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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Deniseuk190466 on March 26, 2007, at 10:57:49
I'm just wondering if anybody on this board has added an agent to an SSRI that's stopped working or which is not working very well.
If so what agents did you add and with what results?
Thanks....Denise
Posted by Joe Bloe on March 26, 2007, at 11:32:38
In reply to Successful aumentation strategies for SSRI poopout, posted by Deniseuk190466 on March 26, 2007, at 10:57:49
Just a few off the top:
- Buproprion, from small dose of 75 mgs a day for sexual dysfunction caused by SSRI to full dose.
- Lamictal (might allow you to lower SSRI dose, which might improve the negative side effects).
- Ritalin or Adderall
- Benzo (?), not my area of specialty
- Fish oil
- Magnesium
- Switch from one SSRI to anotherUltimately, I think it depends what you and your doctor are looking for. If you feel fatigued, then one of the stimulating meds would be a good augmentation, whereas if you're suffering from bad anxiety, then something anxiolytic would probably be a good choice.
I'm sure people will add some more. Good luck!
Posted by TheMeanReds on March 26, 2007, at 14:59:33
In reply to Re: Successful aumentation strategies for SSRI poo, posted by Joe Bloe on March 26, 2007, at 11:32:38
When I had taken lexapro in the past, I needed to add something to control anxiety still. So I augemented lexapro with klonopin. I've heard some moderate talk about klonopin causing some depression, even though on an anti depressant.
It was true for me. So now I'm on Xanax, and its so much better in my opinion.
Posted by FredPotter on March 26, 2007, at 18:45:10
In reply to Re: Successful aumentation strategies for SSRI poo, posted by TheMeanReds on March 26, 2007, at 14:59:33
Pindolol
Lithium
Naltrexone (25mg/d)
Posted by Racer on March 26, 2007, at 20:33:44
In reply to Re: Successful aumentation strategies for SSRI poo, posted by FredPotter on March 26, 2007, at 18:45:10
I've read of people having good success by swapping through the various SSRIs -- as one poops out, take a different one. Basically, about three SSRIs that you can cycle through.
Of course, considering how much trouble it can be to find a tolerable drug that works, maybe that isn't great advice... But since I read it, and it made some sense, I figured I'd offer it here.
Otherwise, adding in Wellbutrin, Buspar, fish oil, SAMe, probably other options as well.
Good luck.
Posted by FredPotter on March 26, 2007, at 22:58:32
In reply to Re: Successful aumentation strategies for SSRI poo, posted by Racer on March 26, 2007, at 20:33:44
I've just started Nardil. Is it known for pooping out? I suppose I could swap to Parnate if it did, and then back again. Cyclic drug-swap poop-out treatment. There's a PhD there for someone
Fred
Posted by stargazer on March 26, 2007, at 23:19:51
In reply to Successful aumentation strategies for SSRI poopout, posted by Deniseuk190466 on March 26, 2007, at 10:57:49
Usually my pdoc raised the dose before adding another med but that usually didn't work too well. The best meds that were added were:
Wellbutrin SR 150 mg and Adderall-XR 10-20 mg wer the only ones that did anything for me.
Thyroid never worked, Lithium never worked, Cytomel never worked, dexadrine never worked, Lamictal never worked but took forever, seroquel didn't work, there were probably more but thatis all i remember now.
Posted by Deniseuk190466 on March 27, 2007, at 10:44:57
In reply to Re: Successful aumentation strategies for SSRI poopout, posted by stargazer on March 26, 2007, at 23:19:51
Hi Stargazer
Thanks for responding.
How long did it take for the Wellbutrin and Adderall to kick in with the drug you were taking?
Also, you said Lamictal never worked but took forever, not sure what you mean by that???
What are you taking now and is it working?
Denise
Posted by Deniseuk190466 on March 27, 2007, at 11:03:35
In reply to Re: Successful aumentation strategies for SSRI poo, posted by Joe Bloe on March 26, 2007, at 11:32:38
Hi Joe,
Well the Lexapro is helping a bit in that I'm not so suicidal, agitated and I'm eating better. But I still am not really enjoying anything, I still feel physically uncomfortable all the time and I have a hard time just sitting and watching the telivision. I just know it's not working propertly. I suppose I feel lack lustre more than anything.
I lack motivation more than anything although can acomplish things by forcing myself to.Thanks for the suggestions anyway.
Denise
Posted by Deniseuk190466 on March 27, 2007, at 11:14:01
In reply to Re: Successful aumentation strategies for SSRI poo, posted by TheMeanReds on March 26, 2007, at 14:59:33
Hi,
Thanks for your suggestion. It's hard to know what I'm still suffering from right now. I just know the Lexapro is not working properly. Still no real desire to talk to anyone, socialise, still not really enjoying things so I think it's more depression than anxiety although hard to say.
I did try Klonopin a month or so ago with Mirtazapine, which I ordered from the internet and I can't say it did much of anything.
Thanks again anyway......Denise
Posted by Deniseuk190466 on March 27, 2007, at 11:47:56
In reply to Re: Successful aumentation strategies for SSRI poo, posted by TheMeanReds on March 26, 2007, at 14:59:33
Hi,
Thanks for your suggestion. It's hard to know what I'm still suffering from right now. I just know the Lexapro is not working properly. Still no real desire to talk to anyone, socialise, still not really enjoying things so I think it's more depression than anxiety although hard to say.
