Combining Effexor and Atomoxetine - didn't work one way, would it work the other?

[JohnBoy2000]

So - I normally dose Strattera/Atomoxetine in the morning.

I wanted to add in a serotonergic component - so I tried Effexor.

It combined awfully dosed simultaneously with Atomoxetine in the morning - so I tried it at 4 pm - and it was better tolerated.
I can't dose it at night - as it induces insomnia like that.
I dosed it to a max of 75 mg - as that was all I could tolerate.

But ultimately - I had to taper off it as, although I benefited, the long term interaction proved to be negative.


So - Atomoxetine, I dose it high at 80 mg - activating - fantastic restoration of functionality.

I am considering reducing this dose, instead dosing Effexor in the morning to 225 mg - the activating dose - and using Atomoxetine as a "booster" of the noradrenergic effect, as it were.

I have no idea how that will work out.

Is it possible it may be tolerated given the dose increase/decrease, in contrast to the initially poorly tolerated approach?

As to the underlying pharmacology - technically Effexor has a favourable interaction profile but - it didn't work out that way before.


Can anyone lend some kind of insight as to this?

 

[sekio]

Effexor (venlafaxine) is a SNRI, it already has noradrenaline reuptake inhibiton as its boquet of effects. So combining it with atomoxetine is kind of overkill as you'll produce the same effects as increasing, perhaps doubling your atomoxetine dose.

I would take one or the other, but not both, at whatever dose you find comfortable. Another option is to try a straight up SSRI instead of a SNRI, maybe escitalopram or whatever.

Also, in general, if you find atomoxetine to work OK, there's probably not a lot to be gained from going over to a SNRI. You didn't specify what beneficial effects you got, but I'm of the mind that fewer drugs are better, especially antidepressants. Overprescription can lead to more side effects than "targeted strikes"...