overall will eventually target the adrenal system: anxietyboss.com/how-to-reduce-adrenaline-response/

Diphenhydramine is a nice little sedative for panic.

It can work, on an as-needed basis

@@CarloCarandang Family member was taking 50mg of the Unisom, which is diphenhydramine, for sleeping. It caused severe anxiety & irritability. People need to know it can have the opposite effect of being a sedative for some people. Would like to hear your opinion on this Dr. Carandang.

Yes that makes sense. You can also consider a natural remedy: KalmPro.com

Effexor is more serotonergic at lower doses, but once you hit around 150 or higher it starts to work on norepinephrine as well.

Yes- the amygdala is suppressed by propranolol. And yes to the second part of your question.

This could be caused by a medical condition, such as petit mal seizure, also called absence seizure. Your sister should get a medical evaluation from her doctor.

In some people, the increase in norepinephrine from an NRI can eventually downregulate norepinephrine receptors, leading to decreased anxiety. However, the noradrenergic surge can cause the physical anxiety symptoms you describe. I'm not a fan of NRIs for anxiety disorders, which is why I made this video.

@@CarloCarandang I have been on many different antidepressants in my life so far, i think close to 25, and Im only 20. This was my GP's attempt to help me out of a horrible depression/anxiety spell that lasted months while waiting for a psychiatrist referal. Now im on venlafaxine, and life is tolerable for the depression but the anxiety is still very much there. This downregulation you talk about, is this permanent or an effect that occurs only while on the drug? Furthermore, everytime i have attempted to taper off the drug under supervision (it numbs my emotions) i have awful brain zaps and nausea, mood swings etc. Can you please explain why this happens if you have the time? I have done plenty of research, but only find solace in forums and no real medical cause. I can only speculate. Thank you for this video.

Joanie Mortimer for anxiety disorders not responding to SSRIs, SNRIs may work, on the premise that norepinephrine reuptake inhibition may desensitize the NE receptors downstream, hence reducing anxiety. Please see your psychiatrist about this.

Possibly...you may need to treat the anxiety disorder separately. See your psychiatrist for more help on this.

@@CarloCarandang Thank you!

SNRIs are stimulating. If SSRIs don’t help you, then benzodiazepines definitely will. The problem with benzodiazepines is that they can be addictive.

My thoughts on meditation for anxiety: anxietyboss.com/the-problem-with-endorsing-meditation-for-anxiety/

Sounds like a plan- go back to what works

Celexa is less likely to cause racing heartbeat than Effexor

Good luck on the new medication!

As I stated in the video, an SNRI is different than an SSRI in that the SNRI also increases norepinephrine in the synapse from norepinephrine reuptake inhibition. This increase in norepinephrine from the SNRI can potentially make the anxiety worse. Ask your GP to refer you to a specialist, a psychiatrist.

I Dr, thanks for the reply. I still don't get what it does to the brain maybe because I also have Asperger Syndrome. I think my paranoia is linked to delusions that I have long suffered in my life. My thoughts are persecutory thoughts that I think people are spying on me and watching me for the goverrnment for example. The delusions are perceived by me as real to me and that I am at a danger. I also get extremely panicked and anxiety overfills me when I am paranoid with my delusions.. Is venlafaxine for this condition of paranoid delusions or is there another medication for this treatment?

Venlafaxine does not treat psychotic symptoms such as paranoid delusions. Please follow-up with a psychiatrist immediately.

+Carlo Carandang Hi Dr. which medication do you suggest. I only see my GP. I've started venlafaxine 37.5mg. it seems to be OK. I have had a terrifying psychosis episode that felt surreal when 15 years old that I felt my senses and thoughts were being intercepted that left my mind confused, anxious, paranoid for many years. I did not talk about it for many years and was left untreated without medication that i suffered persistent dizzyness, anxiety, low mood and delusions of paranoia ever since. In my 30s I have been diagnosed Asperger's. I had told my doctor I have paranoid delusions of my surroundings that seem real to me but not to others that others are looking at me watching me against my will. Doctor does not know my psychosis episode and diagnosed me depression, anxiety. I had a bad experience with citalopram. The sertraline was better, but my anxieties was worse after a while with sertraline. I'm now on venlafaxine it seems to be triggering part of the brain that is most effective for my paranoia than these SSRI. I've only just started it so see how that goes. Doctor always said to try tranquilliser but I refused due to the nature of my paranoia. I wish I listened to my GP because the SNRI is definitely have a better response on me.

