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Re: Nortriptyline trial a failure?

Posted by glennb on December 6, 2008, at 22:25:18

In reply to Re: Nortriptyline trial a failure? glennb, posted by bleauberry on December 5, 2008, at 15:20:13

Thanks for the updated thoughts. I will definitely do some research on zyprexa. I neglected to mention I've tried the stimulants. Adderall has been useful to me when I'm up and about and trying to focus on work and being productive but none of the stimulants are useful to get me out of bed if I'm feeling severely depressed; basically I just lay in bed uncomfortably stimulated. I just trialed provigil as an augmentor for nortriptyline. I slipped into this relapse a few days in..went up to 400mg on the provigil, still wasn't enough to get me out of it. I wonder if other people feel this sort of binary function/can't function thing. The only thing I've found useful to break the grip is oxycodone. I was prescribed it, but am no longer using that doc and am about to run out. For this relapse, it hasn't really gotten me going, but it has allowed me to get online and do some research and post here, and it has very dramatically eased the 'psychic' pain which is getting uncomfortably high with each relapse. I guess for me (and I wonder how it is for other people), it's not motivation or stimulation that I'm lacking when I can't get out of bed, it's more like there is a force keeping me in bed. I often have the sensation of fear, without actually fearing anything so it seems like some sort of emotional paralysis (for lack of a better term).


> Interesting updates. Ok. That kind of changes the picture a little bit.
>
> Don't rule out zyprexa. It is different than the others, especially good with prozac. Also, while I touched on Provigil, overnight I was thinking about that and realized I had totally forgotten the stimulant route. Ya know, Ritalin and Adderall and Dexedrine and Provigil are all strong contenders for treatment resistant depression/anhedonia/energy/lack of motivation when combined with an SSRI. They can be troublesome by themselves, but somehow the SSRI can be a synergistic ingredient. People have responded remarkably well to those combos in as little as one to a few days, even after failing to improve on ECT. If agitation is ever an issue, a tiny dash of klonopin or lorazepam should fix that.
>
> Anyway, as I see it, the potentials on your radar screen include all the stimulants, Prozac, Zyprexa, possible benzo. After that, MAOIs. But hopefully you'll be well long before then.
>
> AND, this is very important, do not get suckered by the insurance game...insist on and pay the higher price for BRAND names. No generics! If this were a gambling hand in Las Vegas, you need every potential winning wild card in your hand, and going brand is one way to do that. Brand equals higher success odds, generic equals lower success odds. Simple as that.
>
>
>
> > I should have included that I have tried some antipsychotics. abilify gave me akathisia, risperedone I was on for awhile with both prozac (in this episode) and effexor and it didn't seem to do much, seroquel I was on at the same time as lamictal. The suggestions to try zyprexa are interesting to me. I gave Celexa a decent trial year back so lexapro doesn't excite me to much. I had thought of raising the nortriptyline and will bring that up when I find a new pdoc, my blood levels are at 140 on 75mg so I'm not going to mess with it on my own. An MAOI may be the next step though I'm discouraged by the star*d numbers.
> >
> > Thanks for all the suggestions.
>
>


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Psycho-Babble Medication | Framed

poster:glennb thread:866692
URL: http://www.dr-bob.org/babble/20081204/msgs/867159.html