Posted by blueberry on April 22, 2006, at 13:40:52
In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50
Hi Scott,
You have been so helpful in trying to help me figure out my own problems. I feel pitifully inadequate in trying to help figure out yours. It saddens me how you are feeling, and it saddens me I don't have any magic ideas.Some off the wall thoughts though. Increasing wellbutrin to 450mg for 2 weeks and then even to 600mg for 2 weeks might be an idea. That's what they did back in the old days before seizures became a concern. You have lamictal to help protect from that.
Maybe something to stimulate the release of neurotransmitters, rather than just damming them up. You could do a quick easy experiment to see if norepinephrine stimulation is an area to explore. Chromium picolinate. Take 400mg to 800mg. It mainly helps insulin response, but it also stimulates norepinephrine release. When I tried it at just 200mg, I definitely felt a noradrenergic boost of mood and energy, though the resulting anxiety was a bit much. But it is an easy experiment just to test noradrenergic stimulation response, versus noradrenergic reuptake inhibition.
It could be that dopamine receptors just get desensitized to any increase you give them, and then you are right back where you started. On pubmed I saw a couple studies where siberian ginseng prevented dopamine receptors and opioid receptors from developing tolerance. Who knows. Just an idea.
Maybe with the high focus on norepinephrine, serotonin has been squashed out of the picture. Except for the sexual side effects, you sound like the kind of person who might respond well to 200mg to 350mg zoloft, where the serotonin reuptake has long ago maxed out at lower doses and the dopamine reuptake is now significantly catching up at higher doses.
But then again, you were on an maoi which boosted all of them. Something developed tolerance or immunity to the increased neuros. That's why I think maybe neuro stimulation, rather than neuro reuptake, might be an angle to consider. Maybe add in low dose prozac and zyprexa just to get some flow of all 3 neuros going. Ritalin maybe.
And sometimes I think it makes some kind of unlogical sense to go for something that does not make sense. For example, it doesn't sound like you need xanax and it is unlogical to see how that might help you. But that's the point. Everything that is logical hasn't been quite right. Maybe a little prozac and a little xanax could do wonders, for some unexplainable reason we'll never know.
And of course there is good ole low dose lithium. I've read several studies where when it was combined with noradrenergic agents, it stimulated the release of all 3 neuros, but not by itself, and only in the presence of a noradrenergic agent.
Risperidone. It seems like a lot of treatment resistant things respond to low dose risperdal addition. Probably because it stimulates the flow and release of more dopamine.
I'm just thinking. Wild ideas. I would sure like to wave a magic wand for me and you both.
poster:blueberry
thread:635786
URL: http://www.dr-bob.org/babble/20060417/msgs/635850.html