Posted by blueberry on April 27, 2006, at 16:08:28
In reply to Add Risperdal or switch to Emsam for unipolar MDD?, posted by tom_p on April 27, 2006, at 13:29:09
Considering how long you've been on ssri's, I think a massive switch would be very hard. Coming off high dose lexapro would be hard, especially with anxiety issues involved.
Seroquel made me very depressed, so you aren't alone on that one.
I generally shy away from the atypicals, but I was on low dose zyprexa for 5 years. My GP and my pscyhiatrist use them to augment antidepressants. I think the big concerns with the atypicals are diabetes/glucose/insulin problems, and movement disorders. With low doses, careful diets, and periodic monitoring, these risks can be controlled.
Risperdal is used to augment antidepressants. From what I have heard, it is better in very low doses, as that is where it causes a release of dopamine. Medium or higher doses do more blocking of dopamine. It might be that the lexapro and klono are squashing out dopamine, so a little dopamine release might be good. Risperdal does have the worst sexual side effects of them all though, as it raises prolactin levels significantly. Zyprexa would be a better option in that regard.
You could try lowering the lexapro dose and see what happens.
You could lower the lexapro dose and add in 20mg of cymbalta to get some norepinephrine/dopamine action going.
If you could do it without anxiety, a stimulant might be an option for dopamine/norepinephrine action.
Dumping the whole program to try ensam sounds scary to me.
poster:blueberry
thread:637502
URL: http://www.dr-bob.org/babble/20060423/msgs/637536.html