Posted by West on January 20, 2010, at 8:37:56
In reply to Re: switching from venlafaxine/mirtazap to moclobe » europerep, posted by conundrum on January 19, 2010, at 11:05:10
Usually lithium/lamotrigine or an typical antipsychotic like olanazapine are used to augment SSRIs, personally I would prefer to try lamotrigine before lithium, but I've no idea about which has better efficacy. Then again I have trouble dealing with side effects a lot of the time, I had akathisia from 7.5mg mirtazapine.
I do think that while bupropion is somewhat dopaminergic, it is a bigger hitter of NE, and can give you a right kick up the posterior.
Give that a shot first if you're doc's willing before trying lithium/lamotrigine, maybe add a something like zopiclone at night initially to help you get to sleep. I take it with a sedating antihistamine called doxylamine which also has hypnotic properties and find it to have less hangover than diphenhydramine, though either will do (and probably lots more like it.)
I actually found less twitchiness and agitation from high dose venlafaxine with bupropion on board (or perhaps noticed it less), maybe because of the dopaminergic action. Some people find the opposite and feel dysphoric. This might be explained by its blocking the release of dopamine as well as its uptake.
poster:West
thread:930533
URL: http://www.dr-bob.org/babble/20100113/msgs/934434.html