Psycho-Babble Medication Thread 635786

Shown: posts 4 to 28 of 76. Go back in thread:

 

Re: Another drug failure linkadge

Posted by SLS on April 22, 2006, at 10:30:13

In reply to Re: Another drug failure linkadge, posted by linkadge on April 22, 2006, at 10:12:38

I have also wondered if any of my drugs are interfering with a positive response. That is one of the reasons why I discontinued Keppra.

> What all are you taking currently?

nortriptyline 100mg
Wellbutrin 300mg
Lamictal 150mg
Abilify 10mg

I really appreciate your concern and input. I couldn't ask for a more brilliant mind than yours to brainstorm my case.

:-)

Thanks.


- Scott

 

Re: Another drug failure

Posted by bassman on April 22, 2006, at 10:38:02

In reply to Re: Another drug failure linkadge, posted by SLS on April 22, 2006, at 10:30:13

Scott, I don't have a clue on the medication issue itself, but I just wanted to say how much courage it takes to go through the whole damn list of meds there are until you are "good enough". It is so very discouraging-no wonder compliance is such a problem with psychoactive meds. You take a person who feels awful and give him some meds that make him feel worse with the hope that eventually he'll feel better. Yipes.

Please take care and hang in there-and give yourself credit for enduring this ordeal. Hope to see a post that you're doing much better very soon!
bassman

 

Re: Another drug failure SLS

Posted by Racer on April 22, 2006, at 11:06:01

In reply to Re: Another drug failure linkadge, posted by SLS on April 22, 2006, at 10:30:13

>
> nortriptyline 100mg
> Wellbutrin 300mg
> Lamictal 150mg
> Abilify 10mg
>

Have you considered raising the Wellbutrin to 450? I went from what I guess qualifies me as "disthymic" on 300mg, up to "Really OK" at 450. It made more of a difference than I would have expected.

How long have you been on Lamictal now? I know you had a good response to it when you started, but could it be that's turned on you now? (Probably just me, because Lamictal did a little happy dance for me, then turned into a depressant very rapidly. I'm wondering if it might have turned for you, too, and increased your depression, rather than improving it.)

And do you think the nortriptyline could be part of the problem? Not on its own -- I remember it was a good drug, and saved my life -- but because it's targetting the same range of neurotransmitters as the WB? Maybe adding something that hits 5HT would help balance things?

Or, what was your reaction to Provigil, again? Could that be worth a try, not for the sleep/wake thing, but for the potential mood brightening? (I can't remember what your experience of it was.)

Whatever happens, Scott, you're a good man, and I hope things turn around very soon for you. Your hopeful nature is inspiring.

 

Re: Another drug failure SLS

Posted by Crazy Horse on April 22, 2006, at 11:06:22

In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50

> Another drug failure.
>
> The addition of Wellbutrin to my treatment produced a profound improvement in my depression during weeks 3 and 4. No more. I have relapsed. There is no vestige of an antidepressant response. I do not expect one to reappear regardless of how much time I remain on this drug.
>
> I don't know how much more I can take. I don't know what there is left to try. The logical part of me concluded quite some time ago that my brain will never respond to treatment. The emotional part of me masks the logical part and continues to have hope. I probably would not continue to live without it. I must therefore suppress and ignore my logic in order to survive.
>
>
> - Scott

Hi Scott,
Well, i certainly don't have the brilliant scientific brain of Linkadge, but i can say that i'm sorry that you have to continue to go through this living hell, and you have my support. I will continue to pray for you as well. Please don't give up...there will be better times Scott.

-Monte

 

Re: Another drug failure

Posted by Caedmon on April 22, 2006, at 12:01:27

In reply to Re: Another drug failure SLS, posted by Crazy Horse on April 22, 2006, at 11:06:22

Hi Scott. Can you increase the Wellbutrin? Also what would happen if you cut the Abilify in half? Have you ever augmented w/ a stimulant? I read somewhere you're bipolar, could the TCA be causing some mood instability and hence lack of consistent response? Just some ideas, you probably have thought of them or tried them already.

