Posted by JohnL on February 23, 2000, at 5:48:46
In reply to help!!!!!!!, posted by kayla on February 22, 2000, at 11:40:44
Have you tried the psychostimulants? Antipsychotics? Benzos? Mood stabilizers? In cases like yours a combination that often works very well is a blend of: low dose favorite SSRI so far OR low dose benzo, with a favorite stimulant (experiment short trials) and a tiny dose antipsychotic. All of these will target other chemical imbalances that have so far been missed, and that can cause your symptoms. Any one or all of these drug classes can target your symptoms. Clearly the antidepressants are missing the mark. And even more clearly enhancing NE function for you is especially bad. Your medication responses so far indicate the underlying problem is elsewhere, and will likely be targeted by a benzo, stimulant, antipsychotic, but likely a blend of all three in small doses each.
It's also possible that a chemical instability or electrical instability exists, which would respond to one of several mood stabilizers.
I don't think Serzone is a good idea. It has some NE action, and your past trials of NE drugs made you much worse. Besides which, it's just another variation of things you've already tried. At this point I think it has become crucial and urgent to explore other classes of drugs. The antidepressants are not targeting whatever the underlying problem is.
But whether you start with benzos, stimulants, antipsychotics, or mood stabilizers seems like a flip of the coin to me. The best way to get a clearer picture of what's going on is to convince your doc to give you short trials (1 to 2 weeks) of each. Be a guinea pig for a while (as long as you're stable enough to endure). The purpose is to further narrow the search. Some drugs will give you an adverse response. Abandon them quickly, and try to make sense of the clues they give you. Other drugs will be neutral. Move on. You will accidentally stumble onto something that helps a lot. Then you'll know where to concentrate the search. In the end you can go back and combine low doses of the more favorable trials for a blend that will take into account all the chemical imbalances/instabilities you discovered during trials. It just doesn't make sense to me to continue more antidepressants at this point. I think better results will be found elsewhere.
The hesitancy to explore outside the antidepressant class when they aren't working is, I believe, a major cause of treatment failure and continued patient suffering.
poster:JohnL
thread:23086
URL: http://www.dr-bob.org/babble/20000220/msgs/23296.html