Posted by Whit_in_Texas on April 4, 2005, at 20:04:29
Brief History: Been on psychobabble for a couple of years, just starting over with a new name...I am bipolar type 2 (more accurately "other than specified" in DSM jargon) and a veteran of treatment resistant depression since 1991...my wife is a licensed psychologist with a Ph.D. from UT and she may post or reply in my name from time to time...my wife and I are starting her private practice in the Dallas/Ft. Worth area...anything responding to any post I put out may be used and/or published anonymously. We have found this website to provide an invaluable resource to those suffering from depression and/or bipolar disorder and hope to contribute positively.
Message: I am going to start a new med regimine made up of everything that has ever had a positive effect on my depression: Parnate, Adderall, and (probably) Zyprexa. I am currently on Desipramine 250mg but will be quitting as I feel no effect whatsoever. I am already taking 10 mg Zyprexa at night and 60 mg (regular) Adderall daily, with periodic 48 hour "holidays" to counteract tolerance (as anyone who's been there knows...pure hell).
I came to the conclusion about six months ago that, while Adderall has provided the most robust relief from depression for me, it cannot be relied on alone for long-term relief. Tolerance is inevitable and the rebound depression is very severe. I tried using tricyclics (currently Desipramine) as a mainline anti-depressant most recently, but after 8 weeks or so have given up on it. About a year or so ago I found moderate relief from depression with Parnate after an unsuccessful trial with Nardil; however, I eventually quit Parnate due to tolerance to above recommended dosages (don't recall specific dosage).
Anyway, I intend to start a medication regimen using Parnate as a baseline anti-depressant augmented with Adderall and mood-stabilized with Zyprexa (most effective with me in the past). First I need to find a new pdoc in my area that is okay with this combo, but it should be soon since my wife knows the doctors in the area pretty well.
From my own experience, I have found regular Adderall to be superior to Adderall XR and any other stimulant at quickly relieving depression. I have even noticed a small difference between brand-name Adderall and its generic, with brand-name providing a slightly better response. I tend to acquire tolerance very rapidly to all drugs, with Adderall being no exception and I need at least 40 mg in the morning to initiate a positive effect and another 20 mg around lunchtime to extend the effect. I have found that going beyond 60 mg is dangerous and that even at 60mg per day I need a 48 hour or more "holliday" from Adderall every 2 weeks or so to restore effectiveness.
I guess that's it for now. I will intend to follow-up regularly once the medication regimine is initiated. Thank you for tolerating my long-windedness!
Whit_in_Texas
poster:Whit_in_Texas
thread:479831
URL: http://www.dr-bob.org/babble/20050404/msgs/479831.html