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Re: What are current regimens for extreme rumination?

Posted by Christ_empowered on December 25, 2019, at 9:05:03

In reply to What are current regimens for extreme rumination?, posted by TriedEveryMedication on December 24, 2019, at 17:58:13

if the ssri drugs don't cause major problems for you, that's one common treatment. buspar never did much for me, solo, but it did boost antidepressants that hit serotonin.

maybe...try gabapentin or lyrica, even as needed, just to give your mind a break now and then? benzodiazepines are a valid option, but now docs are supposed to be more careful about Rx'ing, blah blah blah, plus the very real risks involved with long term use, blah blah blah...

i don't know if you have other "issues" coming into play, but the wellbutrin+ssri combination is a golden oldie that can cover a lot of bases. personally, wellbutrin was less apathy-making than ssri drugs, but after I dropped it, I suddenly realized it had taken the edge off some of my 'obsessive traits' or whatever.

in bona fide ocd, low(ish) doses of neuroleptics can sometimes be helpful. id avoid unless its needed, but...yeah. an option. more 'atypical' than typical, i seem to recall reading that the current data (such as it is...) supports a low dose of risperidone above other options. i could be mistaken.

can you take tricyclics? they tend to be rather harsh and all, but there's one...amoxapine...recommended to me by a psych for severe depression with intense ruminations...

partially metabolized into loxapine, an older antipsychotic that is OK, in low(ish) doses. when it works, it often lifts mood, calms agitation, etc. within 1-2 weeks, which kind of lines up with more recent data on 'atypical'+antidepressant combinations...even when there's no improvement in overall remission rates, the rate of response is often accelerated.

the dual-acting (SE+NE) drugs, old and new, are sometimes a valid option. helpful, I know (LOL). the oldest option out there would be Tofranil or the newer Tofranil-PM (pamoate), which apparently has a relatively balanced action on serotonin and NE, but...

its -rough-. trust me on that one. oh, and overdoses can result in an agonizing death. there's that, too.

ok. hope this helps a bit. :-)




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