Posted by bleauberry on March 5, 2009, at 18:47:05
In reply to TOO LATE - IT'S 1AM, posted by Fivefires on March 5, 2009, at 2:36:10
What's the chance of seeing another doctor? A second or third or tenth opinion may be the magic one. The current doctor doesn't seem to be showing much skill, management, or concern. Not cool. I mean, if you're stuck with him, fine, kick his *ss into gear.
I have little to go on other than your description in this thread and I don't remember from your previous visits what your history was. But with what I see in front of me, I cannot for the life of me figure out why you were not put on something fast and powerful for the entire spectrum of symptoms...like for example, Prozac+Zyprexa; Lexapro+Abilify; Lexapro+Risperdal; Prozac+Lithium; Effexor+any AP. Important note, I'm not talking APs in general, or ADs in general, I'm talking about the specific combinations listed above at normal medium doses.
Provigil just happens to go well with those too.
I'm not sure about the Nortriptyline thing. I mean, anything's possible, ya know? The best psychiatrist I ever had told me that. All I can say is that based on how fragile the situation is right now, it might be wise to approach it gently. That is, very low doses to start with a slow titration to higher doses. I do believe Nortriptyline will at first make things seem a little jumpier and a little more out of control for about 3 days, followed by rapid calming and control before the first week is over.
I would feel a whole lot more comfortable with this thing if a Zyprexa or Abilify were on board.
I hate it when untalented doctors bring us down a treacherous road of high dose benzos or max dose effexor where the treck back is like facing a hurricane naked.
Hey, I thought about you several times today. At work. In the car. At lunch. You aren't alone. I wish I could storm into your doctor's office and say, "Hey!".
Final note...if I understood your history correct, you came down from 450mg Effexor to 75mg? I don't know when that was though. I just wanted to comment that the after-effects of that, even after the withdrawals are gone, can last months. Some or much of what you are feeling could be post-high-dose-Effexor, in which case, again, I feel a Zyprexa or Abilify could really help smooth things out and raise the spirits.
poster:bleauberry
thread:883132
URL: http://www.dr-bob.org/babble/20090304/msgs/883954.html