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Re: amitriptyline and apathy?

Posted by linkadge on March 27, 2016, at 13:04:23

In reply to Re: amitriptyline and apathy? » linkadge, posted by B2chica on March 27, 2016, at 0:52:55

Hey B2,

The gabapentin, Topamax, ambien and lunesta could be contributing to anhedonia. Are you taking the topamax and gabapentin for anxiety, pain, or mood stabilization?

Too many anticonvulsants in particular can (slowly over time) lead to apathy / depression.

Gabapentin isn't always the best mood stabilizer and can sometimes lead to depression. You may try lightening up on this a little (-300mg?). You may try splitting the amitriptyline in half (12.5mg) to titrate up a bit more slowly.

Also, how has the pristiq helped? You may find that with higher doses of amitriptyline, you need less pristiq, which *may* reduce anhedonia.

Would you have as much insomnia on less Adderall? TCAs can sometimes help ADHD (amitriptyline metabolizes into nortriptyline - which builds in the system over time, this can make amitriptyline more stimulating). It can augment the norepinephrine boost from stimulants. If getting by with less Adderall meant less nighttime sedation, then it might be a win-win.

My strategy is always to fight the medication / dosage creep whenever possible. Higher doses of multiple medications can sometimes just end up being counterproductive. Too much GABAergic medication can block the antidepressant response to certain ADs. Brain cells don't always know what to do with a thousand conflicting messages coming in.

Also, do your best to make sure your diet is stellar. It will help recovery.

Linkadge



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URL: http://www.dr-bob.org/babble/20160306/msgs/1087594.html