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Re: Abilify + TCA? tensor

Posted by SLS on April 10, 2012, at 7:08:24

In reply to Re: Abilify + TCA? SLS, posted by tensor on April 10, 2012, at 6:31:09

> > Abilify + Lamictal is particularly effective in BD according to some recent studies performed by the NIH. It works well to prevent future episodes. I have seen it work to treat ongoing depression as well. It might be worth a shot.
> >
> > What has been your experience with Wellbutrin? Anything positive at all?
> >
> >
> > - Scott

> Do you have any links?


I read it in a NIH bulletin that is not yet available online.

Terrence Ketter performed a similar study but reported no significant clinical effect. Sometimes it is difficult to decide whose study is worth basing decisions upon. Remember, though, that this was a study of prophylaxis against mania in bipolar I disorder, and not for the acute treatment of ongoing depression.

http://www.ncbi.nlm.nih.gov/pubmed/22329471

> When I tried Wellbutrin a few years ago it worked very well for about six weeks then it made me tired.

That's what I was hoping to hear, although I would have hoped that you would get more than six weeks out of it. In any even, your reaction to Wellbutrin might be a prognosticator of response to the combination of Lamictal and Abilify. I have seen this occur.

> When I tried Lamictal a few years back 200mg was the target dose and we stopped there because of lack of efficacy.

I have never seen Lamictal work as monotherapy for depression, despite early blip improvements occurring during titration.

> It made me a little tired and some headache. I talked to a person who did not respond to 200mg but had a good response at 300mg.

It happens. If you don't experience significant cognitive impairments at higher dosages, it might be worth pursuing.

> Maybe all I needed was higher dose? Only one way to find out, I guess.

Things happen between Lamictal and Abilify that are synergistic and may involve the potentiation of dopamine activity. My doctor has had success combining Lamictal with Wellbutrin. It sounds as if you have not exhausted your options. This is a good thing.

To what extent is mania a component of your disorder?

You'll get there. It might involve a little bit of luck to come upon the right treatment sooner rather than later, but you will find it. A partial or brief success is not a failure to respond. It is a reasonable strategy to identify such treatments and combine them, especially if the agents have different mechanisms of action. That is how I chose the drugs to remain on as I experimented with the addition of new. Combining Lamictal + nortriptyline was the first base treatment I used to maintain an improvement, albeit a very small one. It was enought to allow me to live independently and discourage me from entertaining thoughts of suicide.

Currently:

Parnate 80 mg
nortriptyline 150 mg
Lamictal 200 mg
Abilify 10 mg
lithium 300 mg
prazosin 6 mg

Good luck.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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