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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by hansi555 on March 24, 2011, at 9:41:07
I am wondering how to continue my drug cocktail and hoping for some inputs from you all.
I am currently on 50 mg of Valdoxan, 100 mg Noritren and 3,75 mg Mirtazapin.
I am trying to stabilize after my second episode of unipolar depression (stress released) which started in december 2010 (first one started in Nov 2007).
Before that I had tapered off from all drugs during a 6 months period (June to Nov 2010) but I somehow did too many things (as I was actually doing quiet good during most of the taper, it may have been too quickly at the end) and eventually crashed and had to leave my work place for 2,5 months.As I had just finished the drugs I hoped to get through this crisis without drugs and focuse on exercise, therpy etc. But after 4 weeks it was simply too much, couldnt sleep, couldnt get out of bed,no interest etc. and together with my therapist I agreed to go down the drug way yet again. Arrrgh.
I only raised the dosages slowly and after 5 weeks more (9 weeks after the start) I was on 75 mg Nort, 50 mg Valdoxan and 3,75 mg Mirt. During this period it was ups and downs constantly and I went from 25 to 50 mg of Valdoxan.
A few days after this a 3,5 week of doing well to good started but then ended. At the end of this period I started to work again, but only half time.
Then came a bad period for a week or so and we therefore raised to 100 mg Nort - also because my bloodlevels were to the low side compared with the so-called therapeutic window.
A couple of days after I was back on doing ok to very good for 8-9 days. And then it all turned around again this weekend and I had some really bad days this week.This pattern of days or weeks doing well/very good and then have some very bad days (crying, no energy, cant sleep etc.) have been the same during my previous 3 years on drugs and it was the reason I decided to taper off last year. The quality of life with drugs was simply too poor. It is a big shame that I overdid it but I have learned from this for the future.
My pdoc have earlier mentioned to add Lamictal and I am seriously concidering this. I cant decide if Valdoxan is doing something on the AD side - would it be "normal" with these huge variations if it did work? Nort is helping with sleep and appetite but is getting troublesome in larger doses due to dry mouth. After the first dep episode I was on Lexapro also but I dont like the numbing feeling it gives me in larger doses so I would like to avoid SSRIs.
Talked on the phone w my pdoc today and he wants me to raise the Nort to 125 mg and reduce the valdoxan to 25 and maybe stop soon. He dose not regard Valdoxan as being a "strong" drug but also says that it is helpful for some of his patients.
I know it is a big change to start working again but I dont think this is causing the ups and downs. I really like my job and only stopped working because the stress was too much.
It feels almost chemical to me, one day everything is fine, then during the cause of 1-2-3 days it all turns around and I am depressed again.
There are 3 options I guess:
a. continue as it is and accept the swings, be patient about it, its too early to conclude anything etc.
b. go up in Nort, maybe reduce Valdoxan
c. add Lamictal, reduce/remove ValdoxanWhat do you think?
Posted by Phillipa on March 24, 2011, at 11:19:04
In reply to Decisions..., posted by hansi555 on March 24, 2011, at 9:41:07
I feel it's a tough decision to make. What does your gut tell you? Phillipa
Posted by hansi555 on March 24, 2011, at 11:57:03
In reply to Re: Decisions... » hansi555, posted by Phillipa on March 24, 2011, at 11:19:04
> I feel it's a tough decision to make. What does your gut tell you? Phillipa
Well, if I am going to chase the medicine solution, at least for a while, I think I would like to try a different route a la Lamictal or Deplin (but it is not availble here in Europe) instead of just adding more and more ADs.
I am also wondering if I am just under-medicined, especially in regards of Noritren, but the SE are hard to tolerate at 125 or 150 mg.
But maybe I am just being too demanding in my expectations in regards of how well I can get on ADs. I just feel that all these down periods are too much and it is disturbing my life in a serious way.
Posted by Phillipa on March 24, 2011, at 21:34:11
In reply to Re: Decisions..., posted by hansi555 on March 24, 2011, at 11:57:03
That's a problem unless you have a site to order from as food so they say? Phillipa
This is the end of the thread.
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