Posted by med_empowered on October 30, 2005, at 14:26:27
In reply to Re: Treatment resistant depression, posted by willyee on October 30, 2005, at 13:36:14
Hi! For the first poster...I also think boosting dopamine can help with depression; the problem for me is that stimulants don't really cut it long term. Wellbutrin+another med might help. High-dose (up to 600mgs) Effexor helps some people, but those kind of doses scare me b/c of side effects. Provigil might be helpful; its primarily an anti-narcolepsy drug, but it does seem to help some people with ADD and depression with minimal side effects...supposedly, tolerance is much less of a problem than with Adderall and other "traditional" stimulants. You could try a kind of stimulating tricyclic, such as Pamelor but..those tend to have side effects, and they can impair cognition. It kind of seems like you might benefit from something that works on serotonin without re-uptake inhibition, since that will tend to reduce dopamine levels...maybe Remeron (try for higher doses, like 30mgs, at nite to prevent weight gain) plus Wellbutrin (or Straterra) ?
For the poster about Klonopin...yeah, I don't know what the deal is with Klonopin being used for depression. I think it may have to do with the location of some of the research--from what I understand, alot of asian psychiatrists use benzos for depression. In the US, our conceptualization of depression has changed over the years; in the past, many people DX'd today would be DX'd as "anxious" and given something for that (Miltown, Valium, Xanax) which actually will help a lot of people (some studies show benzos, in the short-term at least, pretty comparable to prozac for depression relief). So...in countries where a different conceptualization of "depression" and "anxiety" is used, its possible that Klonopin could be popular b/c they're actually dealing with a slightly different problem. Also, since some depressed people may have very mild bipolar-type issues, Klonopin could help even out mood swings, which would make the antidepressant more effective and improve the overall quality of life. As for xanax...it can be a wonderful drug for some people ..I think the big reason antidepressants are so popular now is more big pharma marketing hype than actual effiacy or safety issues. I don't know how you'd do Xanax dosing for depression; usually the doses range wildly, from 2-10mgs/day, but that's for anxiety. Good luck!
poster:med_empowered
thread:573337
URL: http://www.dr-bob.org/babble/20051024/msgs/573422.html