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In which direction should I go?

Posted by hansi555 on November 7, 2008, at 5:15:21

Hi all
As many others on this site I am searching for right drug or combination of these.
I am currently on 20 mg Lexapro and 30 mg Remeron (taken for sleep around bed-time). 5 weeks ago I was added 25 mg of Nortriptyline and the original plan was to skip Lexapro and go full speed on Nort due to melancholic features. But the adding (or just pure luck?) of just 25 mg of Nort made me feel better than for a long time, so we (PD and I) decided to use a small dose Nort as augmentor for the Lex.
It has been working good for 3 out of these past 5 weeks.

But the last couple of days I have yet agian had crying spells and depression-like feelings.

When looking back through my notes I can see that the periods when I feel normal/good lasts for 9-14 days.
A good period is then followed by a similar lenght period of mixed days, some days are bad w crying spells, other days are ok.
Then comes a new good period, then a new mixed/bad period etc.

I am regarded uni-polar depression (stress released and stress burnt out after 12-18 months of waaaay too much to do). I have the melancholic features, these seem to have more or less vanished since the adding of Nort.

I am working currently 25-30 hours a week (part time) as area sales manager and doing pretty well - my area of responsability has been reduced to a minimum. I have cut down on a lot of activities in my spare time as well.

My question is:

a. is my pattern normal for a depression? Thought that the drugs should make me more stable than this...
b. if I am still doing to many things as I do in the good periods (I am not feeling stressed) and this can cause bad periods?
c. should I just accept the relapsing thing or go for heavier drugs
d. if so should it be more Nortriptyline og maybe Lamictal/Lithium?

Thanks for all inputs...


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poster:hansi555 thread:861264
URL: http://www.dr-bob.org/babble/20081106/msgs/861264.html