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Re: Treatment resistant atypical depression-what next? » eln

Posted by Ritch on April 16, 2003, at 10:34:06

In reply to Treatment resistant atypical depression-what next?, posted by eln on April 16, 2003, at 2:38:37

> Hi -
> While I haven't tried every combination of every drug out there, I have given fair clinical trials to all of the modern SSRI and other antidepressants, with a huge supporting cast of add-ons, including a myriad of anti-psychotics and also lithium over the past 6 years.
.....
> Suggestions? Thanks for reading this long post.
> -E
>


I get bipolar depressions that are atypical in nature and found that no single AD seems to be very helpful. AP's just cloud my brain and make me apathetic. Low-dose combos of different class AD's have worked the best for me thus far. I don't know if you have already tried this stuff in combo or not, but... what about:

1) Nortriptyline+Effexor or
2) Nortriptyline+Effexor+Wellbutrin or
3) Effexor+Wellbutrin or
4) Nortriptyline+Wellbutrin
5) Add a little buspirone to any of the prev. 4
????

Of course it is just personal response here, but Effexor seems to pack the most punch out of the SRI family, and Nortriptyline seems to punch the hardest out of the TCA's, and Wellbutrin seems to do something helpful in combo with either or both that is special.

"Mood stablizer"-wise, you might consider adding on to the above either Lamictal, Tegretol, or Trileptal, or Neurontin.

Fishoil add + SAMe + L-tyrosine + DLPA might be worthy of looking into.


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poster:Ritch thread:219739
URL: http://www.dr-bob.org/babble/20030411/msgs/219804.html