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Re: Exotic Meds for Treatment Resistant Depression » uncouth

Posted by SLS on September 27, 2008, at 18:24:15

In reply to Re: Exotic Meds for Treatment Resistant Depression » SLS, posted by uncouth on September 27, 2008, at 17:04:35

Hi Uncouth. (Great name)

Great questions.

> scott,
> what do you believe to be the most effective A/D adjunct in your mix. e.g., if you had to choose just parnate and one other drug for the depression, what would it be?

Nortriptyline. Before my case became complicated with a manic reaction, Parnate plus nortriptyline were all that were needed to perform miracles. 20/20 hindsight: my doctor should never have removed these two antidepressants. It makes more sense to me that one not discontinue antidepressants when a manic reaction occurs in a TRD patient. Simply treat the emergent mania with mood stabilizers and antipsychotics while continuing with the antidepressants.

> i'm on parnate and did a 2 week trial of abilify with some old stock i had from trying the drug years ago. i found that it had a profound affect. to me, all A/D tune up the 'hardware' -- speed it up or slow it down or whathaveyou, while abilify was like a 'software' upgrade. its hard to explain but the antipsychotic effects definitely kicked in at 10mg for me, although i'm not psychotic (just BP2), i do get obsessive and ruminatively depressive thoughts.

I find that Zyprexa and Abilify both help with these thoughts. They make pretty damned good anti-suicide drugs.

> im' curious why you are on lamictal AND abilify.

Quite simply, they both work through entirely different mechanisms. Actually, Lamictal makes for a better antidepressant adjunct than it does a mood stabilizer. It is not very effective at treating acute mania. Interestingly, Lamictal is often used successfully to control ultra-rapid cycling presentations.

I should add that I sequentially discontinued each of the drugs I am taking to establish their role in my treatment regime. Each of the drugs I am taking are necessary, as the discontinuation of any one of them allows for a deterioration in my condition.

> and what dose of abilify and lamictal?

Lamictal: 200mg
Abilify: 20mg
NAC: 1200mg (600mg b.i.d.)


I take a multi-vitamin. Nothing fancy.

- Scott

 

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