I can't diagnose nor recommend treatment for individuals on an online forum. Please follow with your GP, and demand an immediate referral to a psychiatrist. From what you describe, a GP will not be able to treat you...you need a specialist, a psychiatrist.

For depression, you’re on the right medication

There are some people who really respond to venlafaxine for their anxiety symptoms, as both the serotonergic and noradrenergic post-synaptic neurons downregulate to produce less anxiety symptoms.

Chrispy Bacon well there you have it

I have snakes, burning snakes!

wow, that's an image 🦇🦇🦇🔥🔥🔥

I have high anxiety, phobias, and ocd.....I was on wellbutrin xl for 3 days and felt like my body wanted to go up to heaven and burst into glitter. Wellbutrin was absolutely terrible for EVERYTHING I deal with. Idk why the hell they prescribed it to me.

@@ariyogatravels Why would you take an NDRI medication with anxiety? Fire your provider immediately

Thanks for visiting, and your statement about Effexor is true.

@@CarloCarandang sir is it true for desvenlafaxine (pristique) .

I can't answer questions for individual cases- please follow up with your psychiatrist.

Glad to hear that

Cody B just follow up closely with your doctor. Thanks for visiting!

Let us know how you go with it.

How did it go for you

30 mg is a lot! Jesus

Good luck and hopefully this SNRI helps you.

Updates ?

Did it go well for you? Im starting snris soon as my psychiatrist said that snris could desensitize me to Norepiphrine.

Talk to your doctor about Mirtazapine: anxietyboss.com/anxiety-treatments/prescription-drugs/#Mirtazapine

Yes- that problem is called polypharmacy, a common problem that doctors create when they prescribe too many medications at once.

First question- it doesn't. Second question- Effexor is great for depression...anxiety- not so much.

i heard the simple illustration for the difference of SSRI vs SNRI. Here is the 2 of ratio for 2 elements in our mind , {Hopelessness : Anxious}. A unit of SSRI removes {3:7} in our mind, while a unit of SNRI removes {5:5} . So, the patient has {4:5} , then better to go a unit of SNRI which remove Both in the mind. (Anyway, if large amount of units can be prescribed , the result will be same with either SSRI/SNRI)

Tomohiko Mukai I never heard of that before...who is the quack that told you that?

@@CarloCarandang From a vid to amatures by a Local Dr. He said he did intentionally oversimplified it to illustrate to amatures (Like me) with ease. i and all knew his illustration is a kind of abstraction, and Not very Sciencial, Statistical. What he want to tell was... "The latest developed SNRIs are Not superior as folks believed, SNRIs may be slightly better or almost same as old SSRIs (like paxil)."

@@CarloCarandang Thanks to taking your time. and i love your vids.

That's called polypharmacy...not good practice.

Why wouldn’t this be a good idea

@@susannelacorte2921 It's not a good idea to double up on drugs that do the same thing- it's called polypharmacy, which increases the risk for side effects and drug-drug interactions.

@@CarloCarandang It very well might cause serotonin syndrome. Very very bad!

Andrew Daley increase in appetite is a big problem for mirtazapine at any dose.

It is possible that SNRIs, which are a type of antidepressant, could raise dopamine levels in the brain. This is because SNRIs work by inhibiting the reuptake of both serotonin and norepinephrine, which can lead to an increase in the levels of these neurotransmitters in the brain. Norepinephrine is a precursor to dopamine, so it is possible that increasing norepinephrine levels could lead to an increase in dopamine levels as well. However, this is not always the case, and more research is needed to fully understand the effects of SNRIs on dopamine levels.

