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Re: discontonuimg Emsam » Donna Louise

Posted by SLS on September 16, 2006, at 8:35:00

In reply to discontonuimg Emsam, posted by Donna Louise on September 16, 2006, at 5:40:39

Hmm.

I'm sorry things didn't work out.

Can you express how you experienced the hypomania?

You may have been experiencing a mixed state. Lamictal might not arrest the hypomanic part, but it should help with the depressive part. If you remove the Emsam, retaining the Lamictal might help take the edge off the depression, even though it might not bring you to full remission. If adding the Lamictal and raising the Emsam leaves you in an unacceptably hypomanic state without mixed depressive features, you can either choose to go with Depakote or an atypical AP like Abilify or Zyprexa.

Given your partial response to Emsam, I would proceed to another MAOI should you choose to make a change. If you enjoyed the stimulant-like effects early in your Emsam trial, perhaps you might like Parnate. It doesn't always work like that, though. You know that Nardil and Zyprexa can produce weight gain. However, I think that is probably a better combination for AD effect were one to keep statistics. Parnate + Abilify + Lamictal could work very well, and you shouldn't gain very much weight at all. If you should opt to use Depakote instead of an AP to prevent mania, you must reduce the dosage of Lamictal by 1/2.

Good luck.


- Scott

 

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