In that case, it looks like your best options are either Nardil + a mood stabaliser and maybe doxepin or a benzo for sleep, or Parnate (perhaps in a higher doseage) plus a benzo for anxiety.
I'd decide which one you prefered, and push the envelope so far as dose and combinations go
What exactly do you mean by "a bit hypomanic", just more energy than usual, or somthing more serious?
Parnate (perhaps at 80mg) plus a long acting benzo such as Valium
or
Nardil plus a mood stabaliser (your guess is as good as mine here) plus either a benzo or doxepin for sleep
Dont give up, keep tryimg, keep hope
> > Sorry if my comments about side effects came across as me having a dig, it wasnt intended that way..... its just that you often get the side effects before you get any of the improvement, and its easy to say "this stiff is crap" and stop it.
> >
> > I'd consider either a high dose SSRI (Sertaline 200mg/day) or Effexor 300mg plus mirtazapine to help with the depression, OCD and anxiety, with or without a benzo
> >
> > other options are the parnate + nortriptyline i mentioned earlier with a benzo, or Nardil plus nortriptyline and a benzo, or a high dose SSRI with bupropion and a benzo, all of course depending on what you've tried in the past
> >
> > Which drug or combination of drugs has come closest to giving you relief?
>
> Unfortunately, I found nortriptyline stimulating rather than sedating, so don't think I'd be able to tolerate it with an MAOI. Same thing with clomipramine -- it produced a lot of akathisia and agitation and isn't something I'd be desperate to revisit.
>
> As I said, the closest I came to relief was on Parnate, which helped my depressive symptoms (anergia, lack of motivation, rejection sensitivity) and, to a degree, my ADD (which no other AD has done), but which didn't relieve my anxiety, and in fact may have increased it. I was only permitted to try up to 60mg, which was the minimum dose necessary for an anti-depressant response. Nardil helped too, but the insomnia was terrible and it made me a little hypomanic.
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