Posted by blueberry on September 23, 2005, at 19:57:42
In reply to Paxil and augmentation, posted by denise1966 on September 23, 2005, at 11:18:24
I like your thought of adding remeron. It's a completely different mode of action, causing neurotransmitters to be released, as opposed to reuptake inhibitors that just cause them to hang around longer. Remeron releases serotonin at lower doses, then norepinephrine at higher doses, and even dopamine at really high doses. I don't think adding more reuptake inhibition is the way to go. Paxil actually has some fair norepinephrine reuptake inhibition to it.
A stimulant like provigil or ritalin could be a thought as well. Zyprexa is a great add-on to ssri's for apathy, doing similar stuff as remeron but also working on dopamine. Wellbutrin is funky, either helps a lot or sucks a lot.
In any case, I think it would be a good idea to choose meds that work by a totally different mechanism than reuptake inhibition. At your current dose, you already have a ton of that going on.
poster:blueberry
thread:558480
URL: http://www.dr-bob.org/babble/20050921/msgs/558693.html