Posted by SLS on January 9, 2013, at 2:27:19
In reply to An update, posted by tensor on January 9, 2013, at 1:37:44
Hi Tensor.
> Have been doing fairly well on Lamictal 100mg, Seroquel 300mg, 2mg Clonazepam and modafinil p.r.n. for seven months, taking it for depression (fatigue, low drive) and anxiety. I am working but I'm feeling my energy level's dropping, although I eat healthy and exercise six times a week.
> I haven't been researching treatments for quite a while, I don't do that while in remission. So it would be nice if someone could update me if there are any new medications in the psychiatry field.
>
> Thanks.What kind of exercise do you do? There is such a thing as over-training, in which case you could experience a drop in energy and motivation. I don't know about anxiety, but I imagine it is possible that it gets worse if you are under physiological stress.
New drugs? I don't think there is anything new since your last visit...
The most recent antidepressant is Viibryd (vilazodone). It is a serotonin reuptake inhibitor and serotonin 5-HT1a partial agonist.
Latuda (lurasidone), already available as an antipsychotic, will soon be approved for depression. It is a sister drug to Geodon (ziprasidone), and has 5-HT7 antagonism as an antidepressant property.
Saphris (asenapine), and antipsychotic, has an interesting pharmacological profile, including NE alpha-2 antagonism (similar to Remeron). It can be energizing.
Minocycline seems to work well for depression in some people. It is an anti-inflammatory and is also anti-glutamatergic. There is a possibility that it might work particularly well with Lamictal. Minocycline can take months to exert its full effect, although the two people I know who take it (including me) experienced an improvement during week 1.
I am having luck with prazosin. It might be particularly beneficial to people who have PTSD or a history of chronic childhood traumas (developmental PTSD). To me, it feels like an antidepressant.
NAC (N-acetylcysteine), a food supplement, is still being promoted by the NIMH and people at Harvard for treating depression. I had a bad reaction to it. It made my depression moderately worse. NAC can take 3 months or more to work. It is a precursor to a powerful antioxidant, glutathione, and has a suppressive effect on glutamate activity.
Have you tried adding a psychostimulant? I don't consider modafinil to be a psychostimulant, but rather, a promoter of wakefulness and vigilance. Amphetamine and methylphenidate are more robust stimulants and can help with energy, motivation, and anhedonia. I have read that methylphenidate is better for anhedonia. Focalin (dexmethylphenidate) would be my choice.
I'm sorry to hear that you have taken a dip. Maybe it is just temporary. If you do intense resistance training 6 days a week, I recommend that you allow 2 weeks for recovery by not performing any anaerobic resistance exercises. You can do some light aerobic exercise, just to help maintain your calorie balance.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1035051
URL: http://www.dr-bob.org/babble/20121231/msgs/1035053.html