Posted by JohnL on March 2, 2000, at 3:51:03
In reply to questions for the meds specialists around here, posted by SIGOLENE on March 1, 2000, at 15:13:52
> all the SSRI's I tried untill now were worsening my depression.
> But I wonder, if I take a tricyclic which acts on serotonine, (but in an other way than SSRI's), would it possible that the reaction will be different ?
> Thanks.
>
> SigoleneSigolene,
I'm certainly no specialist, but I wanted to put in my two cents worth. I think trying a tricyclic at this point makes sense. If for no other reason, just to see if norepinephrine medications help or make you worse. That will give more clues as to what chemistry is causing your symptoms. Two good choices with the fewest side effects are Nortriptyline or Desipramine. Of the two, Desipramine is the most NE specific.If you get worse on one of these, then it proves there is some other chemistry involved. Then we would want to look at: Stimulants (NE/dopamine failure), mood stabilizers (chemical/electrical instability), antipsychotics (dopamine excess), or benzos (GABA deficient). Any or all of these may target the chemistry causing your symptoms when antidepressants don't. The fact that antidepressants worsen your condition proves there is some other chemistry involved, but testing a NE antidepressant is worth a try first in my opinion.
You might ask your doc to prescribe for you a dozen doses each of Stelazine (antipsychotic) and Xanax (benzo). Both of these are good anticdotes to take for relief if the antidepressant makes you feel worse. You shouldn't have to suffer through a bad reaction. Hold the broken pill in your mouth for a minute before swallowing to speed response (minutes). Both of these drugs are like seatbelts when the going gets rough. Not only that, but if you by chance find you feel better after taking either Stelazine or Xanax, that will further prove there is some other chemistry involved in your case.
For any of the classes of drugs I mentioned, long drawnout trials are not needed. If one is right for you, it will be obvious within a week, and possibly just a day or two. It all depends on how directly a particular drug targets the underlying chemistry. It will be very helpful if your doc will be prepared to allow you to make quick comparisons of various drugs. The purpose is to probe. Once superior matches have been found, then the purpose focuses on getting well. But first the right drugs need to be discovered. Probing allows us to do that. After multiple antidepressant failures, I believe it becomes a high priority to probe drugs of different classes. There are several chemical imblances/instabilities that can cause depression that antidepressants won't target, and indeed will only make worse.
poster:JohnL
thread:25205
URL: http://www.dr-bob.org/babble/20000220/msgs/25400.html