Posted by PsychoSage on February 13, 2004, at 16:05:56
In reply to Re: Difficult situation - what to augment PROZAC with?, posted by bipolarspectrum on February 13, 2004, at 15:29:13
> Hi psychosage,
> Thanx for the post.. I'm 22 and have been through 28 different medications and 10 ECT treatments.. I only had a manic response to wellbutrin and this was pre-ECT.. Post-ECT, wellbutrin just made me very anxious, with tremors and an insomniac.. My great difficulty is side-effects, they are always hit me very hard.. I've tried all the SSRI's (including serzone), SNRI's, all the MAOIs (I'm a Canadian, therefore moclobemide too), most of the antipsychotics and even bloody SAM-e.. My reaction to all of them is the same, excessive side-effects...
> Anywayz, thats my sad story in a nut shell, but at least I achieve partial remission of my depression (which is what i experience 99% of the time) with prozac... I just hope someone has an interesting suggestion(s) for augmentations
> Thanx
Well, your apathy makes me feel you need to be perked up and stimulated, but your anxiety and insomnia make me think you are experiencing what is typical of prozac which is a caffeinated effect.Have you read "Electroboy" by Andy Behrman? It's not exactly as intelligent or intentionally profound, but by the end I knew there is another compulsive manic person with whom I can identify. Naturally, I judge manic memoirs against "Prozac Nation" and "An Unquiet Mind" by lizzie wurtzel and Dr. Kay Jamison {who wrote me a short note over postal mail once with a handout with URLS for lots of crazy people links}
There are other ways to combat apathy {structured activity, supervised exercise}, and to me the best is discontinuing SSRIs and antipsychotics.
Abilify is the only stimulating antipsychotic I have heard of. I have done two other ones not worth mentioning because of side effects. However, again, it sounds like stimulating is not necessarily the best thing unless you need to be evened out the way an ADD person needs to be.
I can list some individual drugs here that I have found to be decent in terms of their side effect profile, but if you are bipolar you need a mood stabilizer:
Antidepressants:
Celexa
Serzone
WellbutrinAnticonvulsants:
Trileptal- that's all i know from experience, but the rest gives rashes and makes you dead tired.Stimulants/Inattention:
Provigil
Strattera{supposed to be just like wellbutrin} and i have never tried it though I have asked, and my doctor thought there was no need to switch from wellbutrin.Antipsychotics:
Risperdal - was really unnoticeable, but it was when i needed a nueroleptic the most, so maybe that means it was working.
Abilify {sounds like the best one out there}
So obviously you should make a list of what you already like because what I have found is that doctors just go with what you like because it's just like ordering from a menu. Food is food.If you are treatment resistant then you gotta pray to something to pull things together for you. Thoughts and behaviors affectyour mind, so while treating the chemicals that affect them you can augment by going the other way around. They are really inextricable.
Wellbutrin Zoloft is one combo that covers a lot of bases.I have heard of effexor/Remeron.
Again, a mood stabilizer is an excellent way to go for anxiety.
Perhaps you should go with Symbyax{prozac/zyprexa}. Zyprexa can be bad if you like sweets. It has antidepressant effects and antianxiety, so I was told when I took it. I would go for the lowest dose. naturally, you may be dulled as I was.There is a whole bunch of anti parkinsonians and alzheimer's and dopamine agonists that can counter cognitive dulling.
Benzos will make you dumber even the next day.
poster:PsychoSage
thread:312904
URL: http://www.dr-bob.org/babble/20040210/msgs/312925.html