Posted by Matt on April 1, 1999, at 22:10:44
In reply to Re: question for Matt, posted by mila on April 1, 1999, at 19:43:34
Wow, you've been on more meds than I have. You've had adequate trials on all these meds, I take it? Why did you discontinue the Risperdal? (I personally won't take it long term because it has a much stronger effect on the basal ganglia than does the other newer antipsychotics, and this increases the possibility of TD. I too found it helpful, though.)
Has your doctor indicated that there is any element of psychosis associated with your depression?
Have you tried Seroquel? It's another atypical antipsychotic. It's excellent on anxiety, and it has even less of an effect on the basal ganglia than does Zyprexia.
I also note that you haven't tried any tricyclics. You might give something like nortriptyline a shot. Nor does it look like you've tried adding pindolol to any of the SSRIs. That might be something to think about. (See psych. tips for info on this.) I think that Remeron is a terrific drug for anxiety and depression. It has shown much promise even in treatment-resistant depression such as your depression.
So the benzodiazepines like lorazepam and xanax were totally unhelpful on your anxiety? I found Klonopin, another benzo. to be very helpful for my anxiety. Its advantage is that it's much longer lasting than the two above. I'm guessing that if you found lorazepam and xanax ineffective, it's because you didn't take enough of them. It took a while for me to figure out how much Klonopin I needed to alleviate my own anxiety. For long term treatment, xanax probably isn't the best solution, anyway, because of how short acting it is (it's harder to stop and there is breakthrough anxiety with it.)
Anyway, I guess the upshot of all this is that I'd discuss Klonopin, Remeron, Seroquel and perhaps a tricyclic with your doc. (though not necessarily all together). Don't be afraid to take the amount of K you need to deal with your anxiety; for me it was 2mg. Remeron causes less sedation and weight gain at higher doses than it does at 15mg. Seroquel at 25-50 mg is quite helpful with anxiety, and more can be used if there are elements of psychosis with your depression.
Anyway, those are just some thoughts--I'm no doctor or anything, for sure. Good luck with things, though.
Matt
poster:Matt
thread:3795
URL: http://www.dr-bob.org/babble/19990501/msgs/4303.html