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Re: Mood stabiliser + antipsychotic for depression SLS

Posted by undopaminergic on January 5, 2023, at 9:02:37

In reply to Re: Mood stabiliser + antipsychotic for depression NKP, posted by SLS on January 4, 2023, at 20:30:57

> > Currently I'm on venlafaxine 225 mg/day and lamotrigine 200 mg/day. This combination works well except for the following side-effects: (i) excessive sweating; (ii) no sexual desire; (iii) apathy and lack of motivation. I think that venlafaxine is the culprit.
> >
> > I'm seeing my psychiatrist on Wednesday. I want to propose a few alternative combinations to him. Any ideas will be appreciated.
> >
> > (i) sertraline 50 mg/day + flupentixol 0.5 mg/day
> >
> > (ii) sertraline 50 mg/day + lamotrigine 200 mg/day
> >
> > (iii) flupentixol 0.5 mg/day + lamotrigine 200 mg/day
> >
> > (iv) duloxetine 20 mg/day + flupentixol 0.5 mg/day
> >
> > (v) duloxetine 20 mg/day + lamotrigine 200 mg/day
>
>
> The side effects you are concerned about certainly sound like those of a serotonin reuptake inhibitor. I know nothing about flupentixol. Is it capable of producing the side effects you are experiencing?
>

Flupenthixol is an older (atypical) antipsychotic with antidepressant effects starting at very low doses, but I don't know if it is more effective as an antidepressant at higher doses (typically used for psychosis). In my experience, it is capable of inducing anorgasmia -- this happened for me at a dose of several milligrams. But to reduce sexual desire? Possibly, but not as far as I know. Reduce motivation? As a dopamine antagonist, you might expect the possibility at high doses. Induce sweating? Probably not.

-undopaminergic


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