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Suggest Alternative Over-the-counter Pill For Sinequan
Question: Psychiatry
I need to get some information which may help an elder in my life. About--well---in the 1970's they were put on two drugs......Librium 10.t.b.d. and Sinoquin 10mg t.b.d. which he remained on until 2007 when Sinaquin was taken off the market. Since that time he has been put on Lexapro 10mg and now Prozac 20mg but has never felt as well as he felt on the two original drugs. I do not know what to suggest as I know a lot of these drugs as I work in a related area. I would be pleased if you could advise on what ssri would be most suitable as a substitute......or is this possible at all. Thank you
He took himself off Lexapro 10 as he felt uncomfortable, but appears to at least tolerating the Prozac 20mg. He is now 63 years old.
I need to get some information which may help an elder in my life. About--well---in the 1970's they were put on two drugs......Librium 10.t.b.d. and Sinoquin 10mg t.b.d. which he remained on until 2007 when Sinaquin was taken off the market. Since that time he has been put on Lexapro 10mg and now Prozac 20mg but has never felt as well as he felt on the two original drugs. I do not know what to suggest as I know a lot of these drugs as I work in a related area. I would be pleased if you could advise on what ssri would be most suitable as a substitute......or is this possible at all. Thank you
He took himself off Lexapro 10 as he felt uncomfortable, but appears to at least tolerating the Prozac 20mg. He is now 63 years old.
Brief Answer:
I think reverting back to TCA is better, if no SNRI are preferable
Detailed Answer:
Hello,
Thanks for reverting back to me.
Since sinoquin was a TCA it is better to revert back to Sinoquin or alternative drug from same class. It may not be available in your country but it is still available in many of countries including XXXXXXX
If you ask me the most right thing to do, it will be procuring sinoquin from some other country.
In case that is not possible it can be replaced with similar dose of other similar TCAs which are available in your country. The commonly used TCAs are amitryptiline, nortryptiline, desipramine, impipramine, dothiepin etc. In the elderly nortryptiline and desipramine have most data and prtefered because of least side effects.
In case your doctor is not willing for same then it will be better to try any of SNRI particularly venlafaxine and desvenlafaxine (Pristiq).
No SSRI is similar to TCAs as it blocks only one receptor while TCAs block two receptors which mediate their action. SNRI too block two receptors and can be used as discussed above.
I hope this assists you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
I think reverting back to TCA is better, if no SNRI are preferable
Detailed Answer:
Hello,
Thanks for reverting back to me.
Since sinoquin was a TCA it is better to revert back to Sinoquin or alternative drug from same class. It may not be available in your country but it is still available in many of countries including XXXXXXX
If you ask me the most right thing to do, it will be procuring sinoquin from some other country.
In case that is not possible it can be replaced with similar dose of other similar TCAs which are available in your country. The commonly used TCAs are amitryptiline, nortryptiline, desipramine, impipramine, dothiepin etc. In the elderly nortryptiline and desipramine have most data and prtefered because of least side effects.
In case your doctor is not willing for same then it will be better to try any of SNRI particularly venlafaxine and desvenlafaxine (Pristiq).
No SSRI is similar to TCAs as it blocks only one receptor while TCAs block two receptors which mediate their action. SNRI too block two receptors and can be used as discussed above.
I hope this assists you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. Is there any problem in moving from Prozac to a Venlafaxine. Sinoquin is no longer on the market here. I would not like to recommend a purchase of a drug online. Am I to understand that Sinoquin works on both Serotonin and Dopamine? and that Prozac works only on Serotonin. It has taken me a long time to find out why this change in medication has had such a big impact on my brother, as he was being treated for anxiety/depression from the time he was in his late teens, and then remained on Sinoquin and Librium. He is no longer on the Librium either.
It will make a big difference to his life if I am able to understand what drugs we needs to be asking for.
Thank you very much.
It will make a big difference to his life if I am able to understand what drugs we needs to be asking for.
Thank you very much.
Brief Answer:
There is need of slow tapering of prozac
Detailed Answer:
Hello,
Thanks for reverting back to me.
I do not think there will be problem baring initial few days when prozac is discontinued. If discontinued slowly the chance of withdrawal symptoms will be minimal.
Regarding venlafaxine it acts on both serotonin and norepinephrine like doxepin (seroquin). So I feel that it will be good fit for your elder brother.
I am sorry it is not primarily dopamine, it is actually norepinephrine.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
There is need of slow tapering of prozac
Detailed Answer:
Hello,
Thanks for reverting back to me.
I do not think there will be problem baring initial few days when prozac is discontinued. If discontinued slowly the chance of withdrawal symptoms will be minimal.
Regarding venlafaxine it acts on both serotonin and norepinephrine like doxepin (seroquin). So I feel that it will be good fit for your elder brother.
I am sorry it is not primarily dopamine, it is actually norepinephrine.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. Very pleased with the quality and of the information you have given me. Sincerely.
Brief Answer:
You are always welcome
Detailed Answer:
Hello,
Thanks for your positive feedback.
I will be glad to assist you for any psychiatry related question.
If you do not have any further questions please close the query and rate the answer.
Thanks
You are always welcome
Detailed Answer:
Hello,
Thanks for your positive feedback.
I will be glad to assist you for any psychiatry related question.
If you do not have any further questions please close the query and rate the answer.
Thanks
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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