Posted by desolationrower on December 13, 2008, at 19:08:44
In reply to Re: SSRI insomnia, restlessness, poor concentration, posted by crittercuddler on December 13, 2008, at 16:11:33
Well, not only would combining another med with an ssri make it work better, it could also work faster, so you might start to get some benefit within a few days. Also, the sort of symptoms you describe relating to cognition are often helped by nris. even if it doesn't help you get on an ssri, you might get some benefit for your depression at least. I guess i'm trying to think of how to get you onto an ssri in a way that doesn't bother you because they're really the gold standard, and it sounds like theyve helped you in the past. Perhaps being hospitalized for a week or two could help you? also have you tried nefazodone
Oh and inositol has shown efficacy in ocd, through soem of the same mechanisms as ssris, but with fewer side effects. buy it bulk, you need 15-20g a day. its tastes like sugar though (actually it is a sugar...). i have no idea if that would synergize with an nri as sris appear to do.
as for glutamatergics, N Acetyl cysteine would be the easiest, its an over the counter drug that is usually used to boost glutathione levels, which might be beneficial as well. Riluzole and memantine have been used as well. I'd go in order NAC->memantine->riluzole, just because of price and there isn't much data on whihc is best. Generally they have been studied as augmentation to ssris. probably need 1.5-3g of NAC a day, probably split doses. Memantine, i'd aim for 40mg.
Theres also psylocin. If you have time to go for a nice nature walk to prescribe it, its certainly the most pleasant way to reduce OCD.
Not that you asked about it, but hopefully you are doing healthy things like getting fish oil and meditating that also can help.
-d/r
poster:desolationrower
thread:868434
URL: http://www.dr-bob.org/babble/20081204/msgs/868584.html