Using Prozac as bridge off of Effexor
Have a patient who is very sensitive to Effexor taper. Thinking of using Prozac to bridge her. Seems simple enough but just wanted to run it by the gallery here. She's currently on 225mg. Would it be as simple as stopping the Effexor in favor of 60-80mg Prozac and then decreasing over a few days until shes off Prozac? (Source: Student Doctor Network)
Source: Student Doctor Network - December 11, 2023 Category: Universities & Medical Training Authors: uhmocksuhsillen Tags: Psychiatry Source Type: forums
Medication monitoring
We have been having some discussions about what type of labs are needed and how often for medications. I am curious what if any labs do you do and how often for certain medications. Obviously if the patient has underlying medical issues this will change.
Amitriptyline: We do not check anything
Duloxetine/Venlafaxine: Do not check anything
Gabapentin/Lyrica: Right now we are being asked to check yearly kidney function, I don't really see the need to do this unless underlying kidney issues...
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Source: Student Doctor Network - June 20, 2022 Category: Universities & Medical Training Authors: kstarm Tags: Pain Medicine Source Type: forums
Persistent tachycardia in potential first-break psychosis
Hi all,
I have this patient on our unit who is in their early 20s. She presents as having severe borderline personality disorder but has a strong family history of bipolar disorder I as well. She was medication naive at presentation save for venlafaxine. The only odd thing about her is that she has persistent tachycardia into the 120s and has since her arrival. She's not dehydrated. She has negative ANA and CRP. Do you think there could be something organic underlying her mix of BPD +/-...
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Source: Student Doctor Network - January 16, 2022 Category: Universities & Medical Training Authors: Psychferlyfe3000 Tags: Psychiatry Source Type: forums
Venlafaxine plasma level
Hello
Patient has venlafaxine 225mg in the morning
When shall i draw bloods? In the evening 12h post dose or just before the morning dose ?
Thank you (Source: Student Doctor Network)
Source: Student Doctor Network - November 15, 2021 Category: Universities & Medical Training Authors: Sikrouf Tags: Psychiatry Source Type: forums
What do you guys prefer for neuropathic pharm treatment?
I'm a Psych resident, hoping to go into pain.
Anyways, our program, if we have a patient with depression and neuropathic pain, we seem to always jump straight for Cymbalta.
Was interested what the literature/your anecdotal data suggests for neuropathic pain? Effexor? Elavil? Neurontin?
Is Cymbalta the best? (Source: Student Doctor Network)
Source: Student Doctor Network - August 21, 2020 Category: Universities & Medical Training Authors: Blitz2006 Tags: Pain Medicine Source Type: forums
Safe to prescribe SNRI + Wellbutrin?
I Know officially Wellbutrin is NDRI.
So I'm concerned about the norepinephrine levels, and using wellbutrin as an adjunct to Cymbalta or Effexor for depression.
Should I avoid, or am I overthinking/wrong on this?
Thanks (Source: Student Doctor Network)
Source: Student Doctor Network - January 17, 2020 Category: Universities & Medical Training Authors: Blitz2006 Tags: Psychiatry Source Type: forums
Duplicate Therapy- SSRI+SSRI/SSRI+SNRI
How often do you encounter this combination working in retail and how do you resolve it? I have seen numerous patients that have prescriptions for escitalopram 10 mg + escitalopram 20 mg from the same prescriber, in addition to something like venlafaxine/duloxetine or fluoxetine and/or amitriptyline from another.
To make it worse, most of these all are usually a (re)fill 05 and only have DUR comments that only contain 'dose ok' or 'patient on both' without providing any more information. (Source: Student Doctor Network)
Source: Student Doctor Network - September 19, 2017 Category: Universities & Medical Training Authors: josh6718 Source Type: forums
SSRI/SNRI Cross-Taper, increased risk for serotonin syndrome?
Just wondering, because I came across some discussions on patients that were on Cymbalta/Effexor, and due to no efficacy, was decided to be switched to a SSRI. Also pain docs who want to switch a patient off SNRI...
But as we know, at higher doses of Effexor (>100 mg), less serotonin reuptake, and more on the Norepi reuptake.
So if you do a cross-taper, e.g, tapering at 225 mg Effexor, starting 20 mg Prozac, is there a heightened risk of serotonin syndrome? Should you first taper off the...
SSRI/SNRI Cross-Taper, increased risk for serotonin syndrome? (Source: Student Doctor Network)
Source: Student Doctor Network - August 26, 2017 Category: Universities & Medical Training Authors: Blitz2006 Source Type: forums
venlafaxine: risk of adverse cardiovascular effects and of overdose deaths
(Source: BMJ Comments)
Source: BMJ Comments - April 2, 2016 Category: Journals (General) Source Type: forums
Venlafaxine, citalopram and escitalopram: risk of adverse cardiovascular effects and of overdose deaths.
(Source: BMJ Comments)
Source: BMJ Comments - April 2, 2016 Category: Journals (General) Source Type: forums
Re: Selective serotonin reuptake inhibitors and venlafaxine in early pregnancy and risk of birth defects: population based cohort study and sibling design
(Source: BMJ Comments)
Source: BMJ Comments - July 25, 2015 Category: Journals (General) Source Type: forums
