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Re: To Scott (SLS) » deniseuk190466

Posted by SLS on January 31, 2008, at 6:20:31

In reply to To Scott (SLS), posted by deniseuk190466 on January 30, 2008, at 16:00:45

> Scott, > > I hope you haven't done a runner again.

Still here for now.I was away for a few days setting up a new computer.

> I just wanted to ask you how you responded to a tricyclic on it's own,

My "virgin" (drug-naive) response to imipramine was robust, but short-
lived. It was the first drug I tried.

> if you ever actually took noratryptaline on it's own that is.

No. I did try amitriptyline, the parent compound of nortriptyline. I experienced the same sort of transient robust effect from it.

> The reason I ask is I wonder if my American friend who suffers fro Bipolar (mainly depression now) would respond too the same combination as you.


Ah, if only a crystal ball...

To answer your question, how could we really know for sure. You do know that Lamictal is particularly effective as an augmentor of antidepressants. It has a pronounced antidepressant effect in addition to its mood stabization properties (especially when combined with lithium). Here is my current regime:

Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg

If you throw enough crap against the wall, some of it is bound to stick. You can try to remove one drug at a time to strip away useless agents.

I discontinued Deplin because I wanted to experiment and determine if it remained a contributor to my treatment with chronic use. It seems to have pooped-out. I remain without it. It has only been a few days since I discontinued it, though. Damned uncertainty.

> As he said that tricyclics made him "punch walls" he is reluctant to try
one again.

Which TCA?

> Did they affect you that way when or if you took Noratryptaline on it's own. > > I'm just thinking your response to Nortryptaline (alone) would be an indication of his response to a tryciclic/MAOI combination. > > >


I find that if you keep a record of which drugs had a positive effect, even if only transiently, you can use it to combine the ones that had been of some benefit previously. I would say to give Nardil monotherapy a shot if there is no reason not to. If a partial, although inadequate, improvement is the result, I would add things to it rather than switch. I wish I had some evidence that my treatment was universally effective for bipolar depression. Damned uncertainty.

Things that can be added to Nardil:

TCA: Nortriptyline, desipramine, and perhaps trimipramine. Clomipramine and imipramine are to be avoided because of they are more likely to precipitate serotonin syndrome.

Wellbutrin.

lithium

Anticonvulsant mood stabilizers

Lamictal

Dextroamphetamine

Ritalin

Thyroid hormone

DA receptor agonists - Mirapex, Requip, piribedil

Atypical antipsychotics - Abilify, Geodon, Zyprexa, Seroquel, Risperdal (5-HT2a antagonists)

Remeron?

NO SSRIs - Prozac, Zoloft, Paxil, Celexa, Lexapro, Luvox

NO SNRIs - Effexor, Cymbalta


I'm sure I am forgetting something.


Please ask more questions.


> Thanks.....Denise

You are very receptive to new ideas, and process information effectively. You might have to think "outside the box" in order to get well.

Good luck - always.


- Scott

 

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