Posted by bleauberry on November 7, 2008, at 19:46:23
In reply to to blueberry, posted by Jeroen on November 7, 2008, at 2:13:21
> thanks! what about trazodone?
My guess is trazodone wouldn't be the one. But ya know, it is easy to be totally wrong, as your doctors have seen with their own choices.
Overall trazodone just doesn't seem to have enough oomph in my opinion, and maybe that is why it is used mostly as a sleep agent? I can't even think of the last time anyone ever said trazodone was their magic medicine. Happens with all the others though.
In that same family though, serzone sounds like a better choice. But going through a trial of two to three tricyclics makes a lot more sense to me, just based on other case reports similar to you. Amitriptyline, nortriptyline, imipramine, possibly desipramine. I mean, all you would need is about 2 weeks on each one to give them a good feel. If you don't get worse on one, or improve slightly, then keep going with it for more time. If you do get worse, switch to another one straight across without any washout.
When I read about tough cases like yours, it seems like tricyclics keep coming up. While most of these other meds we take are fairly fine tuned in what they do, the tricyclics hit so many different things. I mean, for example, hyper histamine can be the same as psychosis. Hyper choline can too. Tricyclics are anti both of those. Maybe seroquel worked for a short time because it was such a strong antihistimine, but tolerance developed to that. Tolerance that maybe could be avoided if the anti-histamine effect was coming from two different directions from two different drugs acting on a wider coverage of the various different histamine receptors? I am just thinking out loud.
poster:bleauberry
thread:860907
URL: http://www.dr-bob.org/babble/20081106/msgs/861373.html