Posted by Quintal on May 3, 2007, at 17:02:03
In reply to Do antidepressants work ?, posted by jenny80 on May 2, 2007, at 19:19:53
>Do you think I may benefit from a more noradrenergic antidepressant or may be RIMA or tricyclic. What would you recommend for me ?
I'd recommend something dopaminergic. Bupropion (Wellbutrin/Zyban in the UK) would be the best place to start if you're looking for something to boost dopamine that's also noradrenergic. I remember you tried sulpiride? Did that have any effect? How about *low-dose* amisulpride which boosts dopaminergic transmission? From personal experience and reading many others here I'd say noradrenergic drugs increase drive and motivation but that comes at the price of increased anxiety and irritability. I've never had the impression they're very good for dysthymia though.
Tricyclics are excellent antidepressants - I was compiling a chart of all the meds I've taken recently and when it came to dothiepin (a popular TCA in the UK) I had to give it a 10/10 for effectiveness - I stopped it after two months because I was well again. Dothiepin was the only antidepressant that got a 10/10 for effectiveness in the whole chart. Clomipramine is generally considered to be the most powerful TCA, having a strong serotonin reuptake properties alongside the typical TCA profile, but the side effects are harsh. Lofepramine is the other TCA I'd recommend because it generally better tolerated than other TCAs due to milder side effects while still retaining the TCA efficiency. A friend of mine achieved a full remission on lofepramine in a short space of time and came off it after six months. She's still doing well as far as I know. If you have problems tolerating drugs I'd recommend lofepramine first if you decide on a TCA.
Then there's opiates. These are the only class of drug I'd say will certainly attack dysthymia, and by that I don't mean getting high. A dysthymic person would probably be able to feel some relief from doses as low as 16mg codeine (personal experience), while a person using it for recreational purposes will usually take 120-400mg.
Anyway, if you're curious about whether they'll work for you, you can buy a pack of painkillers OTC and see for yourself. There's some evidence lamotrigine can prevent tolerance to opiates, so low doses can be effective for long periods of time.Q
poster:Quintal
thread:755317
URL: http://www.dr-bob.org/babble/20070502/msgs/755564.html