Posted by mtdewcmu on January 1, 2010, at 22:58:14
In reply to Re: Remeron + Paxil: so far, so good!, posted by floatingbridge on January 1, 2010, at 11:03:33
Well I had a pretty good day at work today. The GI side effects wore off for the most part. I felt some edginess in the first part of the day when the Paxil and Wellbutrin were kicking in hard. Later on, the feeling mellowed out for a brief interval, then around sunset my mood dropped again. Although it was not as bad as it has been. So it seemed that I was on too much ADs in the morning, and not enough in the evening. It has occurred to me that the feeling of dropping off a cliff moodwise could be due to the Wellbutrin wearing off (I don't put much faith in Budeprion's 24-hour time release). I think over the longer term I'd like to drop WB and possibly replace it with nortriptyline. In the short term, I may decrease the Wellbutrin, and I think I'll divide the Paxil into two doses to simulate a time release. I think I also need to decrease the Remeron, because Paxil is a potent CYP 2D6 inhibitor and Remeron is metabolized by CYP 2D6. I wonder if it would be worth paying a lot to get Paxil CR in the future. Another thing I am wondering is whether a mood stabilizer might smooth out the up and down that I get through the day. If so, what would be a good choice? In the past, Lamictal made it hard to drive safely. Or maybe this nighttime crashing is just a symptom of depression and I should wait it out...?
poster:mtdewcmu
thread:931562
URL: http://www.dr-bob.org/babble/20091227/msgs/932067.html