Posted by bleauberry on October 1, 2008, at 21:00:21
In reply to severe depression! has anyone had it this severe?, posted by james dean123 on September 30, 2008, at 3:13:30
I am so sorry for the horribleness you feel. I feel it too, as do many here. I know it probably doesn't help much, but you need to at least know that it is not just you, it is many people, and you are not alone in what you have to endure. I mean, yes, we are all alone, but there are thousands of other people feeling exactly what you are feeling.
All antidepressants, even ones with very close similarities to each other, have an equal chance of working. So even if one doesn't work, another could work real well. Based purely on observation and personal experience, I would suggest this:
Start with Lexapro 2.5mg a few days, up to 5mg for a few days, then 10mg and maybe 20mg. If after 8 weeks you see no improvement, then switch to Prozac 20mg. A final effort in that family would be Zoloft 50mg-200mg.If you get a partial response to any of the above, add one of these to it: Zyprexa, Ritalin, Nortriptyline.
As for the generic wellbutrin I strongly suggest requesting your doc write all prescriptions for the original brand names and accept no generics. Brands are more expensive but in many cases worth it. There have been countless stories of how a brand was working well but symptoms returned when a generic was substituted. Everyone will tell you they are the same active ingredient and they work the same, but that is not true. The active ingredient can vary as much as 8% from pill to pill in either direction compared to the original. No one knows why yet, but somehow the supposedly inactive fillers in pills do play a role. If a generic med does not have the same exact fillers that the brand does, they are not the same drug. Hard to figure, I know, but believe me it is so true. Seen it over and over. That doesn't mean a generic won't work, it just means reliability and potential go way down. Clinical studies were based on the brand name drugs, not generics, so duplicate those studies. In the wellbutrin category I have seen countless bad reports of generic wellbutrin, where the extended release brand name seems to be the best. Like you, I responded badly to wellbutrin. It was generic.
At the very least, start with brand names until you see significant improvement. Then try switching it to generic to save money. If everything stays cool, great. If you feel you are sliding back, return to the brand.
Your doc should not have a problem prescribing the meds listed above, in that order, and should have no problem with any of the add-ons. I wrote them that way, in that order, for a reason. Too long to explain. You don't need to keep suffering as you are. One of those meds or combinations is bound to help you get out of the dungeon.
A friend of mine was started on meds for lifelong depression. He was started straight away with low dose lexapro and low dose risperdal at the same time. He actually felt much improvement in just 4 days. Usually it takes weeks, but sometimes combination work faster. Zyprexa or Risperdal are good ones to accelerate an antidepressant, as is Ritalin. So if you need fast, really fast, consider starting two meds like that at the same time.
If at any time one of them makes you feel a lot worse, like wellbutrin did, ditch it right away. Move straight to the next.
poster:bleauberry
thread:854903
URL: http://www.dr-bob.org/babble/alter/20080612/msgs/855183.html