Best of luck! You're such a smart and caring person on this board, you deserve to feel better!

- C

 

Re: Another drug failure

Posted by Phillipa on April 22, 2006, at 12:07:02

In reply to Re: Another drug failure, posted by Caedmon on April 22, 2006, at 12:01:27

Scott I don't know what to say other than you are an inspiration to the others on this board to keep trying and doing research. There must be a combo for you. I am on your side and I care for you. You have helped me many times and I wish I could do the same with knowledge but the most I can do is offer my support and love. Love Phillipa ((((((Scott)))))))))

 

Re: Another drug failure

Posted by linkadge on April 22, 2006, at 12:26:14

In reply to Re: Another drug failure linkadge, posted by SLS on April 22, 2006, at 10:30:13

>nortriptyline 100mg
>Wellbutrin 300mg
>Lamictal 150mg
>Abilify 10mg

Nortryptaline, lamictal, abilfy seems to be a good base. Have you tried omega-3 augmentation? (I don't know how you are on the alternitives, but EPA is pretty potent.)

I'd add around 1 gram of EPA, and perhaps some folic acid. Zinc too, can augment antidepressnat responces. You could always try inositol. It acts as a second messenger to the noradrenergic system.
(Although, inositol and nortryptaline might have mania writtain all over it!)


How did you fair on SSRI's? The combination of sertraline and a nortryptaline would be like a triple uptake inhibitor. I remember taking doxapine and sertraline was fairly potent.

Linkadge


 

Re: Another drug failure SLS

Posted by blueberry on April 22, 2006, at 13:40:52

In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50

Hi Scott,
You have been so helpful in trying to help me figure out my own problems. I feel pitifully inadequate in trying to help figure out yours. It saddens me how you are feeling, and it saddens me I don't have any magic ideas.

Some off the wall thoughts though. Increasing wellbutrin to 450mg for 2 weeks and then even to 600mg for 2 weeks might be an idea. That's what they did back in the old days before seizures became a concern. You have lamictal to help protect from that.

Maybe something to stimulate the release of neurotransmitters, rather than just damming them up. You could do a quick easy experiment to see if norepinephrine stimulation is an area to explore. Chromium picolinate. Take 400mg to 800mg. It mainly helps insulin response, but it also stimulates norepinephrine release. When I tried it at just 200mg, I definitely felt a noradrenergic boost of mood and energy, though the resulting anxiety was a bit much. But it is an easy experiment just to test noradrenergic stimulation response, versus noradrenergic reuptake inhibition.

It could be that dopamine receptors just get desensitized to any increase you give them, and then you are right back where you started. On pubmed I saw a couple studies where siberian ginseng prevented dopamine receptors and opioid receptors from developing tolerance. Who knows. Just an idea.

Maybe with the high focus on norepinephrine, serotonin has been squashed out of the picture. Except for the sexual side effects, you sound like the kind of person who might respond well to 200mg to 350mg zoloft, where the serotonin reuptake has long ago maxed out at lower doses and the dopamine reuptake is now significantly catching up at higher doses.

But then again, you were on an maoi which boosted all of them. Something developed tolerance or immunity to the increased neuros. That's why I think maybe neuro stimulation, rather than neuro reuptake, might be an angle to consider. Maybe add in low dose prozac and zyprexa just to get some flow of all 3 neuros going. Ritalin maybe.

And sometimes I think it makes some kind of unlogical sense to go for something that does not make sense. For example, it doesn't sound like you need xanax and it is unlogical to see how that might help you. But that's the point. Everything that is logical hasn't been quite right. Maybe a little prozac and a little xanax could do wonders, for some unexplainable reason we'll never know.

And of course there is good ole low dose lithium. I've read several studies where when it was combined with noradrenergic agents, it stimulated the release of all 3 neuros, but not by itself, and only in the presence of a noradrenergic agent.

Risperidone. It seems like a lot of treatment resistant things respond to low dose risperdal addition. Probably because it stimulates the flow and release of more dopamine.

I'm just thinking. Wild ideas. I would sure like to wave a magic wand for me and you both.

