Posted by Racer on February 14, 2008, at 11:19:00
In reply to need a new coctail....AD Advice?, posted by B2chica on February 14, 2008, at 9:42:09
The Ritalin could be contributing to it, so it's probably worth trying to lower that a little bit as an experiment. See if maybe 10mg BID could do the trick, and limit the breakthroughs.
As far as ADs go, though, since Wellbutrin helped, I think I'd suggest considering Cymbalta. It's got the benefit of targeting both serotonin and norepinephrine, which might be more helpful than a medication which only targets serotonin. Otherwise, Remeron is another option, unless you want to try a TCA. The TCAs are pretty potent medications, and quite helpful for many people. The trade off, of course, is side effect profile: they often have more anticholinergic side effects, which means you'd probably want to add in a cholinergic agent to counter those. Personally, I opt for sub-optimal effectiveness in order to avoid those side effects, so that's not the way I'd go. Then again, I'd bet you and I have very different responses to medications, so that probably shouldn't influence you. (For instance, on 10mg Lexapro, I was nearly catatonic -- didn't even speak, since it wasn't worth the effort it would have cost me. It wasn't fatigue, wasn't amotivation, nothing like that -- it was feeling as though I was locked deep inside myself, and couldn't get to the surface. I only ate when my husband put food in front of me, and sometimes not even then. Slightly different from your experience, huh? lol)
Another thought is to give EMSAM a try -- it would mean dropping the Ritalin, but you probably wouldn't miss it. You'd also probably need to try something for sleep -- I used Rozerem, which was great and I highly recommend if sleep is an issue. Otherwise, it did seem like a helpful medication.
I do hope that helps.
poster:Racer
thread:812648
URL: http://www.dr-bob.org/babble/20080207/msgs/812676.html