Posted by colin wallace on May 10, 2003, at 10:31:48
In reply to SSRI for Anger and ARD (Anal Retentive Disorder)? » colin wallace, posted by Ron Hill on May 9, 2003, at 12:31:14
> Ron,
Firstly, I have to confirm that the Prozac(original)has really impressed me, despite my initial reservations.There is no doubt whatsoever that it has greatly improved my overall stability and outlook(which shocked the hell out of me!).However, I also intend to string up another safety net, by adding a small(200mg perhaps)dose of Valproate, meaning I can get away with less Lamictal.
As my concentration is pretty apalling(it can take me almost 5 minutes to read a page thesedays)I also intend to bring in reinforcements in noradrenergic form - desipramine or imipramine etc(low dose of course).This could well help counter any SSRI anerga, although wellbutrin would also be worth a shot here(different mechanisms at play of course).
The natural supplement route is pretty much out for me, unfortunately.Unravelling lifelong, severe depression with such remedies is a bit like throwing a marble at an Abrams tank, in my case at least.I have to sigh, and accept this.
For life.Far preferable to the ruinous state of health depression has inflicted for so long.
I agree with you about the benefits of rigorous exercise-I've noticed a marked improvement in stamina since taking Lamictal/Prozac too.When I was very ill, training was agony.
Looking at your dilemma from afar,it does seem as though an AD will be unavoidable,in some form,at some point.It also seems clear that you'll need an additional safety net too-you mentioned a *low* dose of valproate, and perhaps that's not such a bad idea as a starting point?? (like you, I'm keeping Trileptal and the Ap's in mind as second line).
If Prozac has helped your temper spells in the past, then I wouldn't dismiss it out of hand.May even be worth a tentative shot.I've also been considering NADH further on down the line to zap any dopamine depletion- I take 20mg prozac on alternate days(more than enough)and may yet add NADH on the days inbetween-I really did like the feel of the stuff, but only as an add-on(small arms fire!!).I personally wouldn't get by on NADH alone, but as a counterweight to an SSRI...could well work.
I'm sure you'll like Neurontin(very relaxing, even uplifting), but it's only got *mild* antidepressant properties, and it can't
masquerade as a mood stabilizer either.It won't stop mania/hypomania, guaranteed.But that's fine if you're going to do without an AD.
I did try 5htp too, but we didn't get along at all.:(
Another contender in my list has to be Selegiline-as you know, it prevents the breakdown/re-absorption of dopamine, and that's a route I've yet to explore.It's also believed to have neuroprotective effects, etc. etc.
I won't hesitate to try an MAOI if necessary, but for now at least, it's back to basics with my newly discovered stability.
Take what I say with a pinch of salt here Ron- I'd hate to see you become hypomanic(echoes of Zoloft+ Sam e for us both !!!)Keep us informed..
Col.
ps. A benzo??why on earth not, at least untill the anger issue is nailed.A mere 2 to 4mg(child's dose)works well for me.I can take it or leave it as necessary too.
antidepressive effects of Prozac, it's your opinion that it also smoothes out your dysphoric mood states (anger outbursts), right? This was my experience with the SSRIs, in general, and most notably with Prozac. For me, the SSRIs provide an antidepressant effect AND they treat my anger outbursts as well as my anal retentive nit-picky personality quarks. However, as I have discussed with you repeatedly in the past, after several weeks the SSRIs adversely affect my dopaminergic pathways causing me to lose my motivation and become apathetic and emotional blunted.>
> While the Enada NADH and TMG are doing a good job treating my atypical depression, I find myself in need of some anger management (in tablet form) and some anti-anal medication. In my previous life (before psychotropic medications), I managed my anger, anal, and depressive symptoms fairly well with a rigorous three-hour-a-day workout routine. Exercise didn't totally take away all the symptoms, but overall it did pretty good job. And I think that would work again, but it's hard to get there from the poor state of conditioning I currently find myself.
>
> So I'm thinking about experimenting with some meds for treatment of the anger/anal issues. After I get my exercise routine back in place I might be able to discontinue or reduce any such medication. For the past month or so, I've been using a few milligrams of 5-HTP under my tongue PRN when I get angry. It works, but only for an hour or so. If I started to take higher dosages of 5-HTP on a more frequent basis, I suspect it would loose its effectiveness altogether.
>
> Here’re the options I’m currently considering as add-on to my 600 mg/day of Lithobid and my OTC supplements:
>
> Neurontin
>
> Trileptal
>
> Depakote (low dosage only because it caused hair loss, rash, weight gain, and increased depression when I took it years ago at 750 mg/day).
>
> MAOI
>
> Benzo
>
> AP
>
> Prozac (Dare I say it?! Maybe about three mg per day? Maybe the Enada NADH will counteract the adverse dopaminergic effects?)
>
>
> I’d really rather not put any of these man-made drugs in my body (let alone the cost of this stuff to my self-insured pocketbook) but, at the same time neither my wife nor myself are satisfied with a rage-o-holic, anal retentive, SOB living with us.
>
> Any thoughts?
>
> > If you do venture over this side of the puddle, give me a yell and we can go visit Ron's new gogo bar in Kings Cross, London....
>
> Yes, please do bring John-John (johnj) to the club. Remember to bring your money, however. The cover charge applies to everyone, even my good friends. Also bear in mind that touching the dancers is strictly prohibited.
>
> -- Ron
>
poster:colin wallace
thread:223158
URL: http://www.dr-bob.org/babble/20030505/msgs/225557.html