Posted by bleauberry on January 14, 2008, at 18:37:49
In reply to Your psychiatrist is incompetent., posted by cumulative on January 14, 2008, at 14:49:54
I agree. Not only have you not tried the full line of antidepressants (such as lexapro, effexor, cymbalta, wellbutrin, nortriptyline, desipramine) you also have not had much opportunity to experience the synergistic benefits of combinations, which is most common these days. I mean, psychiatrists hardly ever get someone well with one drug.
That being said, there was a metastudy that looked at the comparitive effectiveness of newer antidepressants. The two winners were Lexapro and Effexor, both showing statistical superiority over the others. That is very generally speaking of course and someone may do well on a drug that appeared inferior, such as me doing best on prozac.
Just thinking out loud. Prozac+Zyprexa. Effexor+Zyprexa. Celexa+Risperdone. I'm leaning in the antipsychotic combo direction because of the description of symptoms and because of prior decent response. Just need a different one this time.
It's pretty sad when strangers at a forum have to suggest things that good psychiatrists have dozens or hundreds of patients doing well on, when one's own psychiatrist didn't mention those things. So he thinks its the end of the road, eh? Sounds like he is already there but you are nowhere near the end. There are good options and tons of hope.
The only general piece of advice I can give is to embrace combinations, not single drugs, and keep an antipsychotic like zyprexa as one of them in the combo. Oh, and maybe call around for another doctor who has experience with MAOIs (just to weed out the wimps) and is willing to try things.
poster:bleauberry
thread:806208
URL: http://www.dr-bob.org/babble/20080114/msgs/806500.html