Posted by Mr. Scott on January 30, 2002, at 19:34:03
In reply to Re: BEST Med Combo! (IsoM, Rick, Ray, OldSchool), posted by Mark H. on January 30, 2002, at 1:13:19
> As is often the case, I agree with IsoM. I think it is risky to generalize, but yes, there is validity in your observation that a number of us have had success with a combination that includes at least some of the medications you've mentioned.
>
> It took me four years and trials with more than 25 different anti-depressants and adjunctives before hitting on the right combination for me. If my experience can help cut short your search, then that is wonderful. However, each person is unique.
>
> This is my working cocktail:
>
> Effexor (not an SSRI, but let's not get into that), 150 mg a day with breakfast. NOT sustained-release -- I WANT it to wear off some by bedtime to avoid aching legs and restlessness.
>
> A stimulant: methylphenidate, 20 to 40 mg a day, on awaking in the morning. Again, I want it to wear off by the end of the day. Two powerful benefits: not falling asleep at my desk at 2pm AND it potentiates Effexor so that I don't have to take ever-increasing dosages.
>
> Alternative experience: I tried Provigil for four months, felt great, but didn't get a damned thing done! Looking back, I can't believe how much I procrastinated and how little I cared about the potential of losing my job. Not good! REALLY not good! And DINGBAT, check the price for Provigil before you get any romantic ideas. :-)
>
> Alternative experience #2: Dexedrine. Experimenting with it currently as a way to take a break from Ritalin and still stay awake during the day. My intial impressions are that it is a little too much like caffeine (which I quit completely 14 years ago) and adrenaline for my body.
>
> Pindolol: a beta-blocker. It used to be a medical supposition that the over-production of adrenaline was associated with depression. That theory has since fallen out of favor, except with those of us whose bodies chronically produce too much adrenaline -- we're pretty sure it has *something* to do with our depression, whether doctors understand it yet or not. :-) Lots of down-sides to taking beta-blockers, but two amazing pluses: it too potentiates Effexor (makes its effect stronger, allowing me to take a smaller dose than I otherwise would, and with improved anti-depressant effect), and it helps insure a great night's sleep by blocking the effects of adrenaline. I should also mention that taking a small dosage of a beta blocker morning and evening has also kept me from going into my annual adrenaline addiction-exhaustion cycle, which used to occur every August.
>
> And yes, clonazepam! I take it primarily because I have Periodic Limb Movement Disorder and a REM defect, which is fancy talk for saying I kick my poor wife while I'm dreaming and keep her awake with jerky, rhythmic movements if I DON'T take it.
>
> It also is the safest and least habit-forming of the benzodiazepines. In my opinion, it should be over-the-counter in 0.25mg doses. It too contributes to a great night's sleep, which helps with my depression and periodic hypomania. At 0.5 mg, I can't get up in the morning, however, so I have a built-in incentive to keep my dosage as low as possible.
>
> To a "normal" person, my regimen may sound like I take stimulants to wake up, an anti-depressant to make it through the day, and a mild tranquilizer and a beta-blocker to sleep at night. On one level, I suppose that's true.
>
> However, this mix of meds, followed by two years of intensive therapy once meds put a working floor under me, enabled me to get out of four years of severe depression and maintain a responsible job, which benefits everybody.
>
> That my regimen bears some similarity to others' is perhaps no coincidence. At the same time, I cannot caution you enough about how carefully I have balanced and worked with my doctor on fine-tuning my meds. A tiny bit more beta-blocker than I need, and I get cardiac disrhythmias and nearly pass out from moderate exercise, for instance.
>
> Good luck in your quest, and please let us know what winds up working for you!
>
> Best wishes,
>
> Mark H.Mark H.,
Quick Question on that combo...Any side effects?
Scott
poster:Mr. Scott
thread:91674
URL: http://www.dr-bob.org/babble/20020124/msgs/92265.html