Posted by lpslpslpslpslpslps on June 7, 2010, at 18:51:43
In reply to Re: Brainstorming alternate treatment options, posted by desolationrower on June 7, 2010, at 10:16:32
> well i would drop the quetiapine and increase the mirtazapine
>The weird thing about the quetiapine is that when I started taking it at 25 mg per day, it pulled me out of a long (1 year) dark depression in a matter of 2 days. But I'm as depressed as ever now, with weeping fits every few days and fantasies about death (I'm not at all suicidal, but sometimes I do imagine dying in an accident as a form of relief).
It occured to me this weekend that maybe I'm not really Bipolar II. My doctor has suggested this in the past, noting that it may not be that important to have a perfect diagnosis, but that he suspected that I wasn't a 'true bipolar.' I am ADHD and I was a compulsive gambler, and both of those things 'look' like bipolar disorder, but I've never had a hypomanic episode that lasted more than a couple hours except when I was gambling. If what I have is unipolar depression, it most closely matches the description for atypical depression: hypersomnia including sleep paralysis, it temporarily responds to positive events (mood reactivity), and I've had a problem with interpersonal rejection since I was a child, and it is often the precipitating thing that starts a depressed episode. I don't have an overeating problem, but I do take a stimulant (and even so I've gained 10 pounds in the last 6 months).
For anyone with relevant experience, does it sound like I'm on the right track? In either event, I'm happy to continue to take the Lamotrigine, since it is (very mildly) stimulating and it (very slightly) slows down the motion of my thoughts from one subject to another.
I've read that atypical depression responds much better to an MAOI like nardil or parnate than it does to a drug like mirtazapine or imipramine. But, I can't take any medicine that makes it impossible to take amphetamine. Does anyone have any experience adding or switching to an MAOI while concurrently taking a psychostimulant?
I'm going to talk to my doc this week's appointment to see what he thinks about increasing my vyvanse dose, dropping the buspar, and then either replacing mirtazapine with parnate or adding something like effexor or cymbalta or desipramine to the mirtazapine.
My doctor has said yes to every medicine request I've had over the years, with the exception of mirapex-- after reading the PDR entry, he (quite sensibly, I think) pointed out that the narcolepsy side effect, though rare, could very easily make my problems worse, and on top of that he had never heard of using mirapex as a psych med. Reasonable. I'm hoping he will either agree with my ideas or offer a counterproposal... all I know with certainty is that I'm taking a whole lot of drugs and they aren't working at all to solve the problems they are intended to solve.
poster:lpslpslpslpslpslps
thread:950034
URL: http://www.dr-bob.org/babble/20100604/msgs/950300.html