Psycho-Babble Medication | about biological treatments | Framed
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Re: Im cracked up

Posted by Elizabeth on November 18, 1999, at 1:10:23

In reply to Re: Im cracked up, posted by JohnL on November 17, 1999, at 3:37:11

> Prozac+TCA (desipramine or nortriptyline).

Desipramine is probably a better choice - nortriptyline levels are dicey enough without adding a CYP2D6 inhibitor like Prozac.

> Any of these with Lamictal (instead of Lithium).

I like the Lamictal idea.

> I especially like the SSRI+TCA option.

MAOI-TCA is an option as well, if you find a pdoc who has experience with it. One psychopharm I know says he's had good results with Parnate + amoxapine specifically. (Add MAOI to TCA, not the other way; don't try this with clomipramine at all.)

BTW I don't think it's a good idea to jump to the conclusion that a person who hasn't responded well to the antidepressants they've tried (especially if they haven't tried the older ones) is bipolar.

And, "Refractory," I've told you this before: IMHO you're not really treatment-resistant until you've failed to respond to TCAs and MAOIs!

Don't give up. You're not even near the end of the road.




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