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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by linkadge on April 23, 2009, at 16:38:31
I know the lithium / nortiptyline combination is recomended for ECT relapse prevention, but is ther any special reason / resarch behind the effectiveness of this combo for treatment resistant mood disorders?
Linkadge
Posted by uncouth on April 23, 2009, at 17:10:19
In reply to Anything special about lithium / nortriptyline?, posted by linkadge on April 23, 2009, at 16:38:31
my impression was just that it happened to be the one combo that they did the study with. i'm guessing any strong A/D like effexor or cymbalta, combined with lithium / lamictal / abilify / geodon, etc. would do the trick.
although, i'm just finishing up my course of ECT and do happen to be on 150mg of nortriptyline, recently switched to from Effexor which this time wasn't doing the trick. But I also can't say it's particularly working because i'm actively in the process of thinking about how to put my affairs in order. So don't look to me for guidance.
Posted by bleauberry on April 24, 2009, at 5:14:28
In reply to Anything special about lithium / nortriptyline?, posted by linkadge on April 23, 2009, at 16:38:31
All I know is that while Dr Gillman of pscyhotropical is basically down on lithium and stopped using it a long time ago because of its uselessness, he does say that it is useful when combined with a noradrenergic med like a TCA. His theory is that it is somehow serotonergic and helps to balance a tca similar to how a ssri would. But of course, you and me both know lithium likely has a wide variety of complex actions that we probably still won't have a clue about in 100 years. And the same goes for all the ADs. If it works, it works, if it don't, it don't, and in our lifetimes we'll probably never know why.
Posted by desolationrower on April 24, 2009, at 14:07:53
In reply to Re: Anything special about lithium / nortriptyline, posted by uncouth on April 23, 2009, at 17:10:19
> my impression was just that it happened to be the one combo that they did the study with. i'm guessing any strong A/D like effexor or cymbalta, combined with lithium / lamictal / abilify / geodon, etc. would do the trick.
>
> although, i'm just finishing up my course of ECT and do happen to be on 150mg of nortriptyline, recently switched to from Effexor which this time wasn't doing the trick. But I also can't say it's particularly working because i'm actively in the process of thinking about how to put my affairs in order. So don't look to me for guidance.lithium is known for anti-suicidal effect, and has a strong long-term neutrophic effect. maybe it might be good to try this combination?
-d/r
Posted by Ceres on April 24, 2009, at 17:18:18
In reply to Re: Anything special about lithium / nortriptyline, posted by uncouth on April 23, 2009, at 17:10:19
"But I also can't say it's particularly working because i'm actively in the process of thinking about how to put my affairs in order"
I hope you can hang in there, put those affairs on hold. There are other things yet to try, some different combinations of meds, & some daily life interventions to make things more bearable in the meantime.
Recently, I retried an old drug, & it turned me around, though still a ways to go. Maybe the combination of things was just right.
I hope the same for you. Take care of yourself.
Posted by Ceres on April 25, 2009, at 19:23:40
In reply to Re: Anything special about lithium / nortriptyline, posted by uncouth on April 23, 2009, at 17:10:19
"...because i'm actively in the process of thinking about how to put my affairs in order"
Hey, UnCouth, I hope you're holding on.
I don't know if this will work for you, but sometimes it's gotten me by. If you can't live for yourself now, maybe you can live for others. That might sound trite, but it is like temporarily closing the valve on your needs, like pruning off a big part of oneself so it can grow strong & new in time. I think of it as kind of giving ones life over as an instrument for good, a priest-like role by default of depression.
I'm thinking of things like volunteering at a soup kitchen or homeless advocacy or sometimes I bring homeless people water & fruit when I can afford it. So many homeless people are also struggling w/ their minds.
Or animals? literacy? elders? urban garden projects? Okay, I might be way off on what you need ...probably support is better than suggestions.
I hope you're getting by & taking it day by day. -Ceres
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