Posted by JohnL on May 12, 2000, at 4:02:57
In reply to HELP, should i start a new medicine?any advice?, posted by Bonnie on May 11, 2000, at 22:18:32
> you probably have seen me in other messages..so to make a long story short, i am a 15 year old female that has been depressed for about a year. I have been on prozac, wellbutrin, celexa, and effexor. None of these have worked, so i stopped taking meds 2 weeks ago cold turkey (mmmmm, sounds good!)I am going to the pdoc on monday, should i get on a new a/d? and is yes, what kind? Thanks
Bonnie
It is just an opinion, but I do think you should keep trying. Since you haven't responded to several serotonin drugs, I'm not sure staying in that class is a good idea. I think the time has come to explore other chemistries. Two choices off the top of my head that stand out are Desipramine or Nortriptyline. With either, expect side effects of dry mouth and mild constipation.I would also consider adding Zyprexa 2.5 to 5mg. It is showing a lot of promise for a wide range of symptoms, especially in patients who have not responded well to more common antidepressants. Though Zyprexa is classified as an antipsychotic, it has powerful antidepressant and mood stabilizing effects as well. You don't need to be a schizophrenic to respond nicely to it. And at the low doses that will probably work, it is very safe. Take at dinner time so its sedation will improve sleep without carrying over into the next day. You will have to tighten up on eating, because weight gain is common.
And another thing to consider as an add-on is a stimulant. They can be fast antidepressants...usually 24 to 72 hours. If one like Ritalin gives any problem, then immediately switch to another like Adderall. Those are probably the two most common.
At this point I just get a little skeptical of the antidepressant class, based on the multiple failures so far. That's why I would suggest observing the clues that some other chemistry is probably at fault. Zyprexa or stimulants would target those other chemistries that your previous drugs didn't...with or without Desipramine or Nortriptyline. Unfortunately there isn't any easy answer, and the choices can be overwhelming. But I would whittle the list for consideration down to these, either as monotherapy or in any combination: Desipramine, Nortriptyline, Zyprexa, Ritalin, Adderall. I wouldn't at all be surprised to see your physcian object to some of these. And that's too bad, because I think one or two of these might really do the trick for you with tolerable side effects and good safety.
JohnL
poster:JohnL
thread:33242
URL: http://www.dr-bob.org/babble/20000508/msgs/33266.html