Posted by JohnL on October 25, 2000, at 16:02:16
In reply to Diminishing SSRI effects--what now?, posted by Rebecca on October 24, 2000, at 19:21:03
Rebecca,
It sounds like Zyprexa and Risperdal were good choices. Too bad it didn't work out. Damn. I hate it when that happens!Anyway, here are some ideas. 300mg to 900mg Lithium might be your best bet. This is a pretty mild dose, nothing to fear. I suggest it for two reasons. First, in a survey of psychiatrists it was the most common augmentation strategy favored. Second, in statistics showing what percentage of patients got well with what medications in a whole variety of different symptoms, Lithium always seemed to be right up there as being one of the better performing drugs (salt, actually) in just about any psychiatric condition you could name. It is well known as a good augmentor. It is also well known for restoring the original effectiveness of your medicine.
Lithium would fall under the category of chemical stabilizer. Other choices might include Depakote first, and then Tegretol second. These are electrical stabilizers, or smoothers. Any of these stabilizers can restore a drugs's original effectiveness.
My hometown general practitioner's favorite strategy is to add in a small dose of a tricyclic like Nortriptyline. Kind of along the same lines would be a small dose of Remeron.
I think since it worked once, it's best to work with it and 'stabilize' it to its original effectiveness, rather than do a complete switch. The above ideas are probably the best options I could think of right now. Something to consider anyway.
John
poster:JohnL
thread:47282
URL: http://www.dr-bob.org/babble/20001022/msgs/47357.html