 

Re: Another drug failure linkadge

Posted by madeline on April 22, 2006, at 13:55:35

In reply to Re: Another drug failure, posted by linkadge on April 22, 2006, at 12:26:14

I take about a gram and half of flax seed oil everyday myself.
I can really tell a difference if I forget it for a day or two.

I'm glad to see other people are doing that as well.

 

Re: Another drug failure Racer

Posted by SLS on April 22, 2006, at 14:09:50

In reply to Re: Another drug failure SLS, posted by Racer on April 22, 2006, at 11:06:01

> > nortriptyline 100mg
> > Wellbutrin 300mg
> > Lamictal 150mg
> > Abilify 10mg

> Have you considered raising the Wellbutrin to 450?

I guess that might be the next step.

> How long have you been on Lamictal now?

For at least 6 years.

> I know you had a good response to it when you started, but could it be that's turned on you now?

I don't think so. Actually, I tried lowering the dosage last week. I felt considerably worse, so raised it back up and added another 50mg.

> And do you think the nortriptyline could be part of the problem?

I doubt it, but it won't hurt to keep that thought as a possibility.

> Maybe adding something that hits 5HT would help balance things?

Many people respond well to Wellbutrin + SRI. I will certainly consider it.

> Or, what was your reaction to Provigil, again?

I didn't like that drug. It made my depression horribly worse, and I couldn't justify continuing the trial beyond two weeks.

> Whatever happens, Scott, you're a good man, and I hope things turn around very soon for you. Your hopeful nature is inspiring.

Thanks. I appreciate the warm sentiments.

(I'm still secretly hoping that this stuff will start working again by this time next week. Don't tell anyone).


- Scott

 

Re: Another drug failure linkadge

Posted by SLS on April 22, 2006, at 14:35:49

In reply to Re: Another drug failure, posted by linkadge on April 22, 2006, at 12:26:14

> Nortryptaline, lamictal, abilfy seems to be a good base.

I think so too.

> Have you tried omega-3 augmentation?

Yes, but not with the combination of things I'm on right now.

> I'd add around 1 gram of EPA, and perhaps some folic acid. Zinc too, can augment antidepressnat responces. You could always try inositol. It acts as a second messenger to the noradrenergic system.

I still have some fish oil, folic acid, and inositol in my box of rejects. The fish oil had some positive effect at first.

> (Although, inositol and nortryptaline might have mania writtain all over it!)

I wouldn't mind becoming manic because for me it is so easily treated with valproate or Zyprexa.

> How did you fair on SSRI's?

Zoloft produced a brief antidepressant response while I was taking imipramine and Lamictal. I think it would be justified to try it again with the Wellbutrin.

> The combination of sertraline and a nortryptaline would be like a triple uptake inhibitor.

I hope my doctor allows me to take all three antidepressants at the same time (nortriptyline, Wellbutrin, and Zoloft).

I tried Prozac, but only at 20mg. I also tried Paxil 30mg and Lexapro 20mg. I have not tried Luvox nor Celexa. I like Zoloft because it wasn't bad with side effects. I've also tried Effexor and Cymbalta. The pattern of response is always the same. I will start to improve during weeks 2-4 and relapse within a week.

You really think Zoloft + TCA is that potent? Hmmm. That might be a way to go. I would want to keep the Wellbutrin, though.

They say that if you throw enough sh*t against the wall, some of it is bound to stick.


- Scott

 

bupe is still out there, right? SLS

Posted by pseudoname on April 22, 2006, at 14:42:16

In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50

> I don't know how much more I can take. I don't know what there is left to try.

I'm so sorry about this latest outcome, Scott. Several times in the last 17 years, I *couldn't* take any more drug failures, and just gave up on them for years at a time.

But I'm now Johnny Appleseed for buprenorphine. It's not a 100% cure, but the benefit is stark to me. I'm pretty sure you haven't tried it yet, right?

 

Re: Another drug failure blueberry

Posted by SLS on April 22, 2006, at 14:42:22

In reply to Re: Another drug failure SLS, posted by blueberry on April 22, 2006, at 13:40:52

> Hi Scott

Hi Blueberry.

