Posted by SLS on October 14, 2001, at 15:09:25
In reply to Scott - medication responses?, posted by JohnX on October 13, 2001, at 12:14:00
> I'm looking over your med list. Maybe we can
reason through to find a pattern that will help
you reach an end to your search. This has worked
well for me. Maybe it is psychosomatic for me, but
my working theories seem to correlate well with
responses I get from various meds.
Hi John.I really appreciate that you have taken an interest in me.
I guess I can give you an idea as to which drugs helped and which ones hurt. I am a DST non-suppressor.
These produced partial or brief improvement:imipramine
desipramine
amitriptyline
nortriptyline
tranylcypromine
phenelzine
clorgyline
venlafaxine
paroxetine
d-amphetamine
lamotrigine
gabapentin
bromocriptine
olanzapine
viqualine
thyroxineThese produced significant exacerbations:
amoxapine
protriptyline
triiodothyronine
bupropion
moclobemide
reboxetine
mirtazepine
idazoxanDrugs I haven’t tried:
nefazodone
citalopram
sertraline
fluvoxamine
topiramate
tiagabine
sibutramine
pramipexole
pergolide
amisulpride
1. Tricyclics have made me feel 100 percent well for two or three days beginning on the 13th day of treatment. The switch into depression is abrupt and dramatic.2. A combination of tranylcypromine + desipramine produced the only long-term remission I have ever experienced in the last 25 years. I was functionally 100 percent, but I experienced residual anhedonia. This remission lasted for 6 – 9 months before a dysphoric or mixed-state mania developed. These drugs were withdrawn, and I was treated with lithium and clonazepam. Lithium produced a mild antimanic effect. The addition of clonazepam helped a great deal. I relapsed into depression 8 weeks after the discontinuation of the antidepressants. My doctor elected to use only tranylcypromine. I received some mild benefit, but it was episodic and inadequate. Subsequent trials of the TRL + DMI were unsuccessful. I was taking lorazepam and triazolam for the entire nine-month period.
3. Several months later, I was switched from tranylcypromine to phenelzine. I experienced a dramatic improvement within two weeks. This state of normothymia lasted for about a month, and then waned. I was left in a mixed-state with some hypomanic features.
4. D-amphetamine can produce a moderate antidepressant effect that begins within an hour of the first dose. This response lasts for two or three hours before disappearing. I received no benefit from increasing the dosage or continuing the treatment for a few weeks.
5. Bromocriptine produced a mild improvement that lasted for three days immediately upon adding it to an ongoing trial of tranylcypromine + desipramine.
6. I received a small, but perceptible benefit upon adding thyroxine to a combination of tranylcypromine + desipramine + d-amphetamine.
7. Sulpiride produced a mild improvement within an hour of the first dose. It lasted several hours and then disappeared.
8. Modafinil produced a mild improvement within an hour of the first dose. It lasted for no more than an hour.
9. Placebo was no better than placebo.
Thanks for trying to brainstorm this stuff, John.
Sincerely,
Scott
- It seems that the brief 3-day response to various drugs is pervasive amongst people with TRD. For me, this has been the case with tricyclics, MAOIs, d-amphetamine, bromocriptine, and atypical neuroleptics. Not 2 days. Not 4 days. I am hoping that a drug like memantine will allow for these antidepressant responses to remain stable beyond this 3-day period.
poster:SLS
thread:81196
URL: http://www.dr-bob.org/babble/20011007/msgs/81285.html