Posted by floatingbridge on January 26, 2010, at 0:43:15
Well, after all the hoopla I put myself through, the consult wad just an ordinary 90 minutes with a (very smart, with-it) psych / pharmacologist.
After checking in a variety of ways for any hint of hypomania/mania--my husband, unaccustomed to these questions, was a valuable, objective source--the doc sees 'double
depression'. Only last month did I ask Meltingpot what that was....No quibble with ptsd--just inquired about flashbacks, dreams, intrusive thoughts. (No real med protocol for that yet he said)
O.K. Let's cut to the chase:
Before going to the maoi's (which is what I sensed he was most interested in) he suggested trials of lithium and remeron before washing out.He wad jazzed about emsam--I think he participated in research trials.
TMs is possible--though labor intensive.
4-5 days for 6 weeks for best result. Is it
like a reset button? I asked. He actually looked sad for a second. No, he said. Guess I'm still hoping for a magic wand....At first I was dissappointed; my husband liked him, and he could tell I was....
After awhile, this is what came to me:
The consult confirmed my instincts as to treatment--and he said I was a 'dopamine responder'. (I had not used the word dopamine once.) Dopamine is not currently addressed by newer anti-
depressants. He mentioned mirapex and requip and expressed small faith in their efficacy as add-ons for MD.His plan reconfirmed that my own pdoc is quite competent if cautious.
He said we should know on a few weeks if the lithium and/or remeron work. Hopefully he will work with my doc if a washout becomes necessary; I think he'd move it along more quickly.
Sigh. No magic wands. But you already knew that.
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poster:floatingbridge
thread:935008
URL: http://www.dr-bob.org/babble/20100122/msgs/935008.html