Your post contains a wealth of ideas, some of which I haven't tried yet. Thank you.

You said, "It could be that dopamine receptors just get desensitized to any increase you give them,"

You might have hit the bullseye with that one. The problem is, what do you do to prevent that from happening?


- Scott

-----------------------------

> You have been so helpful in trying to help me figure out my own problems. I feel pitifully inadequate in trying to help figure out yours. It saddens me how you are feeling, and it saddens me I don't have any magic ideas.
>
> Some off the wall thoughts though. Increasing wellbutrin to 450mg for 2 weeks and then even to 600mg for 2 weeks might be an idea. That's what they did back in the old days before seizures became a concern. You have lamictal to help protect from that.
>
> Maybe something to stimulate the release of neurotransmitters, rather than just damming them up. You could do a quick easy experiment to see if norepinephrine stimulation is an area to explore. Chromium picolinate. Take 400mg to 800mg. It mainly helps insulin response, but it also stimulates norepinephrine release. When I tried it at just 200mg, I definitely felt a noradrenergic boost of mood and energy, though the resulting anxiety was a bit much. But it is an easy experiment just to test noradrenergic stimulation response, versus noradrenergic reuptake inhibition.
>
> It could be that dopamine receptors just get desensitized to any increase you give them, and then you are right back where you started. On pubmed I saw a couple studies where siberian ginseng prevented dopamine receptors and opioid receptors from developing tolerance. Who knows. Just an idea.
>
> Maybe with the high focus on norepinephrine, serotonin has been squashed out of the picture. Except for the sexual side effects, you sound like the kind of person who might respond well to 200mg to 350mg zoloft, where the serotonin reuptake has long ago maxed out at lower doses and the dopamine reuptake is now significantly catching up at higher doses.
>
> But then again, you were on an maoi which boosted all of them. Something developed tolerance or immunity to the increased neuros. That's why I think maybe neuro stimulation, rather than neuro reuptake, might be an angle to consider. Maybe add in low dose prozac and zyprexa just to get some flow of all 3 neuros going. Ritalin maybe.
>
> And sometimes I think it makes some kind of unlogical sense to go for something that does not make sense. For example, it doesn't sound like you need xanax and it is unlogical to see how that might help you. But that's the point. Everything that is logical hasn't been quite right. Maybe a little prozac and a little xanax could do wonders, for some unexplainable reason we'll never know.
>
> And of course there is good ole low dose lithium. I've read several studies where when it was combined with noradrenergic agents, it stimulated the release of all 3 neuros, but not by itself, and only in the presence of a noradrenergic agent.
>
> Risperidone. It seems like a lot of treatment resistant things respond to low dose risperdal addition. Probably because it stimulates the flow and release of more dopamine.
>
> I'm just thinking. Wild ideas. I would sure like to wave a magic wand for me and you both.

 

Re: bupe is still out there, right? pseudoname

Posted by SLS on April 22, 2006, at 14:52:24

In reply to bupe is still out there, right? SLS, posted by pseudoname on April 22, 2006, at 14:42:16

Hi Pseudoname.

> But I'm now Johnny Appleseed for buprenorphine. It's not a 100% cure, but the benefit is stark to me. I'm pretty sure you haven't tried it yet, right?

Yes. You are correct. (Although I don't know how you would remember such a thing).

I've had buprenorphine on my list, but have been reluctant to bring it up with my doctor. I guess I should print out some stuff to give to him.

How do you administer buprenorphine? Route, dosage, schedule?

Thanks.


