Posted by JohnL on February 10, 2000, at 4:48:29
In reply to Re: Mood stabilizers for Unipolar Depression, posted by JohnL on February 9, 2000, at 5:13:38
Hi Patty,
To answer your question...I had no trouble at all convincing my pdoc to try a stimulant with me. Actually, it was his idea. The reasons were several. First, I have been only partially or negatively responsive to a variety of more standard medications. So logically it made sense to try a different class of drugs. Second, my pdoc is an oldtimer and he says back in the old days all they used were stimulants. Third, he says these days a stimulant can enhance the effectiveness of any antidepressant. He prefers this approach over things like Lithium, because he sees it as being safer, less toxic, and very fast acting. Fourth, he is interested in getting the patient well as quickly as possible. If a stimulant will work in a particular person, it will work very fast. He also says that in severe depressions, he will prescribe a stimulant along with an SSRI in the beginning of treatment. The stimulant will provide almost immediate relief while waiting for the SSRI to kick in.
If there is any sign of abuse or addiction, he will switch the patient to a different stimulant that won't pose those risks. Cylert for example is often effective in adults without the abuse potential of the other stimulants, he claims. I learned a lot about stimulants for depression in Dr Bob's Tips. I printed out all I found and brought it to my pdoc to sell him on the idea. But I wasted my time. He suggested it before I even pulled out my papers. He wrote out a prescription in 60 seconds. For pdocs who know, it's a no-brainer. Some of the newer pdocs might hesitate. But the old timers know the value of stimulants. Sometimes only a stimulant will target a person's unique chemical imbalance when everything fails to do so. The greatest benefit of all, as I see it, is how fast they can work.
The only downside risk I can see in stimulants is addiction. But then again, if the person is happy, well, and productive for the rest of their life, being dependent on the stimulant seems no different to me than a diabetic being dependent on insulin. Both keep the patient alive and well. JohnL
poster:JohnL
thread:20861
URL: http://www.dr-bob.org/babble/20000209/msgs/20979.html