Which anti depressants combine well with Lyrica?

[MyNameIsTerry]

Hi pdu and hanshan I have just been prescribed Valdoxan it is very expensive and a private script, I was on Mirt and it was cheap also a benzo,would either of you know why it is so bloody costly?.

Hi Karina

I hope you are holding up

That's a pretty new med. It tends to be because of that and if there is no generic available that drugs are more expensive, or so we find in the UK. Europe only approved it in 2009 and from I can tell, it's the original company only. I'm not sure there are generics yet.

I know pulisa knows about this med as she has mentioned it on a few threads over the years.

[flipp]

Thanks Terry.
I am ok. I just got a shock when I had to pay,it is a lot of money to fork out when you haven't got it.

How are things with you?xxx.

[panic_down_under]

What medication would you suggest for severe anxiety?

All antidepressants except maybe bupropion (Wellbutrin) should in theory be effective, but in practice most respond better to some meds than others. There is no way of predicting which they may be for you which is why I asked what you've tried in the past besides Cymbalta and mirtazapine in the hope there might be a clue in the history.

I usually suggest citalopram (Celexa), or the similar escitalopram (Lexapro) as good first options because they generally have the best side-effects profiles, but sertraline (Zoloft) would otherwise be my pick of the SSRIs.

If you had access to a doctor I'd be recommending either clomipramine (Anafranil) if you have generalized anxiety, or imipramine (Tofranil) if you also get panic attacks. The problem with both is that they can be risky if there are heart issues. Even if you're young and reasonably healthy, your circumstances - poor food, insanitary conditions, high endemic diseases risk, etc - may be having an impact on your heart.

[MyNameIsTerry]

Thanks Terry.
I am ok. I just got a shock when I had to pay,it is a lot of money to fork out when you haven't got it.

How are things with you?xxx.

I saw one in the NHS guide for last year at £7k the other day. For that I would expect the pharmacy to deliver it by Rolls Royce with a butler who opens & closes my mouth for me after popping it in! (like the royals probably have )

I'm ok. Been a bit better recently, getting more done. The brighter weather has started so that helps.

[hanshan]

Hi Flipp,

If it's a private script in Australia, it probably means that it isn't (yet) subsidised by the Pharmaceutical Benefits Scheme (PBS), so you pay the full price charged by the manufacturer.

If the drug is still under patent (ie no competition from generics), the manufacturer will milk it for all they can get (subsidised or not).

This has been the case for pregabalin, which only recently came off patent and isn't PBS listed in Australia for GAD. I found pregabalin so helpful I was prepared to pay the full price, which I told myself was about the same as a barista coffee and muffin every day, which people happily pay for (though not as much fun, taking capsules).

If you have private health insurance over Medicare, your insurance may pay a rebate for a limited number of private prescriptions.

[MyNameIsTerry]

I'd definitely take a successful anxiety med over the muffin & coffee any day, hanshan. It's probably a better reinvestment of the tax on them that the coffee company won't be paying to your government anyway, well if they are like Starbucks over here...

[akb]

All antidepressants except maybe bupropion (Wellbutrin) should in theory be effective, but in practice most respond better to some meds than others. There is no way of predicting which they may be for you which is why I asked what you've tried in the past besides Cymbalta and mirtazapine in the hope there might be a clue in the history.

I usually suggest citalopram (Celexa), or the similar escitalopram (Lexapro) as good first options because they generally have the best side-effects profiles, but sertraline (Zoloft) would otherwise be my pick of the SSRIs.

If you had access to a doctor I'd be recommending either clomipramine (Anafranil) if you have generalized anxiety, or imipramine (Tofranil) if you also get panic attacks. The problem with both is that they can be risky if there are heart issues. Even if you're young and reasonably healthy, your circumstances - poor food, insanitary conditions, high endemic diseases risk, etc - may be having an impact on your heart.

I was on tricyclics a few years ago. Tofranil I tried but it didn't work. Efexor then Cymbalta were great for 14 years total.

Lexapro sounds like a good option and I knowy wife can get hold of some for me.

I'm confused about pregabalin now and nobody has answered my question as to whether its effective for a highly sensitized anxious person in my situation. Its expensive and that's why I hesitate to increase the dose from 200 to say 400.

Please help me I feel desperate at times.

akb

[panic_down_under]

I was on tricyclics a few years ago. Tofranil I tried but it didn't work. Efexor then Cymbalta were great for 14 years total.

Some need to take a fair wack of Tofranil to get a good result. I was on 300-350mg for several years. It worked great. But I wouldn't recommend that in your situation.

Lexapro sounds like a good option and I knowy wife can get hold of some for me.

It is definitely worth a shot. But, given you've had success with SNRIs in the past, also consider sertraline. If necessary it is possible to supplement it with nortriptyline (Pamelor), a noradrenaline/norepinephrine reuptake inhibiting antidepressant, to essentially create a bespoke SNRI. This gets too complicated with Lexapro because of drug-drug interactions and concerns about the impact on the electrical system of the heart.

I'm confused about pregabalin now and nobody has answered my question as to whether its effective for a highly sensitized anxious person in my situation. Its expensive and that's why I hesitate to increase the dose from 200 to say 400.

I'd like to give you a definitive answer, but there is no way of knowing whether it will be more effective at 400mg other than trying it. Sorry.

[akb]

Hi pdu

Thanks for your help
Cymbalta has definitely pooped out for me so I need to replace.
Then try increasing pregabalin and if no effect at higher dose, come off it completely.
That seems a sensible line to take

akb

[panic_down_under]

Then try increasing pregabalin and if no effect at higher dose, come off it completely.
That seems a sensible line to take

Of your options doubling the pregabalin dose would give the quickest response if it works.