Posted by SLS on March 23, 2002, at 13:51:45
In reply to Re: treatment resistant depression » SLS, posted by Ron Hill on March 21, 2002, at 16:33:03
Hi Ron.
> I want to help you! You have been in pain too long, and you are too nice of a guy for me to just dismiss.
It means so much to me that someone should take such an interest. I have been bouncing back between hope and despair for a long time.
> For six years I went from one drug trial to the next never finding long term relief for the depressive side of my BPII. Thanks to a pdoc that does more than just listen to what the drug company reps tell him, I now have my solution; 600 mg/day Lithobid and 200 mg/day SAM-e. (B-6, folic acid, and SUBLINGUAL bioactive B-12 must also be taken. I also add some phosphatidylserine and phosphatidylcholine 'cause they feel good in my brain.
Questions:
1. What is your blood level of lithium at 600mg/day?
2. Do you experience any side effects of lithium, i.e. apathy, amotivation, loss of creativity etc.?
3. How does your (hypo)mania manifest? How often does it happen?
4. 200mg of S-AMe sounds wonderful. How frequently do you think that someone should respond to such a low dosage? How did you go about establishing your optimum dosage? Did you initially take more?
5. Is it safe to combine S-AMe with a MAO-inhibitor?
> For you, it might be 300 mg/day Lamictal and 400 mg/day SAM-e (or as high as 1600 mg/day SAM-e if needed). Start by using 100 or 200 mg/day of SAM-e as an add-on to your current cocktail, then play it by ear to see if you can discontinue your AD.> PLEASE read the very well written and technically informative SAM-e article (posted previously by davex) linked below. All I can do is put out the bread; it's up to you to decide whether or not to eat.
Thank you very much. I think I'll move S-AMe near the top of my list. At this point in time, I am planning to:
1. Try to find an optimum dosage of nortriptyline that will maintain a partial response.
2. Add Nardil, titrating to perhaps 90mg.
Perhaps this would be a good point to try adding S-AMe. What do you think?
3. Retry an atypical neuroleptic. Previous trials produced mild transient improvements followed by the emergence of unacceptable cognitive side effects at higher dosages.
- Zyprexa (olanzapine)
- Geodon (ziprasidone)
- Abilitat (aripiprazole)4. Add Mirapex.
5. Finish reading your S-AMe article. :-)
- Scott
poster:SLS
thread:98310
URL: http://www.dr-bob.org/babble/20020322/msgs/99653.html