- Scott

 

Re: Another drug failure..PLEASE READ SLS

Posted by Jay on April 22, 2006, at 15:05:27

In reply to Re: Another drug failure linkadge, posted by SLS on April 22, 2006, at 10:30:13

> I have also wondered if any of my drugs are interfering with a positive response. That is one of the reasons why I discontinued Keppra.
>
> > What all are you taking currently?
>
> nortriptyline 100mg
> Wellbutrin 300mg
> Lamictal 150mg
> Abilify 10mg
>

Scott....I am sorry to say but, this combo is just 'candy' to me. Let me give you some examples. First, in order to feel better, you need some SERIOUS additions. I don't know what exactly your DX is...I think I do a bit from other posts. Some of this is anecdotal, some from the research. I think now after reading over most 'cocktails', I take the most complicated, bizzare one on here..and you know what? It works! It covers everything. If you don't have insurance, it may cost you a bit more...but it is worth it...believe me. It will take some experimentation. So here goes my reccomendations:

-Add another mood stabalizer..possibly a good one, like depakote. The ER version is supposed to be excellent...fewer side effects because not dumped all into the bloodstream at once.
-You've got stimulating antidepressants, so add some Prozac, at a GOOD dose. (i.e. 80mg's)
-Add another atypical antipsychotic. Risperdal seems safest as far as diabetes goes, and don't be afraid to bump around the dose.
-I'd suggest maybe dumping the Wellbutrin, in place of some new Dexedrine.
-Add a PRN benzo if anxiety is still a problem.

Just do some checking for any drug interactions....I have not had any problems...just need to be cautious with possibly the Depakote..and other m.s's...and if you are seizure prone might be some probs. Otherwise...my doc put me on two's of a.d.'s..a.p's...m.s's...all with fairly good success..way, way better than any little effect a single drug would have.

Good luck...you still have a long road to travel my friend.

Best,
Jay

 

Re: Another drug failure SLS

Posted by Crazy Horse on April 22, 2006, at 15:11:44

In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50

> Another drug failure.
>
> The addition of Wellbutrin to my treatment produced a profound improvement in my depression during weeks 3 and 4. No more. I have relapsed. There is no vestige of an antidepressant response. I do not expect one to reappear regardless of how much time I remain on this drug.
>
> I don't know how much more I can take. I don't know what there is left to try. The logical part of me concluded quite some time ago that my brain will never respond to treatment. The emotional part of me masks the logical part and continues to have hope. I probably would not continue to live without it. I must therefore suppress and ignore my logic in order to survive.
>
>
> - Scott

Scott,
I don't know your med history as well as most of the others, and i probably won't come up with anything that you haven't already tried, but i'd still like to try to "help" if possible.
Have you been on Remeron? High dose Remeron 115mgs. helped me. Also a combo of Remeron and Paxil, both high dose help me for quite awhile. Also, how about Lyrica? For me, this was much more potent than neurontin. Mirapex was also helpful for awhile.
Before i started Parnate, i read that this formula below can be very effective for TR depression- Pindolol, Nefazodone and Tryptophan. 7.5 mg a day of pindolol, 300 mg. of Nefazodone, and 1 gram of Tryptophan. Pindolol stays the same for 20 weeks, gradually increase the nefazodone to 450 mgs. a day, and Tryptophan to 8 mgs. a day. This combo is believed to increase serotonin release and availability in TR patients.

Hang in there Scott, I know there is a medication/cocktail that will help you...you deserve it Scott, you've suffered much too long.

-Monte

 

buprenorphine doses SLS

Posted by pseudoname on April 22, 2006, at 15:43:57

In reply to Re: bupe is still out there, right? pseudoname, posted by SLS on April 22, 2006, at 14:52:24

> How do you administer buprenorphine? Route, dosage, schedule?

In my 5th month on bupe, I take:

Subutex 0.5mg sublingual tablet (Actually, I put it between the cheek & the gum, like chaw. Too much saliva under the tongue.)

I take the 0.5mg once or twice a day, depending on how the day is going. First dose anywhere from 5 AM to 10 AM; second dose 6-8 hours later.

But I had to get up to 1.0 mg, 3 times a day (6AM, 11AM, 4PM), in the first weeks, before I got the antidepressant benefit. For whatever reason, I just need less now.

I just posted a list of reported bupe doses I compiled last year, but it needs updating. Other Babblers have recently reported very small effective doses. http://www.dr-bob.org/babble/20060417/msgs/635901.html

For anyone considering bupe, I think these may be good pages to show your doc. I hope he/she won't think a special DEA waiver is needed to Rx it for depression. (It isn't.)

