Posted by JohnL on April 23, 2000, at 4:01:57
In reply to Serzone--have I overlooked its potential?, posted by Noa on April 22, 2000, at 15:09:55
Noa,
Since you have been on both of these meds for quite a while, I question either of them as being appropriate for your chemistry. They may be helping somewhat, but are obviously missing the mark. Any benefit they are giving you is probably through a trickle down process that is not directly targeting the proper chemistry.Trying new replacement drugs at this point though would be a huge project, requiring a difficult and time-consuming weaning of these two drugs which both will cause considerable discomfort when discontinuing. With that in mind, I think tweeking the doses as you have suggested is wiser than complete switches. Increasing the Serzone dose makes sense to me as being a worthy option. The primary drawback is it will take some time to evaluate response. But again, I must admit I am skeptical of the current meds in the cocktail. If they were the correct ones for your chemistry, you would have experienced considerably more success by now.
Following your posts from months ago, I would think comparing all the stimulants and comparing antipsychotics--leaving the Effexor and Serzone right where they are for now--would be the way to go. Temporarily stop the Ritalin. Replace it with Adderall for one week. Then try Cylert for a week. Then Tenuate for a week. Ionamin for a week. Then choose your favorite to continue. You may find one of them works on your chemistry much better than Ritalin. Since they are so fast-acting, no long trials are needed. I get the gut instinct that norepinephrine stimulation (not just reuptake inhibition) may work well with you. I mention this strategy because I think it would be easier and much faster than adjusting doses of the other meds. Those adjustments will take time to evaluate. And again, I'm skeptical of them anyway. I think it makes sense to look elsewhere.
And if you haven't tried the antipsychotics, it would be helpful to compare a few. You might be surprised at the unexpected good result potential. Risperdal, Stelazine, and Zyprexa would be my top choices. And as with the sitmulants, you should know inside a week how they are working. Two weeks each would definitely give a clearer picture. But overall, results would be easy to judge in a short amount of time.
The hard part is trying to get the physician to cooperate. They are so entrenched in long drawn out suffering trials that they fail to see the simple logic of comparing different meds quickly in an effort to isolate superior matches which are then given longer trials.
You'll know a superior match when you stumble onto it. There will be no doubt. You'll know it inside a week. And it will be dramatic. I think it's worth exploring. I think it makes more sense than tweeking doses of Effexor or Serzone, which have not exactly been star performers in more-than-adequate time trials. So--it's just my nonprofessional opinion--but I would suggest the consideration of sampling all the available stimulants and several antipsychotics at this point. We're looking for a superior match, which will be known quickly. I just don't think there will be any magic found in tweeking doses of current meds. Just my thoughts. I hope it helps stimulate some ideas. I would LOVE to see you feeling better. I just don't think either Effexor or Serzone have the potential to accomplish what you want, given your unique chemistry based on clues provided by responses thus far. JohnL
poster:JohnL
thread:30979
URL: http://www.dr-bob.org/babble/20000420/msgs/31044.html