Posted by IsoM on January 15, 2002, at 13:34:35
In reply to Re: Not sure what to do next ..... » IsoM, posted by spike4848 on January 15, 2002, at 7:41:28
Okay, if it was me, I'd first try out some SSRIs to find one that doesn't have intolerable side-effects. My previous experience with the short half-life SSRIs like Paxil, for example, would steer me away from those. If you're late in taking it or miss a dose, you're more likely to notice withdrawal/discontinuation feelings. It's not true for everyone. My 19 yr old son wasn't affected as strongly as I was, but for me, if I took it normally in the morning & forgot, the unpleasant feelings would start by afternoon, letting me know I forgot. I'd suggest a SSRI with a middle range half-life. For me, Celexa is good. Prozac did nothing for me either, so just because one SSRI (or two) don't work, doesn't mean they're all duds.
I'd take the SSRI alone for a short while to make sure you can tolerate it & to see how well it works. Then, if necessary (& it probably will be), I'd augment it with a TCA that's worked well for you in the past.After that's stable & you find a combo that helps (it doesn't have to help 100%), I'd top it with Provigil (or adrafinil). It's used in Europe as an AD too, not just for memory & alertness. After all, the type of drugs they belong to are called eugeroics or good arousal.
For me, my doctor & I have tried topping up previous combos with lithium (nothing), tryptophan (nothing), Buspar (bad jitters), Inderal (triggered asthma, previously unknown to me), Xanax [alprazolam] (nice but didn't help my constant sleepiness). Celexa isn't enough for me, especially in winter & its darkness, but adrafinil honestly makes it 100% for me. If this isn't 100%, more would have to be hypomania.
By the way, not just women develop hypothyroidism. Have you ever had your TSH levels checked? If it's a little high perhaps a bit of thyroxine would help?
> >"I am reconsidering .... maybe paxil/celexa with augmentation.
What do you think for augmentation desipramine ... provigil .... wellbutrin ... . lithium. Spike"
poster:IsoM
thread:90162
URL: http://www.dr-bob.org/babble/20020110/msgs/90303.html