Posted by Ame Sans Vie on August 12, 2004, at 10:05:21
I'm about to see my pdoc this afternoon (3:30 Central Time). I spoke with him on the phone just now and he left me with a decision to make -- which antidepressant should I add onto my 12mg Klonopin and 120mg Adderall? He's thinking I should either go with Wellbutrin XL, desipramine, or nortriptyline. Currently, my panic attacks, avoidant behavior, social phobia, agoraphobia, performance anxiety, somatic manifestations of anxiety, insomnia, attention deficit disorder, mild obsessive-compulsive disorder and dysthymia are in complete remission. But that still leaves me with the ever so pleasant endogenous atypical reactive depression -- anhedonia (though that's improved about 40% with the Adderall), complete lack of motivation, hypersomnia, and fatigue. Luckily, the Adderall has stopped my binge-eating.
So any votes for one of the above three? Or other suggestions? Obviously Parnate is out of the question with the Adderall, but I may consider bringing up selegiline as an option. I've tried it before with modest results, but what if I were to take it along with Stalevo (for COMT and dopa-decarboxylase inhibition, and even a little l-dopa)? Then, in theory, supplementing with either phenylalanine or tyrosine would be exponentially more effective due to avoidance of first-pass metabolism in the stomach... just a thought. But getting selegiline *and* Stalevo isn't very likely to happen.
I've given amantadine a try and, though it was a bit helpful, it gave me horribly vivid nightmares that still give me the chills just thinking about them... but what about a dopamine agonist? I mean, Mirapex worked beautifully for me before except that after several weeks or so it began to cause sleep attacks. Perhaps now with the Adderall I can avoid that?
But truth be told, I'd really rather stick with one of the more tried and true -- desipramine, Wellbutrin XL, or nortriptyline. My only question is, as best as you can judge by the list of symptoms I outlined above, which of the three would you all guess would be my best bet?
Thanks so much -- I really hope someone reads this in time! T minus five hours and counting!
~Michael
poster:Ame Sans Vie
thread:376819
URL: http://www.dr-bob.org/babble/20040811/msgs/376819.html