Calefornia Rocket Fuel (efexor-remeron combo)

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According to Dr Stephen Stahl -

"california rocket fuel (SNRI plus mirtazapine) is a combination that has a great degree of theoretical synergy, norepinephrine reuptake blockade plus aplha 2 blockade, serotonin reuptake plus 5HT2A and 5HT2C antagonism, and thus many 5HT actions plus norephinephrine actions.

Specifically, 5HT is quadruple-boosted (with reuptake blockade, alpha 2 antagonism, 5HT2A antagonism, and 5HT2C antagonism). Norepinephrine is quadruple-boosted (with reuptake blockade, aplha 2 antagonism, 5HT2A antagonism, and 5HT2C antagonism.) And there may even be a double boost of dopamine (with 5HT2A and 5HT2C antagonism.)"

Dette tyder på at denne kombinasjonen kan være en god løsning på å dempe en tung depresjon. Går selv på den,

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Antidepressant Combinations

Combinations tend to involve two different classes of antidepressants, such as an SSRI with an antidepressant that works on norepinephrine (such as Effexor, with a dual serotonin-norepinephrine action, plus a weaker dopamine action). One controlled study of patients who had not responded to an SSRI showed a 64 percent response when treated with an SSRI-Remeron combination (Remeron has a unique action that works on both serotonin and norepinephrine).

Essential Pharmacology of Depression and Bipolar Disorder (Cambridge University Press, 2002) by Stephen Stahl of the University of California at San Diego describes "California rocket fuel," a combo of Remeron and Effexor which can give a triple boost to the serotonin system, a double boost to the norephinephrine system, and a single boost to the dopamine system.