Posted by polarbear206 on February 1, 2007, at 13:22:50
In reply to Re: Do you have to get a lot worse... - blueberry » laima, posted by Quintal on February 1, 2007, at 10:50:45
> Laima, I for one don't believe that antidepressants *must* exacerbate the symptoms of depression before they get better, I'm just pointing out that this is a very common (and unfortunate) side effect in the beginning of treatment with SSRIS/SNRIs, that people may have to endure if possible before they begin to feel the positive effects. Like going through the wilderness to get to the promised land.
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> >Why cymbalta? Is there not another medication that could at least stay neutral and ineffective during its pre-effective period?
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> The problem is that blueberry has tried umpteen different meds from various classes in the last few months and quit after a few days for the same reason, so why not Cymbalta? It seems likely that blueberry will have this problem with other meds in the same class, so from my perspective switching to yet another SSRI/SNRI would likely just waste time and more money giving the same result. That's also why I suggested he try Parnate plus a benzo since he's never taken this class of med before and it tends to be very effective in depression refractory to other ADs. I'm also wondering if a mood stabilizer like lithium in addition to that combo might be worth trying as an augmenter?
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> >I'm starting to feel a tad cloddish. I have only best wishes for everyone's safety and peace of mind-but I do feel awfully worried about this situation.
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> I don't think you're at all cloddish. You're clearly concerned for blueberry's safety, as we all are, we just have different views on how best to manage the initial side effects of antidepressants. Ultimately blueberry knows his circumstances best and I trust he has enough experience dealing with this illness to judge what's best for himself.
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> Q
As I said in my previous post above, I really think she should trial a low dose of lithium to augment the cymbalta. I totally agree with Q on this. Blueberry's refractory deprssion is a red flag for trying the use of a mood stabilizer. I am very confident she can beat this!!! Blueberry, when you read this post, please consider sending an e-mail to Dr. Ivan Goldberg. He is a highly respected psychiatrist who deals with refactory deprssion. He can offer you suggestions to work with your Doctor. His practice is in NYC. I would go to him in a heartbeat if I were in your shoes. I don't know where you live in regards to NYC. I only live 3 hours away. I have corresponded him in the past.Http://www.psycom.net/ikg 8.html
poster:polarbear206
thread:728186
URL: http://www.dr-bob.org/babble/20070201/msgs/728759.html