An SNRI is basically not a first choice anxiety, given that the effects on norepinephrine are stimulating. If you are experiencing anxiety and activation from an SNRI, then please consult with your doctor for medications with less side effects, such as an SSRI for social anxiety disorder, panic disorder, PTSD, OCD, and generalized anxiety disorder. For situational fears such as encountered with performance anxiety (stage fright), then a beta blocker may be helpful, on an as needed basis. No medications are helpful for specific phobias, as this is mainly treated by exposure therapy and extinguishing the fear.

robert smith it’s great for treating depression. Not so great for anxiety, as I state in detail in the video.

sorry but you did not state that, you said it can stimulate, but exactly how it helps with depression was not clear to me, where on your vlog did you say how it affects serotonin, i m sorry if missed it , but i m sure you just poo poo d it as not an important agent.

I'll make another video soon about how SNRIs work for depression, as apparently, it is not so clear in this video. Thanks for visiting, and stay tuned for the next video.

@@CarloCarandang what is your opinion on taking a SNRI with a benzodiazepine for anxiety?

@@andyog8252 first off, I'm clear that SNRIs are not something I would recommend as a first choice for anxiety disorder, given their activating properties, and people with anxiety are already revved-up. Secondly, benzodiazepines are prescribed like water by doctors, but their long-term problems with addiction and withdrawal symptoms outweighs their short-term benefits for reducing anxiety.

I'm not aware of off-label use of tramadol for depression or ADHD. Psychostimulants such as methylphenidate can be utilized in depression in the senior population that is associated with multiple medical conditions and psychomotor retardation.

i found one swiss study about tramadol and buprenorphine for depression

Tramadol (Ultram) is indicated for pain, and can be helpful for associated anxiety and depression. But Tramadol is not a standard treatment for anxiety or depression- same goes for buprenorphine.

Medication is not a primary treatment for depersonalization/derealization: anxietyboss.com/derealization-a-defense-mechanism-for-anxiety/ Please see your doctor for a referral to a psychiatric that specializes in dissociative symptoms.

Carlo Carandang it’s hard to find one in my area, my last two didn’t know what I was talking about

@@JennellBarrett next time a doctor says that, share my contact information, and I will educate them on how to treat this: carlocarandang.com/contact-me/

Hi!!! Were you able to find a medicine or a combination that helps?

Issac John glad the video was helpful!

Yes your brain and nervous system has been literally poisoned by an SNRI. Pretty simple. Good luck recovering and ever feeling normal again for the rest of your life.

Wow...find another doctor who will listen to you. "He says it's just me"...that is so invalidating.

Thank you. Yes its not a nice feeling.

Hello, glad to hear this combination treatment has helped you. Regarding a different combination for your case, you will have to discuss it with your doctor.

Usually, after being treated successfully with the medication for 6 to 9 months, tapering after one year of treatment may be fine, without relapse. Relapse risk increases when you only take the medication briefly

The answer to your first question- no, it’s not recommended. Go see a psychiatrist for the rest of your questions

You really have to go see a psychiatrist- you have multiple disorders that need specialist care

@@CarloCarandang thank you for your reply carlo. I am seeing one at the moment. He prescribed me dexamphetamine to help me with my memory and brain i jury from road injury but it just made me really anxious. It is hard, i feel because of my ptsd im always on edge and struggle to relax or be happy. Anyway, i will contact him again and hopefully get it sorted. Enjoy your day!

It’s a metabolic disorder watch how you’ll be more anxious when you’ve not eaten and more depressed when you’ve eaten more. Sugar industry is killing us

Answer to question 1: precisely- just use an SSRI for anxiety. Answer to question 2: it depends, as now you have 2 disorders to treat- this question is for your treating psychiatrist.

Carlo Carandang thanks for getting back to me! My doctor has prescribed pristiq but I'm honestly worried about the side effects of high blood pressure and I don't know if it works for anxiety but depression alone

steve rears if you’re worried about this side effect, then talk to your doctor about it, and about alternatives

There's no head-to-head studies of KalmPro to SSRIs for anxiety. But if you want a natural solution to anxiety, and are thinking about making the switch, then talk with your doctor and follow these steps: anxietyboss.com/switching-from-ssris-or-snris-to-kalmpro/

Carlo Carandang thanks for that! The tapering strategy is exactly what I needed

Carlo Carandang I cant seem to purchase kalmpro it is always unavailable! No where else to get it

That’s exactly the point- why even consider it if it is activating?

