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Re: Remeron + Wellbutrin - Remeron + Neurontin = ?

Posted by JohnL on October 21, 2000, at 5:44:27

In reply to Remeron + Wellbutrin - Remeron + Neurontin = ?, posted by allisonm on October 20, 2000, at 19:33:09

Wow, I sure am sorry. I would like to help, but I don't have any specifics. I can though offer some generalities to ponder, which might help steer you in the right direction for the fastest possible results.

What is refractory depression? As I see it, there really isn't such a thing. There are depressions however that are not treated with the correct drug(s). Those will obviously seem to be refractory.

Let's say for example the root cause of someone's depression is low GABA. Of course, we don't know that ahead of time. The person tries 3 different SSRIs six months each. Not good enough. Then a TCA for 3 months. Still no good. Then Lamictal, Neurontin, Lithium, Depakote 3 months each. Not good enough. An MAOI. Still, not good enough. Ritalin, Adderall, still not right. On most of these there may have been some improvement, but without a doubt they all fell short. Is this refractory depression? No. A simple 1mg dose of either Xanax, Valium, or Clonazepam could have been a total cure within one week, fixing the low GABA. Meanwhile, almost 4 years has gone by!! Yikes.

Cases like yours are where the Jensen method shines. Most people don't need the Jensen method. But when the going gets rough and a lot of time is passing by, we need a strategy to identify what the heck is wrong so we can narrow down our choices and fix it head-on. Since the whole psychiatric process is a guessing game anyway, we might as well use that to our favor, rather than have it work against us.

In the example above, each of those drugs could have been tried for only 1 to 2 weeks each, with a one day washout in between. In such a short time we cannot expect miracles or full responses. Though they do happen. What we are looking for is a superior match, which makes itself known by a relatively quick response, not a full response, but enough to say "Wow, I can't believe it, I'm actually feeling a little better in just three days!" That is the clue that we are on the right track to targeting whatever the underlying chemical problem really is.

In the above example, the patient could have discovered the perfect drug in less than a year. At the rate you're going now, it could take a lifetime, if it ever happens at all. In the end, perhaps a blend of 2 or 3 of the favorites could be combined. Regardless, ALL possible chemistries would have been explored and no stones left unturned. If a doctor says one or two weeks isn't long enough, you say "yes and no". It's not long enough for complete response. Sometimes it is actually. But it is enough time to weed out the inferior drugs that either don't do anything or make us worse. If a drug isn't showing considerable promise in 2 weeks, it is totally senseless to stay on it 3 months or 6 months.

The purpose of this whole approach is to identify what system in the brain is malfunctioning. Then we can correct it. If this sounds at all interesting, I would suggest going to and ordering the book "The Successful Treatment of Brain Chemical Imbalance." It's only about $30, probably the best $30 you'll ever spend in your lifetime.
Hope this helps. :-) John




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