Why is there No antidepressant with same makeup of Tramadol

tacogirl

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Joined
Jul 17, 2014
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28
Hello,

I used to take Aramadol, no more, but it did improve my mood. My doctor started me on Cymbalta (Duloxetint} a month ago, felt nothing, and he just added Abilify. Why are they No antidepressant with the exact qualities?...or a combination of drugs. I've herd this many times and there just not seem to be a dupe...does anyone know why??

 
I find ODSMT, which is main active metabolite in Tramadol, to have incredible anti-depressant properties and not to lead to crippling opiate addiction as long as you maintain on low doses.  It's sold as an RC, although it has been studied for ages and is likely to receive FDA approval as a prescription drug soon, and is much more affordable than Tramadol. Your doctor won't  be able to prescribe it but it's something that has really helped me and is fairly easy to locate online.

 
lol... easier said than done
You're not wrong there 😂 but at least it's cheap. And I find that capsuling my intended daily dosages up as soon as the powder arrives helps me to stick to my planned dosing schedule vs. just having a big baggy of powder sitting around.

 
I've studied quite a bit of psychopharmacology, so I think I can shed some light on the OP's question.  Until pretty recently, antidepressant discovery was largely trial-and-error, or random luck/observation.  Only rather recently have chemists begun designing antidepressants by first figuring out what the molecule should look like, and then make and test it.  ("Rather recently" = ~20+ years, but recent compared to other medical advances).  Even now the bulk of new-drug development in this form entails things like selecting a particular optical isomer of a known drug, or modifying like one moiety not thought to be the main driver of the drugs effects.

You'll notice that new antidepressants kind of come in waves—like prozac came out, the shortly(ish) thereafter, a bunch of other SSRIs came out.  Same thing, more or less with MAOIs and tricyclics.  Developing from scratch a drug that has certain desirable clinical effects is really, really hard, and usually requires some luck.

As for combinations of drugs achieving a desired therapeutic outcome, this is really hard for researchers to study, for statistical reasons that I'll spare you unless you're interested.  When psychopharmacologists start down the polypharmacy road with a patient, there's a lot of guesswork and trial-and-error.  The good ones can often develop a successful polypharmacy course of treatment for a given patient, but it's a bumpy process that often takes years of experimentation and evaluation.

But getting back to the thing you (the OP) actually care about, ask your doctor about switching to Effexor (venlafaxine) instead of cymbalta.  If s/he chose Cymbalta because it has some efficacy against chronic pain and neuropathy, ask about accomplishing that with perhaps gabapentin instead, so that you'd be swapping out Cymbalta for Effexor and gabapentin.

As for the Abilify, I urge you to stop that (ask your doctor first, of course...), especially if you are young-ish, i.e., if you expect to live more than another 5-10 years.  My understanding, informed by three expert doctors, is that for someone taking abilify, the question is not *if* they'll develop tardive dyskinesia, but rather *when* they'll develop it.  And TD is largely irreversible, I think.  At a minimum, you should seek a second opinion.  Also, I don't know your insurance or financial situation, and I'm not sure whether it's still on-patent, but back when I briefly took it, only the brand-name was available, and the cash price was like $700/month.  I had pretty decent insurance, but I still had a $60 copay each month.  

But I digress...  Best of luck and G*d bless!

 
I've studied quite a bit of psychopharmacology, so I think I can shed some light on the OP's question.  Until pretty recently, antidepressant discovery was largely trial-and-error, or random luck/observation.  Only rather recently have chemists begun designing antidepressants by first figuring out what the molecule should look like, and then make and test it.  ("Rather recently" = ~20+ years, but recent compared to other medical advances).  Even now the bulk of new-drug development in this form entails things like selecting a particular optical isomer of a known drug, or modifying like one moiety not thought to be the main driver of the drugs effects.

You'll notice that new antidepressants kind of come in waves—like prozac came out, the shortly(ish) thereafter, a bunch of other SSRIs came out.  Same thing, more or less with MAOIs and tricyclics.  Developing from scratch a drug that has certain desirable clinical effects is really, really hard, and usually requires some luck.

As for combinations of drugs achieving a desired therapeutic outcome, this is really hard for researchers to study, for statistical reasons that I'll spare you unless you're interested.  When psychopharmacologists start down the polypharmacy road with a patient, there's a lot of guesswork and trial-and-error.  The good ones can often develop a successful polypharmacy course of treatment for a given patient, but it's a bumpy process that often takes years of experimentation and evaluation.

But getting back to the thing you (the OP) actually care about, ask your doctor about switching to Effexor (venlafaxine) instead of cymbalta.  If s/he chose Cymbalta because it has some efficacy against chronic pain and neuropathy, ask about accomplishing that with perhaps gabapentin instead, so that you'd be swapping out Cymbalta for Effexor and gabapentin.

