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Re: Please help me with medication suggestions

Posted by JohnL on December 12, 1999, at 4:54:40

In reply to Please help me with medication suggestions, posted by Pat on December 11, 1999, at 11:14:24

Hi Pat. There are plenty of options. It would be nice if we could just have one drug in the medicine cabinet. But for many of us that just isn't realistic. We either need a second or third drug to potentiate the primary antidepressant, or, we often need a drug to counteract the most problematic side effect. In your case, treating the constipation secondary to the depression sounds like a very high priority.

If the pdoc cannot help treat the constipation, perhaps another specialist can. Having said that, the drug Bethanecol might be helpful. It is a cholinergic drug used to counteract the anticholinergic side effects of tricyclics. Even a small amount of Lithium might do the trick.

Other suggestions:
Return to the Wellbutrin, treat the constipation, perhaps with Bethanecol.
Return to a tricyclic, add Bethanecol. Nortriptyline and Desipramine have milder side effects than Triavil.
Get a prescription for Amisulpride (a dopaminergic drug) from an overseas pharmacy. It's a friendly drug, and your pdoc shouldn't resist much if he/she thinks you're running out of options (which you aren't).
But if you've had fair response to Wellbutrin and Triavil, it would make sense to refocus on those but make the constipation treatment a top priority as well.

Have you seen Dr Bob's "tips" section? If not, click on "tips" at the top of the main page. Then, after it takes you there, go down to the search box, leave it blank, and click on the search button. The vast amount of tips and tricks from doctors around the world is staggering. You'll realize just how wrong your pdoc is. Talk about options. I've never tried it, but if you type constipation in the search box there might be some tips on that topic. Don't know.

Many of us end up with doctors who just aren't up to speed on their homework. We have two options: 1)Find a new doc who knows all the tricks, 2)Take it upon ourselves to engage in research and become our own best second opinion. If the doc thinks there are no more options, you might have to do your own homework, print out your research to show him/her, and put a little pressure on him/her to do some homework, get more creative. Make your own suggestions, backed up with printed proof. Very simply it seems if you could treat the antidepressant induced constipation you would be all set. There must be a way to do that. Best wishes for you. JohnL




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