When you first start, do NOT take more than 0.1 or 0.2mg a day. Larry Hoover gave me advice on taking such small doses: http://www.dr-bob.org/babble/subs/20051106/msgs/580668.html

The main reference is this:
J. Alexander Bodkin, MD, Gwen L. Zornberg, MD, Scott E. Lukas, PhD, and Jonathan O. Cole, MD. "Buprenorphine Treatment of Refractory Depression." Journal of Clinical Psychopharmacology, 1995, 15, pp. 49-57 http://balder.prohosting.com/~adhpage/bupe.html

I just posted my transcript of this study:
H.W. Emrich. "Antidepressant Effects of Buprenorphine." Lancet, 1982, Sep 25; 2(8300): 709 http://www.dr-bob.org/babble/20060417/msgs/635895.html

And there's this:
Enoch Callaway. "Buprenorphine for Depression: The Un-adoptable Orphan [Editorial]." Biological Psychiatry. 1996 Jun 15; 39(12):989-90. http://www.dr-bob.org/babble/20010625/msgs/67856.html

 

Re: Another drug failure SLS

Posted by ed_uk on April 22, 2006, at 16:45:20

In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50

Hi Scott

Zeugma told me that Wellbutrin may raise the nortriptyline blood level. Perhaps it's now above the therapeutic window? I wonder whether it would help to reduce the dose of nortriptyline.

Regards

Ed

 

Re: Another drug failure

Posted by linkadge on April 22, 2006, at 19:05:00

In reply to Re: Another drug failure SLS, posted by ed_uk on April 22, 2006, at 16:45:20

SLS, how is your sleep affected by these 2 week responses then relapses?

Linkadge

 

Re: Another drug failure

Posted by linkadge on April 22, 2006, at 19:08:48

In reply to Re: Another drug failure, posted by linkadge on April 22, 2006, at 19:05:00

Nortryptaline will supress REM greatly, but bupropion enhances it.

You might be a good candedate for voldoxan.

Linkadge

 

Re: Another drug failure SLS

Posted by blueberry on April 22, 2006, at 20:02:59

In reply to Re: Another drug failure blueberry, posted by SLS on April 22, 2006, at 14:42:22

Ya know Scott, I do not remember exactly where I saw it or exactly what it said. It was definitely at pubmed.com somewhere. Ginseng was able to prevent dopamine and opioid tolerance, and even reverse tolerance after it had already set in.

> > Hi Scott
>
> Hi Blueberry.
>
> Your post contains a wealth of ideas, some of which I haven't tried yet. Thank you.
>
> You said, "It could be that dopamine receptors just get desensitized to any increase you give them,"
>
> You might have hit the bullseye with that one. The problem is, what do you do to prevent that from happening?
>
>
> - Scott
>
> -----------------------------
>
> > You have been so helpful in trying to help me figure out my own problems. I feel pitifully inadequate in trying to help figure out yours. It saddens me how you are feeling, and it saddens me I don't have any magic ideas.
> >
> > Some off the wall thoughts though. Increasing wellbutrin to 450mg for 2 weeks and then even to 600mg for 2 weeks might be an idea. That's what they did back in the old days before seizures became a concern. You have lamictal to help protect from that.
> >
> > Maybe something to stimulate the release of neurotransmitters, rather than just damming them up. You could do a quick easy experiment to see if norepinephrine stimulation is an area to explore. Chromium picolinate. Take 400mg to 800mg. It mainly helps insulin response, but it also stimulates norepinephrine release. When I tried it at just 200mg, I definitely felt a noradrenergic boost of mood and energy, though the resulting anxiety was a bit much. But it is an easy experiment just to test noradrenergic stimulation response, versus noradrenergic reuptake inhibition.
> >
> > It could be that dopamine receptors just get desensitized to any increase you give them, and then you are right back where you started. On pubmed I saw a couple studies where siberian ginseng prevented dopamine receptors and opioid receptors from developing tolerance. Who knows. Just an idea.
> >
> > Maybe with the high focus on norepinephrine, serotonin has been squashed out of the picture. Except for the sexual side effects, you sound like the kind of person who might respond well to 200mg to 350mg zoloft, where the serotonin reuptake has long ago maxed out at lower doses and the dopamine reuptake is now significantly catching up at higher doses.
> >
> > But then again, you were on an maoi which boosted all of them. Something developed tolerance or immunity to the increased neuros. That's why I think maybe neuro stimulation, rather than neuro reuptake, might be an angle to consider. Maybe add in low dose prozac and zyprexa just to get some flow of all 3 neuros going. Ritalin maybe.
> >
> > And sometimes I think it makes some kind of unlogical sense to go for something that does not make sense. For example, it doesn't sound like you need xanax and it is unlogical to see how that might help you. But that's the point. Everything that is logical hasn't been quite right. Maybe a little prozac and a little xanax could do wonders, for some unexplainable reason we'll never know.
> >
> > And of course there is good ole low dose lithium. I've read several studies where when it was combined with noradrenergic agents, it stimulated the release of all 3 neuros, but not by itself, and only in the presence of a noradrenergic agent.
> >
> > Risperidone. It seems like a lot of treatment resistant things respond to low dose risperdal addition. Probably because it stimulates the flow and release of more dopamine.
> >
> > I'm just thinking. Wild ideas. I would sure like to wave a magic wand for me and you both.
>
>

