Posted by yxibow on February 21, 2008, at 3:59:32
In reply to List of conventional ADs exhausted, posted by tensor on February 21, 2008, at 1:45:21
> Have tried and given each antidepressant/antidepressant combo and augmenting substance a fair trial. Nothing really works in the long run. Currently I'm struggling to manage to drag myself to work. But there's never any surplus energy. Also, I seem to cycle between depressed states and episodes of 'more energy' but not hypomanic, i.e. 1-2 two weeks of energy. 1-2 two weeks without. I'm now taking Remeron 30mg + 30mcg of T3. I think T3 has done some improvement but it can't touch the 'down-episodes'.
> I'm seeking a more stable mood and a higher mean of base-line. However, I lack a reference for what is 'normal', I'm I just whining? My pdoc has put me on behavioral activation, where I do exercises and fill out mood diaries.
> Do you think medication-wise I have reach the end? I have not tried MAOI nor antipsychotics and with the mixed results I read on this board I'm not sure I want to. MAOI are not really used here. Any ideas, opinions greatly appreciated.
>
> /MattiasWhat is normal? There are multiple definitions of normal and what is reality. It really isn't fair to label oneself into a box.
I don't think at all that it is whining... and behavioural therapy, when the patient is a willing and active participant has been proven to be just as effective as some antidepressants.
I just don't like the word because it conjures to me that one is misbehaving, but that is not at all the case. Its changing the way one looks and views at things and trying to push through things with tested activities.
Excercises ("homework") are a valuable thing in therapy. And writing a diary to yourself can give you some retrospect when you look back at improvements. Not only that but it can give you some reminders of things you may want to ask your careprovider(s).
I assume you've tried Lamictal, just out of random curiosity, because it can be a fairly good antidepressant for some.
Yes, agents like Seroquel and Zyprexa have benefits that more than outweigh the risks when major depression or mood disorders are an issue and can be augmenters at low dose. I would definately steer towards them or other older antidepressants far before trying MAOIs but I know individuals here have other opinions, and that's fine.
30mg is not the limit for Remeron, one can go to 45+ on it, I wouldn't completely give up on it, personally. I know it is a weight gainer, or can be for some people, at any dose frankly (from just a personal trial) but it is a unique tetracyclic.
Anyhow I hope that provided some perspective, I wish you continued success with trying new things.-- Jay
poster:yxibow
thread:813862
URL: http://www.dr-bob.org/babble/20080207/msgs/813873.html