Posted by mtdewcmu on December 31, 2009, at 11:16:32
In reply to Re: Trying a different tack » mtdewcmu, posted by SLS on December 31, 2009, at 2:20:37
> > > > I am suspicious that Prozac is doing more harm than good, so I am going to try simplifying my regimen to Wellbutrin (300mg, XL) and Remeron (45mg). Wish me luck.
>
> > > Good luck!!!
> > >
> > > :-)
> > >
> > > If you decide to return to an SRI, I would recommend using either Effexor or Lexapro to go along with the other drugs you are taking. You could perhaps add Geodon if your response to these treatments is incomplete.
>
> > Unfortunately, I am paying out of pocket for my meds, and Lexapro and Effexor are both very expensive. The instant release form of Effexor is not, but I don't want to take it 2-3 times a day.
> >
> > Geodon is also expensive. Do you think there is a point in trying Geodon if Abilify has not helped?
>
> I wish I could say for sure. I haven't kept track of anyone who has taken both drugs in this order to be able to come to any conclusions. I would say that the drugs are different enough to entertain the idea.
>
> > I also had unpleasant side effects from Abilify, like heart palpitations (which I attribute to the adrenergic blocking effect)...
>
> I'm drawing a blank. What adrenergic blocking effect are you referring to?
>It was harder than I expected to find a reference for this.
"Similar to the anticholinergic effects of these medications, alpha blockade and postural hypotension may result in reflex tachycardia." from http://emedicine.medscape.com/article/815881-overview
Basically, I think the alpha blockade dilates peripheral blood vessels, forcing the heart to beat faster to compensate for the resulting drop in blood pressure. I am tall, so that may make me especially sensitive to the hypotensive effects.
> > ...and orthostatic hypotension. Is Geodon any better in this respect?
>
> I know that I am not being a lot of help here, but I would again have to say that I don't know, primarily because I haven't heard of hypotension being a problem with Abilify. Geodon would probably be worse as it is a more potent antagonist at NE alpha1 receptors. However, I had no such problem with Geodon at a dosage of 80mg.
>The new drug Saphris is a highly specific 5-HT2 inhibitor. I wonder how effective it would be as an antidepressant or an adjunct.
> > I am thinking of moving on from the SSRIs (and Effexor is very similar to an SSRI) and trying nortriptyline if necessary. I liked the way amitriptyline felt. The only problem with amitriptyline was the tachycardia, but nortriptyline is supposed to be better.
>
> Nortriptyline is better because it has a much reduced potency as an anticholinergic. I think it is a reasonable choice. You can always augment it if it does not produce adequate results as monotherapy.
>
>
> - ScottIt is high on my list of things to try if I can ever get most of the SSRIs washed out of my system. I had to take a Prozac yesterday due to withdrawal. I didn't expect Prozac withdrawal already on the first day without taking it.
poster:mtdewcmu
thread:931562
URL: http://www.dr-bob.org/babble/20091227/msgs/931782.html