Posted by GavinoFelix on October 27, 2013, at 21:52:31
Hey, long time lurker here. Long story short, I just relocated and just started seeing this new doc. Psychiatrist just reduced my clomipramine dose from 150mg to 100mg and I'm feeling pretty bad. Have been stable w/r/t depression for the past 6 months or so. Due to certain side-effects not wearing off (e.g. still unable to exercise aerobically without heart gettin' all worked up, INSANE sweating even when it is 40 degrees F outside) he suggested decreasing dosage.
Previously was going to UPenn for the past year (during which time they, quite heroically, stabilized me) coming in with one of my worst bouts of Depression (225mg venlefaxine and 30mg mirtazapine pooped out entirely) and we tried out tranylcypromine (huge mess), then ran back through the STAR*D thing and eventually landed on the TCA button and they gradually ramped me up on the clomipramine. It's my first TCA and would be willing to try other stuff.
Also, I take 100mg trazodone to help sleep and 3x30mg vyvanse for "severe adhd" according to the formalized testing they administered at UPenn. It was suspected that I was a "rapid metabolizer" of CYP2D6 (and others) at UPenn due to my blood work always coming back as very very low serum levels of clomipramine (in fact, it was only detectable once I got to 150mg). The vyvanse, similarly, is subjectively only functioning for about 2 hours (and yes, all psychiatrists are horrified by this). Adhd-wise, "adderall" really didn't register and years ago I tried atomoxetine.
A week into this decrease in dosing and I feel like the bottom has dropped out on me and I'm completely apathetic. Should I call the psychiatrist this week? I just feel awkward calling this new doctor up right after our 1rst appointment and telling him how I feel like sh*t already. Should I just 'tough it out' until my next appointment in 3 weeks? I'm 27, finally back in school and working part time. Oh, also in a relationship with someone I really love. So I don't really feel up to dealing with 'getting depressed' again or completely re-doing my medication regimen. Thoughts on augmentation? Maybe throw some mirtazapine back in there?
I've always respected many of the posters here. I've scoured plenty of forums, but this is the only one where people are knowledgeable, smart, compassionate and, unfortunately, truly experienced with legitimate MDD.
Thank you
poster:GavinoFelix
thread:1053190
URL: http://www.dr-bob.org/babble/20131025/msgs/1053190.html