Posted by Ant-Rock on October 17, 2001, at 20:18:29
In reply to Re: California Rocket Fuel+++ » Elizabeth, posted by JohnX on October 16, 2001, at 23:25:02
> > Hi everyone.
> >
> > A friend of mine who has had some troubles has recently embarked on a trial of Klonopin 4mg + Remeron 60mg + Effexor XR 400mg + Wellbutrin SR 300mg + Provigil 400mg. (He was already taking the Klonopin, and he added the others in a stepwise fashion in the order in which I listed them.) It may seem like overkill, but I've been amazed at the change in him -- to the point where I'm considering taking the risk of trying something similar myself (which would involve decreasing or eliminating some of my current cocktail). (I would probably use Cylert instead of Provigil (price concerns, plus I took Cylert before with some success), Trileptal or some other AED instead of Klonopin, and Xanax as-needed for panic attacks.)
> >
> > Some things make me a little bit pessimistic about this mix for me:
> >
> > * My friend responded to Remeron by itself (he gave it up because of weight gain), while I did not. OTOH, I had at least some response to Effexor XR, and I don't think that he was helped by Effexor alone.
> >
> > * I had a major serious reaction (the so-called "serotonin syndrome") that was at least in part due to Effexor XR (there were probably other contributing factors since I'd been taking it for several weeks, although I can never be sure). I've heard that Remeron (due to it's 5-HT antagonist properties) can prevent such a reaction, but I'm not sure whether I should believe this claim. I know Remeron can block some of the side effects of SSRIs and Effexor, but I'm not sure if it would prevent the serotonin syndrome. I might try it using desipramine instead of Effexor, at least to start out. Of course, then I have to worry about pharmacokinetic problems.
> >
> > * Despite the side effects, the buprenorphine-desipramine combination is doing so well for me that I hesitate to jeopardize my current state of full remission. My hope would be that the CRF+++ would help enough that I could take buprenorphine intermittently, or maybe even discontinue it altogether.
> >
> > So, does anybody have any ideas or thoughts or whatever? I'm facing a tough choice, here. In partiucular: Dr. Bob, if you have any thoughts on this I'd really like to hear them. (This goes for any other MDs or DOs who might be lurking out there.)
> >
> > -elizabeth
>
> How do you think you would do with all the side
> effects hittin you at once? Better add the meds
> one by one, as suggested. I hope you
> have some experience with the other meds so you
> know what to expect. I wish you the
> best. After all my trials I am sticking to
> the motto "If it aint broken, don't fix it".
>
> Lamictal is my main stay to keep me from major
> depression, and I toy with adding things carefully
> so as not to completely disrupt my life that I
> am trying to repiece.
>
> Anyways,I was bored of my residual anhedonia and I took a bunch of meds that did nothing (without
> side effects either), and combined them into
> a cocktail (I called in Texas Rocket Fuel, but
> maybe Texas Death Sentence would be better).
> The combo was different but based on a theory
> to perpetually stimulate norepinephrine
> neurons in one part of the brain (LC) which would in turn stimulate serotonin neurons in another
> (raphe projections), which in turn would shoot dopamine from the VTA up into the (pre)frontal cortex. A lot of the meds indicated they
> already did this, but I had a particular reasoning
> behind my cocktail, which truly knocked the dysthymia out of me without poop out or exacerbation of facial pain that a lot of meds
> aggravate. I did have a terrible side effect of giving me a racing heart which inderal stopped if
> I ate the wrong foods
>
> here it was:
>
> -Remeron 45mg
> -Reboxetine 4 mg
> -Manerix 300 mg
> -Selegeline ~60 mg
> -Pindolol ~5 mg
> -Lamictal 150 mg
> -Klonopin 4 mg
>
> Thats 7 meds at once. My own record. And complete
> stupidity. 8 if you count the inderal I took
> to keep my heart from exploding! I tried to
> turn the knobs to see if I could subtract things
> and get the same effect, but I ran out of the
> meds. I had dreams where my liver had a conversation with me asking what the *ell I was
> doing. ;)
>
> Now I just take Lamictal, Zyprexa, & Klonopin. I recently dropped a Remeron trial
> after adding Zyprexa.
>
> PS. Less is more. ;) Please don't forget
> how you felt before you came up with your
> current cocktail.
>
> Good Luck,
> JohnHi John,
I'm a little confused. You stated the 7 med combo worked well for your anhedonia. But you no longer use this combo.Does this mean your current combo of 3 meds works just as well or better?
Also, does klonopin help with anhedonia/depression? I wasn't aware of this.
Anhedonia is a big problem for me, that's why I'm asking.
One more thing, the best anti-depressant/anhedonia effect I ever received was from Mirapex. I am considering going back on this med shortly, seeing that the 70mg of parnate I take doesn't touch anhedonia, and possibly makes it worse over time.
Thanks John for any info you could provide.
Anthony
poster:Ant-Rock
thread:81334
URL: http://www.dr-bob.org/babble/20011015/msgs/81541.html