Posted by SLS on November 23, 2008, at 7:42:33
In reply to Treatement resistant bipolar depression..., posted by chocamine on November 22, 2008, at 11:03:47
Hi.
Bipolar depression.
I am currently having success with the following drugs:
Parnate 80mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
I highly recommend Abilify. It is known as a dopamine system stabilizer (DSS), and has produced a more robust antidepressant effect for me than the other atypical antipsychotics.Combining a TCA with a SSRI is currently gaining favor. I would recommend using either Lexapro or Effexor. If there is a serotonergic drug that you responded partially to, I would choose to revisit that first.
Wellbutrin is a drug thought by many clinicians to be well suited for bipolar depression. It generally has a lower rate of precipitating mania. It is often added to Zoloft and other SSRIs.
You have to prevent mania. If you don't, you will always wind up with the depression that follows, despite drug therapy. This will require a mood stabilizer other than Lamictal. I would definitely add Lamictal to the mix, anyway, as it acts as a good antidepressant augmentor. I think you might want to look into Trileptal as an antimanic.
Treatment might look something like this:
Wellbutrin + Zoloft + Lamictal + Trileptal + Abilify.
- Scott
poster:SLS
thread:864627
URL: http://www.dr-bob.org/babble/20081123/msgs/864831.html