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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by linkadge on February 26, 2010, at 15:39:19
I am taking 10mg of amitriptyline with 5mg of escitalopram. I have been feeling pretty darn good with little need of the methylphenidate.
Since adding the escitalopram I have noticed a little more apathy, but my social functioning has improved dramatically.
I may lower the escitalopram to 2.5mg to see what happens.
Linkadge
Posted by Phillipa on February 26, 2010, at 19:30:58
In reply to Update - combo is working, posted by linkadge on February 26, 2010, at 15:39:19
Link that's great. Am reading Kramers listening to Prozac and he lists amitrytalline as being the stimulating TCA. Maybe raise that? Phillipa
Posted by bleauberry on February 27, 2010, at 17:24:45
In reply to Update - combo is working, posted by linkadge on February 26, 2010, at 15:39:19
Very cool. And I'm all for low doses.
Weird, but the doc I was seeing for Lyme actually had patients doing well on 1mg lexapro. I think maybe too often doctors think more is better, when sometimes actually less is better. It's just that we never get a chance to see that because even their starting doses are already too high. My opinion.
Posted by linkadge on February 27, 2010, at 20:49:11
In reply to Re: Update - combo is working, posted by bleauberry on February 27, 2010, at 17:24:45
I remember reading that a 5mg dose of zoloft inhibited the serotonin transporter by 50% !
Thats one tenth of the traditional clinical dose, but almost the same level of transporter inhibition. I was reading too, that SSRI's affect allopregnanalone levels at much lower concentrations than needed for substantial SSRI effect.
Linkadge
Posted by Bob on February 28, 2010, at 0:10:04
In reply to Re: Update - combo is working » linkadge, posted by Phillipa on February 26, 2010, at 19:30:58
> Link that's great. Am reading Kramers listening to Prozac and he lists amitrytalline as being the stimulating TCA. Maybe raise that? Phillipa
Really? I thought amitriptyline was notorious for causing sedation and drowsiness. At least at what the establishment considers to be full, therapeutic doses.
Posted by Brainbeard on February 28, 2010, at 1:44:57
In reply to Update - combo is working, posted by linkadge on February 26, 2010, at 15:39:19
> I am taking 10mg of amitriptyline with 5mg of escitalopram. I have been feeling pretty darn good with little need of the methylphenidate.
>
> Since adding the escitalopram I have noticed a little more apathy, but my social functioning has improved dramatically.
>
> I may lower the escitalopram to 2.5mg to see what happens.Friggin' great, Linkadge.
I'm also on 5mg of escitalopram and it does improve my mood. I raised my amitriptyline to 50mg, but I think I felt better while on a lower dose of amitriptyline - I don't have the patience to wait and see if the higher dose will work better over time. 10mg, that ain't a lot. On the other hand, even 6mg can make a difference for me by reducing the level of my chronic pain.
Perhaps I should also try 2.5mg of escitalopram. Bleauberry's observations are confirmed by anecdotal evidence elsewhere on the web or here on Psychobabble. I wonder what makes escitalopram effective in such low doses. It may be the extra allosteric binding. Oh my, hope Dr. Bob doesn't move this thread to Neurotransmitters for that last remark..
Posted by linkadge on February 28, 2010, at 7:09:03
In reply to Re: Update - combo is working: FRIGGIN' GREAT!!, posted by Brainbeard on February 28, 2010, at 1:44:57
If the r-citalopram really does counteract the clinical efficacy of the s-citalopram than you would actually need *less* than half the dose of citalopram to attain a clinical effect.
I could take more amitriptyline, but 10mg-25 seems to be the best dose for sleep for me.
Linkadge
Posted by conundrum on February 28, 2010, at 7:52:32
In reply to Update - combo is working, posted by linkadge on February 26, 2010, at 15:39:19
Yes this is great news! I never knew what your main symptoms were btw. Just Depression?
Posted by linkadge on February 28, 2010, at 11:19:17
In reply to Re: Update - combo is working » linkadge, posted by conundrum on February 28, 2010, at 7:52:32
My symptoms are strange. It mostly depression.
There is a lot of inomnia and anticipatory anxiety. As well, I iscolate from people and feel anhenonic - like I am dead.
I experience a lot of senosry overload too which sometimes turns into irritability. I have a lot of problems feeling normal.
My cognition goes to crap. I can't speak properly.
I can't remember people's names.It almost resebles a type of schizophrenia, but many of the secondary symptoms are mood congruent. When I feel better, things just seem to snap into place.
Linkadge
Posted by conundrum on February 28, 2010, at 11:50:07
In reply to Re: Update - combo is working, posted by linkadge on February 28, 2010, at 11:19:17
THats an interesting form of depression. So do you feel like things are "snapped into place" most of the time now?
Posted by linkadge on March 7, 2010, at 6:40:41
In reply to Re: Update - combo is working » linkadge, posted by conundrum on February 28, 2010, at 11:50:07
Yeah, since taking the lexapro, things have been pretty good.
I am almost wondering if all of this has been a protracted SSRI withdrawl? Perhaps my teen brain developed around them and now my adult brain needs them to function normally. Cause its not really the same "depression" I originally had.
Linkadge
Posted by conundrum on March 7, 2010, at 8:35:38
In reply to Re: Update - combo is working, posted by linkadge on March 7, 2010, at 6:40:41
Thats funny because I've had the exact same thought. I took prozac during my teen years and never felt normal after, but the symptoms were different. I don't feel sad or anxious just numb and unmotivated, colorless. Recently I found that some prozac, which is what I took when I was younger, still had a positive effect, but only at a tiny dose. Can't handle 20mgs anymore. Its like the brain has adapted to having the drugs but can't fully adapt back.
Posted by floatingbridge on March 15, 2010, at 19:22:36
In reply to Re: Update - combo is working, posted by linkadge on February 28, 2010, at 11:19:17
Link, interesting symptoms--I thought maybe some comorbid add condition...also reminded of a friend who was finally diagnosed with a particular condition symptoms are, among them, sensory overload, especially sonic, auditory input. There's a name for it. Causes her great distress--she's super-brain, however has cognitive issues....
Glad you're feeling better.
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