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Re: discontonuimg Emsam » SLS

Posted by Donna Louise on September 16, 2006, at 15:01:24

In reply to Re: discontonuimg Emsam » Donna Louise, posted by SLS on September 16, 2006, at 8:35:00

> 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

thanks for responding Scott, I am really in a bad place.
the hypomania is definately a mixed state type, very agitated, OCD like, rageful, that sort of thing. the lamictal helped with that but now i am so depressed i can barely stop crying. sleeping is the only way to get away from it. i can't even get my shoes on and go for a walk. never have i felt so depressed while on an AD. I didn't know if the lamictal was making it worse, even though it is supposed to help with anxiety and depression, both i have in buckets full. I had suspected i had the soft bipolar kind and the patch brought it out. i don't know if any maoi would not do that. i did like the energy since the usual ad's make me sleepy and unmotivated. i was thinking i would go back to effexor and add a few mg of selegiline, keep the lamictal. pdoc back on tues, wait until she hears what i have done. pulled the plug on 12mg patch, go cold turkey and get it over with like i did with effexor and paxil. blah blah, i am sick of listening to myself.


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poster:Donna Louise thread:686465
URL: http://www.dr-bob.org/babble/20060909/msgs/686600.html