Posted by Ritch on February 9, 2002, at 15:38:13
In reply to Re: SSRI apathy syndrome (survey) » Ritch, posted by Mr. Scott on February 9, 2002, at 14:22:34
> -------------
> So you're taking
>
> Neurontin
> Wellbutrin
> SSRI of some kind
> varying tricylics
>
> For BP II, ADD, Anxiety
>
> How well is it working? I just ask, because it seems unlike a mainstream approach. But I guess you've probably already been there and done that.
>
> ScottNeurontin 100mg tid
Klonopin .5mg hs, .25-.5mg daytime prn,
Wellbutrin 18.75-37.5mg am,
Celexa 2.5mg am, 4-5x during the week.This combo thus far *hits* most everything fairly well. I really shouldn't whine about it, but I want to find *the* combo-I think you know what I mean.
All I know is that after xxx number of mood stabilizers, Neurontin allows me to function (cognitively) and seems to help all three problems. Although a bit of Trileptal (oxcarbazepine) does help the ADHD a little, as well (mainly impulsiveness-but helps focus a little bit-I am less distracted). I am eagerly awaiting pregabalin (more potent).
The Klonopin can axe a hypomanic state fairly effectively, that is why I push it up when needed, or if I am going to be involved in a presentation or something that tends to trigger panic, and of course works the best for SP "positive" symptoms (panic, freezing, etc.).
So it is the best thing for what I call "manic-panic". Although it totally wipes out my cognitive functioning, and I rarely take it during the daytime anymore.The Celexa works the best of any AD for the SP problems, but I can't take more than just a pinch because it will shred my intestines and I also get some dystonia from SSRi's as well. SSRI's tend to work best on what I call SP "negative symptoms" (avoidance). When escitalopram comes around I will immediately flip to it because I don't take much anyhow and my problem is with tolerance not effectiveness-it really is just an anxiety med-that's how I treat it. I agree with a lot of people here that most SSRI's just don't work well for severe unipolar depression (at least not by themselves).
The WB is the *wild card* right now. We have found out that I *must* have some type of noradrenergic/dopaminergic agent for my seasonal depressions. Nothing else works. SSRI's seem to make it *worse*. In other words, I have tried just increasing SSRI when the depressions strike, but they increase the apathy and make me melancholic, and I get more emotional lability and worsened cycling. That is why I think that the depressions are just a type of depressive limbic ADD state. Why would 5mg of Adderall wipe it out so effectively otherwise? ..and without cycling..
Hey, I am really glad that I have got 3 of 4 figured out-it took a long time.
Mitch
poster:Ritch
thread:92656
URL: http://www.dr-bob.org/babble/20020208/msgs/93466.html