I did try Klonopin a month or so ago with Mirtazapine, which I ordered from the internet and I can't say it did much of anything.
Thanks again anyway......Denise
Posted by Joe Bloe on March 27, 2007, at 13:01:54
In reply to To Joe Bloe, posted by Deniseuk190466 on March 27, 2007, at 11:03:35
It sounds like you a small dose of Wellbutrin could do the trick, maybe even as low as the 75-150 mg range.
Posted by stargazer on March 27, 2007, at 13:33:35
In reply to To Stargazer, posted by Deniseuk190466 on March 27, 2007, at 10:44:57
Denise, The Wellbutrin was added to Celexa first and did take a few weeks to do anything. Then I still was unmotivated enough so Adderall was added, initially 10 ,then 20 once a day, then 10 twice a day, then 20 once a day worked best.
The lamictal never helped and I probably meant it took forever to figure out it was not working and was causing more symptoms than helping, lots of balence problems resulting in several falls.
I'm now on Emsam6 and abilify5, just added past week,so unable to know it's long term benefit yet...SG
Posted by deniseuk190466 on March 27, 2007, at 14:53:33
In reply to Re: Successful aumentation strategies for SSRI poo, posted by FredPotter on March 26, 2007, at 18:45:10
Hi Fred,
Have you tried adding any of these agents yourself and with what results?
Thanks....Denise
Posted by deniseuk190466 on March 27, 2007, at 14:55:05
In reply to Re: Successful aumentation strategies for SSRI poo, posted by Racer on March 26, 2007, at 20:33:44
Thanks Racer but I've already switched from Seroxat (which had stopped working) to Lexapro which still istn't helping enough at 10mg.
Thanks though......Denise
Posted by deniseuk190466 on March 27, 2007, at 14:56:58
In reply to Re: To Stargazer/Denise, posted by stargazer on March 27, 2007, at 13:33:35
Hi,
I hope the Emsam/Abilify combo helps you. Why did you stop the Celexa/Wellbutrin/Adderall combination?
Denise
Posted by Phillipa on March 27, 2007, at 20:12:06
In reply to Stargazer, posted by deniseuk190466 on March 27, 2007, at 14:56:58
Can I follow? Love Phillipa
Posted by stargazer on March 27, 2007, at 22:38:40
In reply to Re: Stargazer » deniseuk190466, posted by Phillipa on March 27, 2007, at 20:12:06
Unfortunately after a few years (3-4)period of time they stopped working. I was able to work while onthis combo and although I did have periods of mild instability, for the most part I was highly functional and social. But the combination I would say, with the exception of the MAO's (Nardil and Marplan both) was one of the better ones. I always compare every med to the MAO's, which also pooped out, but in a shorter period of time. Marplan failed on retrial and I have yet to retry Nardil, but still hold out hope for it. They made me feel the most confident and normal of any meds I've taken.
But what I now realize is that my depression has worsened so much over the years, most meds are useless and I'm running out of options, but I still refuse any suggestions of ECT or VNS, at least for now...Stargazer
Posted by FredPotter on March 28, 2007, at 0:12:54
In reply to To Fred Potter, posted by deniseuk190466 on March 27, 2007, at 14:53:33
Pindolol no
Lithium yes - no effect
Naltrexone - worked really well for a short time
Posted by mattye on March 29, 2007, at 18:11:20
In reply to To The MeanReds, posted by Deniseuk190466 on March 27, 2007, at 11:14:01
I would try and stay with Lexapro for at least a couple months before it really started working. Your symptoms sound similar to mine, and mirtazapine did nothing for me either.
It took me awhile to get started on Lexapro because it made me very agitated at first. Every time I took even 5 mgs I wanted to crawl out of my skin... but I stuck with it.
Start at 2.5 mgs, and then up it to 5, then 7.5, then 10, then 15, then 20. You have to be patient with these things. I was stable on 20 for quite awhile, but my doc decided to put me on 30 to see if I will do better. The only thing that sucks, of course, are the sexual SE's.
Anyway, good luck. I really hope the Lexapro works for you.
Mattye
> Hi,
>
> Thanks for your suggestion. It's hard to know what I'm still suffering from right now. I just know the Lexapro is not working properly. Still no real desire to talk to anyone, socialise, still not really enjoying things so I think it's more depression than anxiety although hard to say.
>
> I did try Klonopin a month or so ago with Mirtazapine, which I ordered from the internet and I can't say it did much of anything.
>
>
> Thanks again anyway......Denise
Posted by Deniseuk190466 on March 30, 2007, at 6:25:10
In reply to Re: To The MeanReds, posted by mattye on March 29, 2007, at 18:11:20
Hi Mattye,
Thanks for the words of encouragement, it does help really.
Sometimes I don't know what to do for the best, part of me feels like just getting back onto Seroxat at least I was doing so so on it. Lately though I've just felt myself going down hill and I've tried so many meds and combinations.
So far I haven't had too much anxiety on the Lexapro but just feel very apathetic all of the time.
Can I ask you how long before you noticed an improvement and at what dose? Also, did you or do you ever have suicidal ideations and fantasies?
Thanks....Denise
This is the end of the thread.
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