Tricyclic Antidepressants

If effexor xr is only doing 1/2 the job??

Question:

Is it comment to be on 2 AD’s at the same,me time….several people have recommended being on effexor xr and Wellbutrin at the same time?????? is this something I should check more into…..why easy…..tired…then wired….then happy…..crying….alone..and so on…

Response:

        Still at this time in the 21st Century, little is actually known about how and why antidepressants work. There are some theories, but studies periodically come along that seem to put them in serious question. The reason there are so many different ADs and the reason some people need more than one is that EACH one, … even if they are "classed" the same.. eg. "SSRI" or tricyclic, or "norepinephrine reuptake inhibitor", and so forth.. all are slightly different in the AMOUNT of effect they have on various kinds of synapses. They keep finding more and more subclasses of different major types of neuroreceptors and find that some ADs affect different subclasses more or less than other ADs. Depression seems to be a very complex phenomenon and not the same set of "imbalances" between one person and the next seem to cause the subjective feeling of depression. Hence, some people need more than one AD to tweak their receptors just the right way to make them feel better without tweaking other receptors that make them experience other problems, such as sleeplessness, anorgasmia, etc, etc. Much is left to be learned, and IMHO the area is still very primative and full of hope and hype.       Perhaps you have to think of it a little bit like aromas… fragrances.. odorants tweak different receptors.. there are many different kinds, combinations of them cause different more complex smells and different people react genetically differently to  various ones and find that different combinations are what they "need" to make them feel good.

Response:

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