Posted by SLS on May 11, 2003, at 9:15:00
In reply to Re: Remeron rocks for treatment-resistant unipolar » SLS, posted by Squiggles on May 10, 2003, at 21:30:20
Hi Squiggles.
> > Why would you want to mix the two?
My reasons are the following:
1. Imipramine continues to be partially effective and responsible for the few brief robust antidepressant responses (usually just a few days) I have experienced. The only long term remission I experienced (9 months) was with a combination of Parnate + desipramine. Desipramine is an active metabolite of imipramine.
2. Remeron is a particularly useful adjunct to other antidepressants because its actions are often complementary. Its NE alpha-2 antagonism might act synergistically with imipramine's NE reuptake inhibition. Perhaps its 5-HT2a and 5-HT3 antagonisms complement the 5-HT reuptake inhibition of imipramine.
3. I would not be able to function without imipramine (combined with Lamictal). I would not be able to manage my apartment and personal affairs. It would be easier on me to remain on imipramine as long as there are no major interactions with Remeron.
> > Oh sorry. Whenever that sort of thing happens, i have
a knee-jerk reaction to ask about the initial diagnosis.
I know that lithium has good success as an adjunct with many
ADs of different types.My initial diagnosis was ultra rapid-cycling atypical unipolar depression. I no longer cycle. I was later diagnosed as being bipolar when antidepressants precipitated severe mania, although I never had a manic episode in the absence of medication. I wish I could become manic again, as mania is easily treated for me using either Depakote or Zyprexa. I don't know what the hell I am other than a pain in my doctor's ass.
I have tried lithium in the past. In fact, it was responsible for abolishing my rapid-cycle (I wish it hadn't). Lithium tends to make me feel worse as it significantly flattens my affect. I still wouldn't exclude it among alternatives, but I would try it at dosages between 300-600mg.
Thanks for the input!
- Scott
poster:SLS
thread:225645
URL: http://www.dr-bob.org/babble/20030505/msgs/225772.html