Posted by zeugma on November 30, 2004, at 16:06:30
In reply to Re: Straterra for Depression » Mr.Scott, posted by Ritch on November 30, 2004, at 13:35:27
> > Hey Mitch,
> >
> > What's your current cocktail if I may inquire?
> >
> > I'm on:
> > 25mg Zoloft, 25mg Lamictal, .5mg clonazepam, 200mg-400mg caffeine and I just started strattera. Occassionally if depression is too lethargic I'll take a provigil as a kick in the pants. However after a few days or weeks stimulants make me more anxious and irritable.
> >
> > It would be so cool if I could tolerate enough ssri or lamictal to get the benefits out of it I need.
> >
> > Scott
>
> Scott, I'm on Fish Oil 2-3G, Depakote 250-375mg, .5-.75mg clonazepam, WB 12.5mg or Stratterra 5mg + Cymbalta .5mg or Celexa .4mg. The "or" has to do with experimenting with an AD combo that doesn't make my acid reflux so bad I french-fry my esophagous. SRI's just toast my GI tract, but help with anxiety (at low doses only). The lowdose Strat+Celexa works better for my head (depression/anxiety), but the WB and Cymbalta come fairly close without aggravating IBS symptoms. Even the Strat bugs my stomach. As far as taking enough SSRI goes... I've reached a point where only the tiniest dose to reduce anxiety is tolerable. I don't even attempt to use them as an AD anymore. Any more than a little sets off rapid-cycling, sleep disruption, even some EPS symptoms. It sounds like you are doing fairly well on your combo-hope the Strat works out. I'm super med sensitive to everything and the range on the Strat for me was 5mg-10mg. Higher doses make my stomach too wrenched, lower than 5mg doesn't do anything.--- MitchStrattera caused a lot of lower GI tract problems for me- not pleasant. It worked, in a particular way, for my ADD_ it made my mind perfectly clear, but this was a mixed blessing, since it inhibited my decision-making capacity- that 'locked' feeling rings a bell- and ultimately I dropped it because of the aggravation of IBS and long-time fatigue it induced (and also see below for a major adverse reaction). A couple of months ago in desperation I used it as a PRN med, and it worked (it has this 'jolting' feeling that kicks in immediately) but I needed high doses to sustain this effect which cut up my GI tract and made me more fatigued (I have virtually zero enrgy anyway). Nortriptyline is a far more tolerable drug in terms of IBS benefit and lack of further energy drain, so I have stuck with nortrip at dosages of 75-100 mg/day.
Unfortunately, nortrip by itself doesn't help adequately with my ADD, and I need high doses of Ritalin (60 mg/day) to get any effect at all, and as a result, my appetite is a thing of the past, and my sleep is not what it should be. I don't know that combining an amphetamine with a TCA would be a good idea, and I cannot tolerate Provigil at all. That's a shame, because provigil had a better effect on my ADD than anything I have ever tried. They should try that drug out on dyslexics, since remarkably it reversed my dyslexic symptoms (made posting intelligible messages a lot less time-consuming!). Unfortunately it rivaled Wellbutrin in the 'weird side-effect' department, and I dropped it, reluctantly, because I simply felt ill constantly on it. (I feel ill enough anyway.)
I would say nortriptyline and Strattera have similar AD properties, but I think a metabolite forms in extensive metabolizers of CYP 2D6 (a majority of the population) which is responsible for the energy drain Strattera causes, and in some people (including me) it can bring on a full-scale anhedonic depression after long-term use.
poster:zeugma
thread:422158
URL: http://www.dr-bob.org/babble/20041128/msgs/422468.html