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Re: The Pain of Treatment Resistant Depression Ilene

Posted by Ron Hill on July 15, 2005, at 14:31:43

In reply to Re: The Pain of Treatment Resistant Depression Ron Hill, posted by Ilene on July 14, 2005, at 19:22:39

Ilene,

> > How can I help you, Ilene? For starters, I could be your friend! :-)

> See you over on Social!

I don't make it over there. I stick to this board and Admin. As an aside, I may have to leave PB soon, but I want to follow up with your first. If I dissappear, feel free to contact me via babblemail.

> > What are your depression symptoms?

> I feel unmotivated, slowed down, stupid, uninterested and uninteresting, I sleep a lot, I think about suicide off and on.

I'm BP II and my depressive phase is the atypical variety. Your depression sounds exactly like mine.

For me, my atypical depression seems to have dopaminergic roots. I'm six weeks into a trial of very low dosage Selegiline. It's too early in the trial to proclaim victory, but so far, I'm getting good results. It's taken me a while to find the best dosage, but I think I'm onto something. Have you every looked into the dopaminergic tx approach?

> > What is your dx?

> Unipolar depression.

No cycling at all, correct? Never any hypomania, right?

> > What are your current meds and dosages?

> Prozac 60 mg, soon to go up to 80 mg, Abilify 10 mg, down from 20, Cytomel 1 microgram. I used to take Neurontin but went off it when I read it was linked to suicide.

I wonder if you are experiencing SSRI Induced Apathy. Raising serotonin levels with an SSRI can, in some cases, lower dopamine levels resulting in apathy, low motivation, anergy, anhedonia, etc. Does the Abilify reduce your apathy at all?

Have you ever tried adding a pstim (e.g.; Adderall XR, Concerta, Provigil, etc) or an MAOI-b like Selegiline? If you've never added a dopaminergic medication to your cocktail, I'd be curious to see what it would do for you.

-- Ron

BP II and OCPD

600 mg/day Lithobid

900 mg/day Trileptal

50 mg/day Lamictal

2.5 mg/day Selegiline <brand name Deprenyl> (as tx for atypical depression)



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poster:Ron Hill thread:523801
URL: http://www.dr-bob.org/babble/20050713/msgs/528095.html