Posted by ChicagoKat on October 20, 2012, at 21:22:06
In reply to Re: Feeling REALLY down » ChicagoKat, posted by SLS on October 20, 2012, at 18:38:45
As always, thanks for your excellent advice and encouragement, Scott.
There have been a few updates; perhaps you have missed them. 1. I'm still on Nortriptyline, but I only take it twice a day, for a total of 50mg/day. Then I take amitriptyline 50mg qhs for sleep. As I'm sure you're well aware, amitriptyline is metabolized to Nortriptyline, so the thought is that I should be therapeutic with my TCAs. 2. I went ahead and increased my dose of Nardil to 60mg/day about a week ago. My pdoc would probably never approve, but I really want this to work. I'm carefully monitoring my gait b/c it is a good warning sign..once it gets funny the falls start happening a few days later. So if I get the funny gait I will immediately go back to 45mg/day. So far, no problems after a week. 3. And, I have to admit, when I'm feeling really low I do take some Ritalin. My BP is generally low b/c of the Nardil, but with the Ritalin I need to take an antihypertensive or two. But it is otherwise well tolerated. And it really helps to get me through this period of waiting.
I will work on my lists, but I can pretty much tell you that most all drugs fall into the not worked/hurt category. And I mean *everything* The only exceptions are MAOIs and Ritalin, they fall into the helped category. It's funny, Ritalin works so well for me, but amphetamines either have no effect or they make me very anxious.
Anyways, this post is getting long, and I believe I've fully filled you in on the changes that have been made to my therapy. I hope you approve. Now I just have to wait...but as I've said, I'm an impatient person! Thank goodness for Ritalin! I'm feeling much better tonight thanks to it.
And again, thank you so much for helping. You're the best. And I'm so happy you are feeling better.
Take care,
Kat> What is your current dosage of amitriptyline? If you haven't arrived at a minimum dosage of 150 mg/day yet, I would think about increasing the dosage before making any other changes.
>
> If it were anyone else, I would suggest increasing the Nardil to 60 mg/day. Most people don't respond to dosages lower than this. How long did you remain at 60 mg/day of Nardil before the ataxia emerged? What about going to 52.5 mg/day for a week or two and then moving up to 60 mg/day?
>
> > God help me, but if Nardil ultimately fails on me, there will be absolutely nothing left for me to try.
>
> How do you know this?
>
> > I'm really scared.
>
> I would be, too.
>
> Perhaps this is a good thing. It might force you to be more patient with your current treatment and encourage you to be receptive to others.
>
> I hate to do this to you, but can you make three lists?
>
> 1. Drugs that have helped.
> 2. Drugs that have hurt.
> 3. Drugs that were neutral.
>
> You can try to build a treatment regime using Nardil as its core. This would allow you to combine things like Lamictal, Wellbutrin, Ritalin, Dexedrine, lithium, Abilify, etc. However, you would need an enlightened doctor to realize that this can be done safely.
>
> Please remain hopeful that something will eventually help. If an untried treatment can be conceived of, you cannot conclude that you are ultimately doomed. A bit of creativity might be needed.
>
> I wish I had more time, but I am out the door...
>
> You'll get there.
>
>
> - Scott
>
>
poster:ChicagoKat
thread:1029238
URL: http://www.dr-bob.org/babble/20121018/msgs/1029287.html