Posted by SLS on June 30, 2014, at 10:44:36
In reply to Re: Update: treatment 37 days; regimen now thoughts?, posted by Louisiana Sportsman on June 30, 2014, at 9:46:23
> Hey, bud! Long time; no see. How's it going with your regimen? I can analyze it if you'd like.
I have had a hellish few months. I had to discontinue minocycline due to the emergence of hyperpigmentation. I elected to discontinue Abilify due to amotivation and metabolic concerns. I switched from nortriptyline to desipramine due to a lack of drive that feels like laziness along with a subdued personality. Weight gain was also an issue. My doctor wanted me to titrate desipramine gradually, as he is perhaps overly cautious about combining it with Parnate, even though we had tried that once before. It has been painful and frustrating. I am currently taking 200 mg/day. I think that I am starting to feel better.
> I plan on turning this current regimen of this:
>
>
> Lurasidone (Latuda) 40mg.
> Armodafinil (Nuvigil) 250mg.
> Topiramate (Topamax) 100mg.
> Bupropion (Wellbutrin) SR 450mg.
> Mirtazapine (Remeron) 15mg.
> Sertraline (Zoloft) 50mg.
> Gabapentin (Neurontin) 2,400mg.
>
> Into this:
>
> Increase dosages where necessitated:
> Lurasidone (Latuda) 60mg.Good.
> Armodafinil (Nuvigil) 250mg.
Good for ADHD, but not for bipolar depression according to recent studies.
> Topiramate XR (Trokendi XR) 150mg. from 100mg.
I found topiramate equally helpful at 100 mg/day as I did at 200 mg/day. The inhibition of carbonic anhydrase and the risk of metabolic acidosis and kidney stones is dosage dependent.
> Bupropion (Wellbutrin) SR 450mg.
> Mirtazapine (Remeron) 30mg. from 15mg.For depression, it is my impression that the most effective dosages of mirtazapine lie between 45 - 90 mg/day.
> Gabapentin (Neurontin) 3,200mg. from 2,400mg.
> DC SertralineIf you end up needing a SRI to combine with Wellbutrin, I would recommend trying Pristiq (desvenlafaxine) first.
> Augment one of the following for ADHD/anxiety/residual depression;
> Memantine (Namenda XR) 7-28mg.
> KeppraProbably underutilized, especially for rapid cyclicity.
> Riluzole
For me, it was an expensive placebo. I believe that someone here on PB is having great success with it.
> Gabitril
This is sometimes used for anxiety and insomnia, but its effects can be quite variable between individuals. Some people become nervous and agitated. Paradoxically, it can also cause seizures.
> Mirapex
Some people report that Mirapex helps with depression. However, I see more reports of disappointment. I wouldn't dissuade you from trying it, though. Just be aware that some people experience sleep-attacks.
> Amantadine
Interesting choice for ADHD.
-----------------------------------------
My current treatment regime for bipolar depression:
Parnate 100 mg/day
desipramine 200 mg/day
Lamictal 200 mg/day
lithium 450 mg/day
prazosin 30 mg/day
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1067551
URL: http://www.dr-bob.org/babble/20140609/msgs/1067648.html