Posted by LouisianaSportsman on April 27, 2014, at 0:53:36
In reply to Start over with clomipramine or combination?, posted by MuseMemento on April 26, 2014, at 20:19:01
> I've just finished, unsuccessfully, a trial of methylphenidate 20 mg in addition to 300 mg bupropion xl, 20 mg escitalopram and 2 mg abilify. Tuesday is the next appointment with the pdoc and TCAs will be the next step. So, question, I know we'll be either discontinuing or tapering off the escitalopram to make way for clomipramine but should I also discontinue the bupropion, which had previously been my only successfuly AD, and abilify or change only the one agent at a time? I'm not sure the abiilify ever helped or that the bupropion is adding anything currently. I also know that there's an enzymatic interaction between clomipramine and bupropion which increases the plasma levels of clomipramine but I also smoke currently and it seems that may even the effect out. Treatment is for MDD, OCD, GAD, possibly PTSD. Thanks for any replies.
Hey, Muse! I appreciate anyone on here who comes and contributes to my hobby of thinking like a PDOC and what I'd do if I was one.I've been on this combination at one time briefly. What a coincidence! :O (but in different forms of the medicament (it was Zoloft, actually, but still it was an SSRI with Abilify with Concerta with Wellbutrin but I'm a completely different combo now).
Straight-forward, you can also discontinue the bupropion. I quit cold turkey 522 mg. bupropion hbr later when I switched to Dexedrine IR because it actually attentuates the effects of amps but not methylphenidates.
I had no side effects except that I got way, way bigger buzzes off my dipping tobacco that I vomited twice. Trust me, I'm not an amateur when it comes to that stuff, and my stimulant (d-amp) was stronger-- but you probably won't have that effect. Basically, it will escape from your nicotinic receptors. Very good idea to continue it considering the enzyme response.
I didn't notice aripriprazole nor bupropion do anything, but I still took them, and I'm not really sure why, just because maybe.
Abilify, I've quit cold turkey one time and it was really easy one time when I directly switched to an another AAP (Latuda) that likely dissuaded side effects. But, with ariprazole, you need to look in to reports about dopamine agonist withdrawal syndrome due to unique mechanism of action.
Good luck finding the right medication! Trust me, I've been right where you are, but I kept going. I'm currently on a rather good combo of Brintellix (2014's SRI), Desoxyn (m-amp), Gralise (special gabapentin xr), Lamictal XR, Latuda, Nuvigil (armodafinil), Trokendi XR (Topamax) and Xanax XR [many, as you can see, are just fancy brand-names for typical medicament]
Keep us in the loop.
poster:LouisianaSportsman
thread:1064818
URL: http://www.dr-bob.org/babble/20140419/msgs/1064833.html