Posted by bob on February 20, 2000, at 2:31:57
In reply to Re: Time for (another) change, posted by quilter on February 19, 2000, at 20:18:39
Thanks Cam, SSuggs, & quilter for the tips (and the welcome backs).
Quite frankly, I'm still surprised I've been here for more than one quick visit. Mid-December hit me with my worst depressive episode in at least a decade and I ain't out of the woods yet. But I guess this place can be more addictive than xanax (and definitely more therapeutic, even after habituating to it).
Cam, 2.5 years of trying SSRIs pretty much demonstrated that I'm a non-responder to them wrt my depression. As I mentioned elsewhere, zoloft did a nice job of handling some OCD-like behaviors, but other than a manic response to it the first time I was on it, zoloft, prozac, and paxil have done little good (or, in paxil's case, some harm). SSRIs have also had a rather disconcerting effect on my cholesterol levels, and my GP doesn't want me on them any longer (yeah, even though he's put me on lipitor to knock it back down ... I still have an extra 50 pounds courtesy of zoloft to take off before he'll consider taking me off that). My pdoc has had me try augmenting with wellbutrin (prozac, wellbutrin, and perphenazine put me in the ER), lithium, and finally nortriptyline. The nortrip worked so well I asked to go off the SSRI (zoloft, again, at the time) and just try monotherapy with a TCA. At the time I was only on 75mg/day of the nortrip (I also take clonazepam 1mg/d for PD). I saw almost no drop in function from ditching the zoloft. We tried bringing wellbutrin back in, but it was making me highly irritable (as always ... before trying the prozac/wellbutrin combo, I was on wellbutrin alone, and I had some near psychotic reactions to it ... that's how I got on the perphenazine as well, to chill out the beast that wellbutrin likes to bring out in me). I think this last trial with wellbutrin was a contributing factor in what triggered this latest depressive episode as well.
Since then, I've gone up to 125mg/d of the nortrip. I was hoping to get up to 150/d, but I've been fighting drowsiness from it that had me literally falling asleep on my feet when I first increased my dosage. That's pretty much worn off as much as I can expect, so depending on my chat with my pdoc, I may go up the extra 25mg.
The problem I'm having is not having a "normal" baseline for comparison. I've been depressed since childhood, so I have a hard time judging where I'm "at". Particularly with this last episode -- every time it feels I take one step forward, I feel like I fall back five.
I'm not saying that the nortrip is loosing its efficacy -- rather the opposite, I believe. You know that warning about giving a severely depressed person medication for the first time...if he's suicidal, he just might find the energy to do something about it? Other than that one manic episode (where I blew right by this suicide-enabling level of affect), I now realize that in 2.5 years of drug therapy I'm only now getting up to that state of mind. The medication is finally working well enough to make me care, and caring about the condition I'm in and how it affects those around me hurts worse than just about anything I've ever experienced.
And since I mentioned it first--no, I'm nowhere near suicidal. The novelty of caring has somewhat ruled that out. Mostly, though, I'm enjoying the self-inflicted pain too much. Like I've said elsewhere, I don't use razors for my self-mutilation since I do my cutting from the inside out.
Anyway, my mood continues to improve on the nortrip, but I still have a long, bad stretch of road out in front of me and I sure ain't moving all that fast down it. I have enough sanity to not want to spend another two months or more in this frame of mind, so I need something to give the nortrip a boost.
I guess that's where the T3 can come in, instead of Luvox. My pdoc has mentioned it before, when we were trying to decide between it and lithium as an augmentor. I guess my test results and the normal thyroid function they showed made him/us forget about the T3 option. Thanks SSuggs & quilter for reminding me.
cheers
bob
poster:bob
thread:21871
URL: http://www.dr-bob.org/babble/20000209/msgs/22649.html