helen-louise (baratron) wrote,
helen-louise
baratron

  • Mood:

new drugs! new drugzzz!

I have now been to the doctor, and am somewhat manic. Not clinically manic, you understand - just happy and bouncy. I'm still depressed, don't think that's gone away, but I saw a good doctor who listened to me and tried to understand my situation. I have seen enough crap doctors in my life that I am always pleasantly surprised to find a good one. The one I saw today not only understood what 225mg of Efexor XL means (in terms of dosage and what my depression must be like to warrant it), she even managed to prescribe another antidepressant to use with it that doesn't contraindicate it. This might not sound like much, but you would not believe how many times I have been prescribed two drugs that should not be used together - even for something as simple as asthma, let alone psych stuff. And she wrote a note to the receptionists to get me bumped up the queue to see my usual doctor - I've got an appointment to see him tomorrow! That's a vast improvement on June 11th, don't you think?


I've been told to take 500 micrograms of fluanxol and 15mg of mirtazapine along with 225mg of Efexor for the time being, and see how I get on with that. Fluanxol I've had before - in large doses (20mg+) it's an antipsychotic, used for treatment of schizophrenia, but in tiny doses it's useful for anxiety along with depression. It's good stuff, but unlicensed in the US, which means it's a pain in the arse to get information about it online. It doesn't help that "they" have decided to change the spelling of the drug from "flupenthixol" to "flupentixol" - bloody IUPAC! Mirtazapine I haven't had before, but it's also known as Remeron if that means anything to anyone. Apparently it was only licensed in the last couple of years, and it is used primarily for "polytherapy". In my current state, the thought of me, being polyamorous and having polytherapy is ridiculously funny. Of course, it just means treatment with more than one drug for the same thing at the same time.

Scary organic chemistry:
Efexor is venlafaxine hydrochloride, also known as (R/S)-1-[2-(dimethylamino)-1-(4 methoxyphenyl)ethyl] cyclohexanol hydrochloride or (±)-1-[a [(dimethylamino)methyl] p-methoxybenzyl] cyclohexanol hydrochloride and has the empirical formula of C17H27NO2 HCl. Its molecular weight is 313.87.
("Meep!" says meeping)

Mirtazapine belongs to the piperazino-azepine group of compounds. It is designated 1,2,3,4,10,14b-hexahydro-2-methylpyrazino[2,1-a] pyrido [2,3-c] benzazepine and has the empirical formula of C17H19N3. Its molecular weight is 265.36.

Fluanxol is 2-{4-[3-(2-Trifluoromethylthioxanthen-9-ylidene)propyl]- piperazin-1-yl}-ethanol dihydrochloride, or C23H25F3N2OS.2HCl. Its molecular weight is 507.4.

And now prepare to meep most ferociously:
Flupenthixol is wholly synthetic. Thioxanthone is converted to an activated butadiene by a Grignard reaction followed by dehydration. Flupenthixol is formed by 1,4 addition to the activated butadiene followed by heating or treatment with strong alkali (Petersen et al., 1977).

The really scary thing is that I understand that! I have distinct memories of nearly blowing up the Perkin lab whilst attempting a Grignard reaction...
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