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Re: Melancholic depression - what med is the best choi

Posted by hansi555 on September 11, 2008, at 10:41:07

In reply to Re: Melancholic depression - what med is the best choi, posted by Racer on September 10, 2008, at 10:27:17

> Hm... You don't say why you want to change, so I'm not sure how helpful this might be...

I want to change because my good periods only lasts a few days or maybe a week before I become depressive (not deep deep but still very annoying) and in these periods have the melancholic features.

See I dont know how well I can expect meds to work since no one can really tell me. I am working 4-6 hours per day as a sales engineer, not doing many customers visits and also as few activities outside work since it was not work it self that brought me down but a HUGE load of things to do at the same time + 2 small kids - stress exhausted and then came depression together w insomnia.

> First, flip as it sounds, "the best med is the one that works for you," since we mostly react differently to meds. I also have classic melancholic features, and have found Wellbutrin a good choice, though it's never brought me to anything that could be called remission.
> A TCA might be a good choice, depending on how well you tolerate it. The biggest appeal to the newer drugs is that they have fewer side effects than the TCAs and MAOIs. They're often more reliable than the newer drugs, though, so that's a good direction to look in.

Which one is the first choice for someone like me?

> What about Effexor, Cymbalta, or Pristiq? Those are very helpful for many people, and target multiple avenues for action.

Heard a lot scary things about Effexor...?

> Lithium is also a good choice for many, as is Lamictal. Lamictal has the benefit of fewer side effects, lithium is better known, since it's been used for a long time. It's a trade off -- which is a better choice to try first? Dunno -- they're both well worth discussing with your doctor.

What is Lacmital?

> I'm not sure what else to recommend, but thought I'd offer those thoughts. I hope they're helpful to you.
> Good luck.





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