Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

To SLS

Posted by denise1966 on October 19, 2005, at 4:44:37

In reply to Re: Need something to hope for. » denise1966, posted by SLS on October 14, 2005, at 16:05:41

Hi Scott,

Thanks for the ramble :-) I hope you get to try mifepristone soon in the meantime good luck with the Dexamethasone.

Thanks for your advice but I'm not prepared to stick out 6 weeks of a drug only to find it doesn't work and then switch to another. In my experience when drugs have worked they've worked within a couple of weeks at least.

When I first ever took prothiaden it worked within a couple of days, same with Seroxat. Two years ago when I went straight onto a higher dose of Seroxat it started to work within about 4 days although not as well.

I def don't want to start any doses on a low dose as it takes too much time and I still get side affects, I'd rather start high and take Zyprexa for the side affects as I feel that nowadays I need higher doses.

I think you're right in saying that I may need to go back and retry other drugs but rather than giving them a longer try, I need to increase the start up dose. That's my gut feeling anyway.

I might give Wellbutrin another try at 300mg but If I do I'll only give it a week. Thing is I hope I don't get a seizure or pass out on it as I did once with high dose of prothiaden and Sertraline.

Mood Stablizers really don't do a thing for me, I took quite a high dose of lamictal and lithium for a long time and felt pretty much nothing on them.

I will always keep neuroleptics in mind as Zyprexa has helped me so much in the past but I like to keep it as my "rainy day" "savings in the bank" drug.

Anyway, thanks again for the post and I hope you get some response from dexamethasone when you take it.

I wish they did trials of mifepristone for unipolar here in the UK but I've already enquired and they don't.

Kind Regards....Denise


> Hi Denise.
>
> I'm currently visiting a friend in Minnesota, so I really don't know what's going on with mifepristone. I would have tried it a month ago had the FDA granted my doctor permission to dispense it. I think there is a misunderstanding as to what is actually required. It's been a bit of a mess, but I still look forward to trying mifepristone. It might come to my having to use a different doctor whose participation can be overseen by an institutional review board. This normally means that the doctor must be affiliated with a university or perhaps be on the staff of a hospital that has one set up.
>
> What I may do in the meantime is try taking dexamethasone for a few days. There is some precedence for doing this for people who are hypercortisolemic.
>
> As for you, my best advice is to avoid evaluating drugs based on how you react to them during the first week. With as many drugs as you have tried, it is becomes imperative to give each treatment an adequate trial. I would return to Wellbutrin if I were you as long as you tolerated it well for the short time you took it. 300mg is practically mandatory. Wellbutrin makes for a good adjunct to other drugs if nothing else.
>
> I would recommend starting at very low dosages of any drug and increase it very gradually so as to minimize startup side effects. These side effects seem to discourage you from continuing with treatment when they might in the end be of little consequence. You have not allowed yourself to work up to therapeutic dosages on quite a few drugs. You have also aborted treatment too early on most of them. You will very likely have to go back and retry these drugs.
>
> You have so many options, I don't know where to start!
>
> PERMUTATIONS. One would like to reduce the number of permutations to try by adding together as many drugs as is safe.
>
> It might make sense to give nortriptyline 75mg a try immediately. If necessary, add Wellbutrin 300mg. If necessary, add Effexor 150-300mg. If necessary, add lithium 300-600mg. This will cover quite a bit and save a lot of time.
>
> Don't discard mood-stabilizers or neuroleptics as adjuncts. You don't have to be bipolar or psychotic to benefit from these drugs. I would at some point try to establish lithium at dosages between 300-600mg. If you feel dysphoric or experience a flat affect after two weeks, you can cross it off your list. If not, you can continue taking it as you move through drug trials. Parnate + lithium / Lamictal can be a potent combination. You can even take Wellbutrin, nortriptyline, or desipramine in combination with Parnate. This is, of course, an aggressive treatment that most doctors will refuse to administer.
>
> I think you should consider building a treatment around either an MAOI or Wellbutrin. The advantage to using the MAOI is that it probably has the best chance of getting you well. The disadvantage is that you cannot introduce drugs that inhibit the reuptake of serotonin with it. On the other hand, almost anything will mix safely with Wellbutrin.
>
> Besides Lamictal, try and find a mood-stabilizer that agrees with you. Depakote and Trileptal are good choices. So now, you are taking Wellbutrin, lithium, and Trileptal. You are tolerating the combination well, but are not gaining an adequate antidepressant response. Now you start adding in your second antidepressant. Effexor would be my first choice. You still need to try Zoloft 200mg, so that might be next. If that doesn't work, I would keep all the drugs in place and add a third antidepressant - a tricyclic. I think nortriptyline at a dosage of 75mg would be best.
>
> If you are experiencing absolutely no benefit, I would suggest discontinuing the antidepressants, retain the lithium and mood stabilizers, and add an MAOI.
>
> You know, there are people who are biologically bipolar who never experience mania. Many people whom display depression only are of course treated as unipolar. It is only when these people fail multiple antidepressant treatments does it then dawn on the physician that he might be dealing with an unusual bipolar presentation and subsequently treat the patient successfully by adding mood stabilizers.
>
> Are you bipolar or unipolar? Who cares? If you pretend that you are bipolar, you will have a better chance of getting well. You may have to revisit Wellbutrin, Prozac, Zoloft, Seroxat, and Remeron for lack of adequate trials (inadequate dosages and inadequate trial periods).
>
> This has not been a well-composed post. It is more of a ramble so that you could gain some insight into previous treatment failures and future treatment successes.
>
>
> - Scott


Share
Tweet  

Thread

 

Post a new follow-up

Your message only Include above post


Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.

 

Start a new thread

 
Google
dr-bob.org www
Search options and examples
[amazon] for
in

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:denise1966 thread:566744
URL: http://www.dr-bob.org/babble/20051017/msgs/568766.html