Psycho-Babble Medication | about biological treatments | Framed
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What to do if you don't respond to SSRI/NDRI/SARI?

Posted by greywolf on April 28, 2004, at 9:40:22

In an earlier post I inquired about whether a therapeutic benefit could ever reasonably be expected from Wellbutrin when one hasn't been experienced at 300mg/day. I'm now at 400mg/day, so we'll soon find out.

I'm very concerned at this point that I will find nothing effective to help me with BPII and OCD. The depressive component is severe, and becoming moreso with each episode. About 5 years ago, I was involved in regular therapy and a meds regimen designed to address a BP problem that was getting out of control and led to self-injury (fortunately nothing major). It basically centered on lithium and a revolving door of SARI and SSRIs, as well as the old Wellbutrin. Nothing worked even remotely well enough to justify the SEs, and the only recourse suggested by my doctors at that point was shock treatment, so I just gave up on all of it (including therapy), and made some major life changes that I thought would be positive, but in the long run resulted in replacing one bad situation with a string of others.

After a couple years of handling things on my own (generally badly), I decided to try the pharmaceutical approach again last year. Since then, Lexapro, Effexor, Trazodone, and Wellbutrin have been ineffective. The Wb is the best of the lot because it has only very minimal SEs, but it too has not accomplished anything therapeutic.

My doctor is very reluctant to try any MAOIs because of realistic concerns that the dietary restrictions just won't work with my lifestyle, and he's pushing this Wb trial like it's my best hope.

So, I am hoping that you kind advisors in Babble land might give me some advice on what to do when all of these meds prove ineffective. Right now we are really focused on getting the depression under control because the hypomania is manageable as long as I stay away from alcohol and opportunities to take risks during those periods. Also, I am extremely reluctant to go back on the lithium for reasons that are probably not quite logical, but relate to the fact that so many bad things happened while I was on it. The anxiety flowing from being unable on a long-term basis to mitigate this depression appears to have manifested itself in more obvious physical symptoms of OCD that I was better able to control in the past, so relief for one may be relief for the other as well. And yes, I've tried CBT with little success.

Somebody throw me a line :)




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