As for the Abilify, I urge you to stop that (ask your doctor first, of course...), especially if you are young-ish, i.e., if you expect to live more than another 5-10 years.  My understanding, informed by three expert doctors, is that for someone taking abilify, the question is not *if* they'll develop tardive dyskinesia, but rather *when* they'll develop it.  And TD is largely irreversible, I think.  At a minimum, you should seek a second opinion.  Also, I don't know your insurance or financial situation, and I'm not sure whether it's still on-patent, but back when I briefly took it, only the brand-name was available, and the cash price was like $700/month.  I had pretty decent insurance, but I still had a $60 copay each month.  

But I digress...  Best of luck and G*d bless!
Effexor is hands down the worst thing I've ever been prescribed. It made my life a nightmare, and this was before I ever "self-prescribed" myself other drugs or took recreational drugs at all.

Of course, everything affects everyone differently, so who knows how it will affect you. But just sharing my experience.

 
@JeffRX  Useful input (seriously!)  Even though drugs affect different people in different ways, I think it's valuable to share our experiences so that if someone else notices the same thing, they'll know it's not just in their head.

For me, Abilify was absolute hell.  I won't even write down the lengths to which I would be willing to go to avoid taking that stuff again.  But for some people, under some circumstances, it's a miracle drug.  Go figure...

Likewise, citalopram gave me disabling vertigo (I couldn't go up or down stairs), and apparently that's a relatively rare side effect, but you never adapt to it, so citalopram is off the table for me.  But my doctor switched me to escitalopram (the "S" enantiomer of racemic citalopram), and it worked pretty well with no trace of vertigo.

To end on a lighter note (kind of), when my brother got his wisdom teeth removed, he was prescribed tylenol with codeine, and he complained to the doctors that it was doing anything at all.  The doctors thought he was just trying to score some stronger opioids, so they blew him off.  He took a lot of recreational drugs at that point, so the doctors seemed to be making a responsible call.  But flash forward several years, and my brother discovers that he has some abnormality with one of his CYP450 enzymes, and he literally can't metabolize codeine!

 
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  1. ontovzik @ ontovzik: When I had long term shingles, lasting two months. All he could give me was a 10 day supply of dilaudid. He looked at the ground while we were talking about it. I could tell he was ashamed but it was the legislature and the governor that tied his hands. He was very upset that non-medical political people, the media, and the scared public were controlling how he treated his patients. Someday those people will need meds and a hospital bed and they will be gone.
  2. ontovzik @ ontovzik: I had a great doctor, he had the true gift of a healer and he stayed on top of all the science. He straight up told me that for many people opiods work for managing short and long term pain.
  3. ontovzik @ ontovzik: He peed it in the snow in my backyard.
  4. WTF7218 @ WTF7218: @xenxra 😆😂. Yes, but only a few brave souls will ever find the number. You must first order a Dirty Shirley from the bartender. Then you must discreetly take the cocktail napkin from under your drink and unfold it. There you will find the map to the location of the phone number, and clues to decipher the code that it is written in.
  5. xenxra @ xenxra: he left his phone number scribbled in a stall at the pub three blocks down
  6. aBBazaBBa123 @ aBBazaBBa123: @rockychoc How do I contact you?
  7. N @ NYStateofMind: @Alkazar I would try one of those easy online ones .. reddit gives useful info about that
  8. Alkazar @ Alkazar: @NYStateofMind I dont really have a history of abusing things, my docotr is just really stingy. I am thinking of switching.
  9. C @ Cheesus: Thanks xenxra
  10. xenxra @ xenxra: @Cheesus yeah, use snote
  11. P @ psychedpsych: Trump is cracking down….
  12. P @ psychedpsych: Hackers are the scum of the earth
  13. N @ NYStateofMind: so it was easy bc of my history
  14. N @ NYStateofMind: I didnt really tell him but he knew I needed a new script since my dr went to jail
  15. N @ NYStateofMind: @xenxra I was on Adderall since 15 years ago so my dr prescribed that w no problems and then when I lost my best friend my doctor rxed the valiums but
  16. C @ Cheesus: Temp.pm down for anyone else?
  17. xenxra @ xenxra: @NYStateofMind my doctor's have always been pretty open minded if i can actually come in and explain the pharmacological action of the drugs im seeking instead of just telling them why i think i should be prescribed. the only time it didn't work out for me is when i was trying pharmaceuticals for depression ten years ago and suggested they let me try testosterone instead (turns out i was hypogonadal so they made a mistake denying my request at face value)
  18. T @ Testisthebest: Even down here in Florida when the pill mill docs all switched over to Suboxone and/or retired you can still find some pretty liberal docs but you gotta know what to look for. Mine does "pain management, detox, anxiety,etc. And no insurance. My doc writes me 60 5mg Valium, 14 2mg Xanax and asked if I had ever tried adderal to get more focus at work as I told him I run my own business.
  19. N @ NYStateofMind: @Alkazar do they know your history? Like I dont tell my doctor anything about myself except what they need to know,...I was able to get my dr to rx the highest dose of adderall along with valiums ..... if they dont know your history or there is no history I would just come out and ask what is the reason for their mistreatment.... they have no problem billing your insurance or taking a payment for the visit
  20. T @ Turbo259: @Layne_Cobain Thank you fam
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