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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Christ_empowered on October 5, 2013, at 19:36:50
I ask because I hate my lingering depression. I don't think I fit neatly into any diagnostic category. I mean, I'm tired all the time, I had some psychotic features, I've had full-fledged psychotic depression before, now...I'm...just...tired. All the time, tired.
I take 1200/Trileptal (600 AM+PM) 20 Abilify (AM) and up to 300/Neurontin (100x3).
My shrink wanted to try amoxapine. Its old school, tca. Part of it breaks down into loxapine, which is quite possibly the strangest "typical" antipsychotic I've ever heard of. Low-dose loxapine may be somewhat atypical, but you still have prolactin elevation (scares me) and EPS and TD (scarier still) and you have to contend with the TCA sides on top of the typical AP sides (scariest of all). Plus, I'm already on Abilify at a slightly higher than target dose (I think the "target" for most people is still 15mgs/day). So...I declined.
Now I'm thinking...what to do? Provigil is expen$ive. This is public health, so any "real" stimulants are out of the question, as are MAOIs of any sort (I think...).
I do Orthomolecular. It helps. If nothing else, my stress levels are down, anxiety and agitation are down, and the sides from the neuroleptic are greatly diminished (there's some indication that high dose antioxidants can treat, suppress, and reverse TD. Given the lack of pharmaceutical options, I figured it was worth pursuing).
What to dooooo? I'm concerned about upping my TD risk. I'm concerned about further emotional numbing. I'm concerned about...everything, really.
California Rocket Fuel (that's Remeron and Effexor XR) is supposed to be as effective as Parnate without the side effects. Yesss! But...that's **2 additional drugs**, at the same time, on top of 3 I'm already on. Plus, tapering off seems like it'd be a nightmare and a half.
My sleep is usually high quality, if excessive. Anxiety is an issue, but I increased the niacinamide and taurine (9 and 6 grams, respectively), and that helped tremendously.
Ugh. What to do? Plus, I get the sense that adding ADs on top of what I've got now will just throw me into a chemical la-la-land, neither happy nor sad, just...medicated. Am I wrong? I could be wrong. There's also treatment-induced mania/psychosis/hypomania/agitation to worry about. Ugh.
The last AD I was on was Celexa, 20mgs. Worked well while deep in the throes of psychotic depression, but then proved to be too numbing, so I quit. Oh wait...there was a brief trial of Luvox, but that made me kinda agitated, possibly quasi-psychotic (could have been the underlying "issues"). Ugh.
I just want a little pep in my step and little anxiety relief. Why don't they make Dexamyl anymore? Ugh.
Any advice?
Posted by Phillipa on October 5, 2013, at 22:43:10
In reply to 2 ADs better than 1?, posted by Christ_empowered on October 5, 2013, at 19:36:50
CE I couldn't possibly advise you. I guess trust your doctor? How do your parents feel you are doing? Phillipa
Posted by sigismund on October 6, 2013, at 1:56:32
In reply to 2 ADs better than 1?, posted by Christ_empowered on October 5, 2013, at 19:36:50
>Why don't they make Dexamyl anymore?
Oh yes. I had some once, a long time ago in a civilised far away country. Absolutely sucks.
Posted by linkadge on October 6, 2013, at 7:35:50
In reply to 2 ADs better than 1?, posted by Christ_empowered on October 5, 2013, at 19:36:50
I am currently on remeron + effexor. I would say it is a pretty good combination. For me, the key is keeping the remeron dose low.
You may or may not get a theraputic benefit to the combination. The augmentation from remeron might simply be to 5-ht2 antagonism. I know that abilify has some research as an augmentation of antidepressants.
You might start with just effexor. I think that effexor + anticonvulsant can be pretty effective.
Linkadge
Posted by Christ_empowered on October 6, 2013, at 10:53:13
In reply to Re: 2 ADs better than 1?, posted by linkadge on October 6, 2013, at 7:35:50
I read a small study abstract on PubMed about Remeron+Abilify. The combo worked faster than just the Remeron, but the overall effect wasn't greater at the end of the study. Ugh.
I'm thinking up the Neurontin (if possible...), go back to 30/Abilify, and add in Remeron, Effexor XR, or Tofranil-PM, wait 4-6 weeks, and see what's up.
What do y'all think?
Posted by Jeroen on October 6, 2013, at 14:24:21
In reply to 2 ADs better than 1?, posted by Christ_empowered on October 5, 2013, at 19:36:50
i don't wish induced psychosis/mania upon anyone,
lamictal was my trigger, and a joyride with the police to the hospital. very very upsetting....
i think the treatment i am currently getting in this Duffel Antwerp clinic is not progressive at all, my pdoc had lupus as a kid, and his left or right hand is disability, can't move it since he was a kid, and he's supposed to treat my psychosis??????
Posted by herpills on October 6, 2013, at 15:03:03
In reply to 2 ADs better than 1?, posted by Christ_empowered on October 5, 2013, at 19:36:50
I agree with linkadge, why not start with just Effexor (or Pristiq) and see how that goes, you might not need two ADs. herpills
This is the end of the thread.
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