Posted by Tony P on February 9, 2008, at 4:39:00
In reply to Re: Me, I'm now exclusively on Trivastal LA, posted by trx resistant on January 28, 2008, at 3:14:31
> If you feel this way, lacking motivation more than normal, I would consider EMSAM. I tried all the SSRI's and got into trouble because pdoc kept cranking up dose, no response to speak of, then seizures.
SSRI's and I don't get along very well either, although Lexapro (Cipralex) was tolerable.
I don't think the EMSAM patch is available in Canada yet, but my oral selegeline is really helping with motivation and energy. I was already taking Remeron (SNRI) and Requip (DA), and selegeline on-label here is officially recommended for boosting the effectiveness of dopamine agonists such as Requip, but presumably it has some degree of balanced MAOI effect on all the big 3, so it should improve the effectiveness of both meds.
10 mg/day oral of selegeline is about right for me, I tried 20 but was getting quite jittery and shaky, (especially after my usual morning coffee!)
Trivastal doesn't seem to be available in Canada, I might experiment with it if I find a reliable overseas source, but while I don't mind the expense and the occasional polite note from Customs & Health Canada, it's extremely frustrating when something simply never arrives. I once got caught short when I was taking tianeptine from Europe regularly and exclusively as my AD; it had always arrived reliably within about 10 days, then one month it just never came - so I was suddenly without any A-D at all. That was when I went on Lexapro for a while, as it's supposed to have the fastest action (and lowest S/E profile) of all the SSRIs.
Thank goodness for my old pdoc who let me experiment with meds from the web, suggest new things to try, and in fact commended me for doing the research, (not without expressing occasional migivings however!) and then prescribed them if they were effective and available in Canada. He really, really wanted me to give Effexor a longer trial and go to higher doses than I was willing to (caused much too much anxiety for me), but in the end I persuaded him to let me go with my present regime. I just hope my new pdoc will be as open.
Tony
poster:Tony P
thread:807882
URL: http://www.dr-bob.org/babble/20080207/msgs/811674.html