The FDA does not recognize any class of antidepressant as being more effective than any other. This does not mean that differences do not exist, but no study to date has sufficiently demonstrated such superiority. It has been argued that direct modulation of serotonin and norepinephrine may convey greater antidepressant effects than are exerted by medications that selectively enhance only noradrenergic or serotoninergic neurotransmission. This greater therapeutic benefit could result from an acceleration of postsynaptic adaptation to increased neuronal signaling; simultaneous activation of two pathways for intracellular signal transduction; additive effects on the activity of relevant genes such as brain-derived neurotrophic factor; or, quite simply, broader coverage of depressive symptoms. Clinical evidence supporting this hypothesis first emerged in a pair of studies conducted by the Danish University Antidepressant Group, which found an advantage for the dual reuptake inhibitor clomipramine compared with the selective serotonin reuptake inhibitors (SSRis) citalopram (Celexa) and paroxetine (Paxil). Another report, which compared the results of a group of patients prospectively treated with the combination of the TCAs desipramine (Norpramin) and fluoxetine (Prozac) with a historical comparison group treated with desipramine alone, provided additional support. A meta-analysis of 25 inpatient studies comparing the efficacy of TCAs and SSRis yielded the strongest evidence. Specifically, although the TCAs were found to have a modest overall advantage, superiority versus SSRis almost entirely explained by the studies that used the TCAs that are considered to be dual reuptake inhibitors-clomipramine, amitriptyline, and imipramine. Meta-analyses of head-to-head studies suggest that venlafaxine has the potential to induce higher rates of remission in depressed patients than do the SSRis. This difference of the venlafaxine advantage is about 6 percent.

Your thesis was about depression. This video was about SNRI in anxiety. Totally different from what you cited above.

If you don't trust your doctor, then please consider getting a second opinion from another psychiatrist.

therichardchannel I think a snri is better than. Ssri for anxiety .. no?

No

Carlo Carandang WHY NOT DOCTOR?? ... Since I have been taking PRISTIQUE 50MG for years, and works wonderful I concentrate, coordinate, exercise,think, I can multifunction, multitask, good energy, and helps very much with pain like fibromyalgia ...explain please! And thank you 😊😚

I was speaking specifically on SNRIs for anxiety. For neuropathic pain associated with various neurological and medical conditions like fibromyalgia, it does work for pain relief. For anxiety, not so much.

Might be a dosing issue with Zoloft- talk to your doctor about adjusting the dose: anxietyboss.com/anxiety-treatments/prescription-drugs/#sertraline

@@CarloCarandang Thank you!!

Should I increase or decrease. On 100 mg Zoloft 300mg Wellbutrin

@@cybell2623 you have to ask your doctor. I can't answer individual medical questions on this channel, as it's meant to provide general education only (free of charge).

Bupropion (Wellbutrin) does not treat anxiety disorders.

Thank you dr my thoughts were that as well I speak with him at my next appt I appreciate your input

@@stefanieadams2170 Good luck and thanks for visiting!

Here is a detailed article on natural supplements for anxiety: anxietyboss.com/what-are-some-over-the-counter-medications-that-help-for-anxiety/

Can I take L-theneane with Pristiq

I highly recommend not combining natural supplements with prescription drugs.

Your doctor can tell you.

Have your doctor watch this video, as your concerns about agitation at higher doses are warranted.

@@CarloCarandang I convinced her to start me on a low dose of 7.5 mg mirtazapine, third day today on the mirt, still the same anxiety but i guess it takes longer than a few days to work (8+ weeks on 150mg ven now).

@@TheJaccen you need atleast 15 or 30 mg of mirtazapine with such high dose of effexor

They work the same, but sometimes it is worth switching to another drug in the same class, and may see an effect.

The answer to your question is contained in this article that I wrote: anxietyboss.com/how-effective-is-zoloft-for-panic-disorder/

@@nathaliedahan7518 good starting dose

Unfortunately, Effexor (venlafaxine) has the worst withdrawal side effects of all the antidepressants, when trying to discontinue it. I would recommend that you allow several months for the taper, and reduce the dose very slowly. Follow-up with your doctor.

This is why I don't recommend going on Effexor in the first place, given the horrible withdrawal side effects when trying to discontinue it.

Carlo Carandang is it the same situation for Pristiq?

