Posted by bleauberry on November 10, 2008, at 17:07:53
In reply to Mirtazapine 7.5mg for sleep, posted by psyclist on November 10, 2008, at 8:37:40
Lithium and andedonistic? I would tend to agree with that. Some people respond well to lithium, but I have heard many talk about its flat effect. When someone has experience the highs of mania or hypomania, the flat effect can seem even more intense than it actually is.
I wonder if you could get by with a lower dose of lithium? I wonder if you could get by with a lower dose of and add in a smidgen of lamictal? With the history of mania that you have experienced, remaining stable is the most important goal. Treating anhedonia is a second goal, but the goal of stability takes priority.
You could try reducing remeron to 3.5mg, but add in 12.5mg to 25mg of seroquel? Maybe take 3.5mg twice...once before bed, once if/when you briefly stir awake?
For both anhedonia and sleep maybe something like low dose nortriptyline or amitriptyline?
Who knows, maybe the days of remeron are gone for you and it is time to find a replacement?
Just some ideas to ponder.
poster:bleauberry
thread:862018
URL: http://www.dr-bob.org/babble/20081106/msgs/862124.html