 

Re: Another drug failure

Posted by zeugma on April 22, 2006, at 21:01:03

In reply to Re: Another drug failure SLS, posted by blueberry on April 22, 2006, at 20:02:59

yes, Ed is correct that I said that Wellbutrin wil raise NOR plasma levels. Wellbutrin is a potent 2D6 inhibitor.

Can you get plasma monitoring of nortrip done on your insurance? I know it's awfully expensive when uninsured.

-z

 

New Idea Scott

Posted by Phillipa on April 22, 2006, at 21:07:20

In reply to Re: bupe is still out there, right? pseudoname, posted by SLS on April 22, 2006, at 14:52:24

Scott I know I'm changing the subject a bit but I have been thinking not being the med expert. Yesterday I was talking to a man at Home Depot his nephew in his 40's has intractable depression he said he would get in a car and drive call home and have no iedea where he was. Well he received a rTMS implant and now his depression is basically cured he functions at 80-90%. Have you considered this love Jan

 

Re: New Idea Scott

Posted by gardenergirl on April 22, 2006, at 21:28:26

In reply to New Idea Scott, posted by Phillipa on April 22, 2006, at 21:07:20

Scott,
I'm sorry you're experiencing this. It's so frustrating.

You're getting some great advice here about meds, and I can't add to any of it. But something else...You may have already considered this, but has there been anything situational going on that could trigger a depression? I ask because I've had depression come back for me, and I've immediately looked to my drug regimen for tweaking. When I met with my pdoc, she pointed out that I had stopped doing some of the behavioral things that had been helping (yoga, light therapy, eating better, etc.) and that I had experienced a number of losses recently. No wonder I was depressed again, she said. So we didn't adjust any meds at that time. I made an effort to go back to doing the things that had helped before, and I tried to deal with the loss issues in therapy. And it eventually passed.

Of course it may truly be poop-out, and that always stinks. But if there's any chance there are psychosocial variables, I just wanted to raise my hand and say, "um..but?"

I share your secret wish.

gg

 

Re: Another drug failure linkadge

Posted by SLS on April 23, 2006, at 7:35:35

In reply to Re: Another drug failure, posted by linkadge on April 22, 2006, at 19:08:48

> Nortryptaline will supress REM greatly, but bupropion enhances it.
>
> You might be a good candedate for voldoxan.

Antidepressants no longer suppress dreaming for me. Parnate once completely abolished it, now it doesn't affect me at all. All of my exposures to medication have definitely changed the way my CNS works.

I found it difficult to detect any differences in the way I slept during the time I was responding to medication this time around.

I would probably try agomelatine simply because it is different from anything I've yet tried.

I am getting depressed about being so ill. I was tempted to stay in bed all day because I would like to just give up.


- Scott


Go forward in thread:


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.