Might be a little bit of an improvement when it comes to withdrawal, because it stays in the bloodstream longer (longer elimination half-life). Pristiq is the active molecule, while Effexor has the inactive and active molecule. Basically the same drug, except for price...Pristiq is expensive, while Effexor is generic. So, yes, same situation for Pristiq.

Carlo Carandang thank you Dr. I have just been given a script for Pristiq. Depression, I guess, mingled with some anxiety symptoms. Maybe some hormonal component....I'm 42, periods are starting to change a bit. I took Cipralex before, post partum, for a couple of years. I don't know if it helped. All this to say, after reading the monograph that came with the Pristiq, I'm scared to try it. Serotonin syndrome sounds scary...recommended not to take with NSAIDS. I have severe OA of my knees...I live on Advil. Lol! Maybe that's where the anxiety comes in - I'm terrified to try the med, because I'm afraid of all those listed side effects.

If the SNRI ultimately leads to decreased adrenergic tone (that’s a big IF), then beta blockers and SNRIs work together, where SNRIs may reduce the adrenergic tone going to the Amygdala, and beta blockers block the peripheral effects of adrenaline. However, if the SNRI induced excess norepinephrine with no decrease in adrenergic tone of postsynaptic neurons, then you have a situation where the two drugs are in opposition to each other.

@@CarloCarandang Thank you very much for your professional reply!

Hello, I'm sorry about your symptoms. Unfortunately, I can't give individual medical advise...only general information. Please follow-up with your psychiatrist about your concerns about norepinephrine possibly making the anxiety worse, and show them this video to state your case.

Laxis 710 no worries, and good luck. If your doctor doesn’t satisfy your questions, find another doctor. The internet calls out doctors who think they have the monopoly on medical knowledge. Soon enough, artificial intelligence will replace them.

Yes, SSRIs and SNRIs can cause severe sexual dysfunction in some people, where even Cialis and Viagra are not effective.

@@CarloCarandang Venlafaxine caused ED. Zero libido too. Prozac never did that oddly.

No, it's not that simple.

Now im confused

Carlo Carandang lmao

Yes, worry about not getting things done due to depression, and worry about the depression continuing...worry and fears due to depression symptoms and loss of functioning can lead to anxiety on top of the depression. Talk to a therapist if this is indeed your scenario.

The SNRIs can be weight neutral, and it could worsen anxiety. If fluoxetine was effective, but made you loopy, why not try a lower dose?

It's always important to be cautious about potential drug interactions, especially when taking multiple medications. It's great that you're reaching out to seek more information! Cymbalta (duloxetine) and Klonopin (clonazepam) are both commonly used to treat anxiety and panic disorders. Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant, while clonazepam is a benzodiazepine. In general, combining an SNRI with a benzodiazepine can increase the risk of side effects such as drowsiness, confusion, and increased risk of falls, especially in older adults. Additionally, taking benzodiazepines with an antidepressant can increase the risk of overdose, as they can both cause sedation and affect breathing. It is important to talk to your healthcare provider about any concerns you have regarding the combination of these medications. Your doctor is the best person to advise you on this, as they are familiar with your medical history and other factors that may impact your treatment. They may adjust your dosages, switch to a different medication, or suggest other treatments. If you have trouble sleeping, it's also worth discussing this with your doctor, as some antidepressants can cause insomnia, while others can help with it. In conclusion, it's always best to err on the side of caution when taking multiple medications, and to consult with a healthcare professional for personalized advice.

Who really knows- fluoxetine could go both ways.

Pristiq is desvenlafaxine, which is the active metabolite of Effexor (venlafaxine). Interesting that you didn't have side effects to Pristiq, but Pristiq has a longer half-life than Effexor, and Effexor's short half-life has been implicated in its reputation as "Side Effexor."

Not sure- would not be my first choice

Yes, that combination can be helpful, when monotherapy is not working.

www.kalmpro.com

It can affect the hypothalamus

talk with your doctor

@@CarloCarandang I went with the Citalopram due to its longer half life and did not want to deal with an SNRI as I had a bad experience with Duloxetine, although Genesight had Desvenlafaxine in my green zone I was reluctant to take it, so I went in the yellow zone and chose Citalopram instead, dropped the Fluoxetine and good results in a two week period, major results.