Posted by JohnL on August 31, 2001, at 17:33:40
In reply to Doc doesn't like cocktails, posted by Kathleen6674 on August 31, 2001, at 9:47:27
> I keep reading all sorts of wonderful advice and information here about how combinations of meds have helped refine everyone's responses. Have any of you had a doc who didn't like combos of meds? Mine doesn't seem especially keen on them - I've been jumping from one med to another instead of piling them on, so to speak, over the past year or so. Does anyone have any advice for working with a doctor who doesn't like to combine meds? Or should I get a new doctor or what? Are there different "schools" of psychopharmacology? I do think that part of his reluctance is that my dosage often gets adjusted, and hence he doesn't want to make more than one change at a time, i.e., if we up a dosage AND add a med, then I get bad side effects, how would we know if it's the new med or the increased amount of the old one? But I'm still curious about the one-at-a-time camp vs. the combination camp, if indeed there are competing "schools" of med management.
I happen to be in the camp that likes cocktails. The reasons are because:
1. I think brain malfunctions are too complex to be completely fixed by a single agent, in most cases (not all). With single agent treatments, we don't often hear things like "I feel better than ever in my life", or "Wow!", or anything like that. Instead, we hear things like "I think it's working", or "I feel a little better", or "at least I'm not having crying fits any more", or "it's been 4 weeks already, how can I tell when it kicks in?" etc. You get the picture.
2. Cocktails can have counteracting side effects, which is good. For example, I take Prozac minimum dose plus Adrafinil minimum dose plus Zyprexa minimum dose. While Prozac is generally known for stimulation and weight loss, Zyprexa is generally known for sleep and weight gain. So the side effects cancel out. And while I felt about 80% better on that combo, I could still tell there was something not quite right. Maybe a little of that SSRI emotional numbness that we hear about. The addition of Adrafinil fixed that better than completely.
3. The different mechanisms of different drugs can potentiate each other, allowing one to actually do better overall with smaller doses. I feel better than ever in my life, and yet I am on minimum doses, have been for over a year with no sign of poopout or tolerance. The best part is that the side effects cancel out. I have no side effects to report, other than a bit of grogginess from the Zyprexa when I first wake up. Prozac alone gave me tons of side effects. Zyprexa alone gave me tons of side effects. Together they cancel out the side effects and simultaneously turbocharge each other.
If someone can do great with just one drug, then I am very excited for that person. But if they can't get completely well on just one drug, I have no problem at all in suggesting the cocktail approach.
If a doctor is unaware or unaccepting of the cocktail benefits I mentioned above, then personally I would try to bargain with him/her to bend for me, or find someone else. After all, you are the paying customer. You should get the kind of service you personally want.
John
poster:JohnL
thread:77066
URL: http://www.dr-bob.org/babble/20010828/msgs/77133.html