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Re: Question for SLS (or anyone else who cares)

Posted by SLS on August 27, 2009, at 13:22:53

In reply to Question for SLS (or anyone else who cares), posted by Bob on August 27, 2009, at 11:45:23

Hi Bob.

> What med regimen are you currently on, if you don't mind me asking. I'm just curious, really.

I'm currently taking:

Parnate 80mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
lithium 600mg

All of the dosages have been tweaked to optimize the combination with the exception of lithium. I am still working on finding the minimum effective dosage for lithium.

> I'm currently on 50mg of Nortriptyline, 10mg of Citalopram, and 0.5mg of Mirapex spread throughout the day in 4 doses of 0.125mg.

50mg of nortriptyline is usually a bit too low. Most people need 75mg or higher. As a guide, you can have your blood tested for a drug level.

I'm sure you know that 10mg of citalopram is too low for the average person. 40mg seems to be about right for most people with severe depression.

Is the apathy part of your depression, or is it a side effect of the citalopram?

I agree with you that it might not be worth increasing the dosage of Mirapex. Although the sleep attacks may not get worse, I don't have very much confidence in the drug to be of benefit for more than a few days to a few months. I really haven't heard of any horror stories associated with the discontinuation of Mirapex. Maybe the withdrawal symptoms won't be that bad.

Which of the following drugs have been helpful?

- Parnate, Nardil, Marplan
- Effexor, Cymbalta, Pristiq
- Lexapro
- Zoloft
- Prozac
- Abilify, Geodon, Seroquel, Zyprexa
- Wellbutrin


If you are looking for a boost in dopamine, after you are done investigating nortriptyline, you could try Abilify + Wellbutrin + Lamictal. If you can tolerate it, you could also add either Effexor, Zoloft, or Lexapro. If you wish to try an MAOI like Parnate, you would have to discontinue the citalopram.

For right now, I guess I would discontinue the Mirapex, titrate the dosage of citalopram to 40mg, and raise the dosage of nortriptyline to 75mg and get a blood level after a week.

If you have any family members with depression, what drugs have been helpful for them? First degree relatives have a tendency to respond to the same drugs.


- Scott

 

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