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Re: adjunctive meds to pair with paxil?

Posted by desolationrower on December 21, 2008, at 13:53:20

In reply to Re: adjunctive meds to pair with paxil? » shadowmon, posted by SLS on December 21, 2008, at 6:41:33

> > Just wondering if anyone out there can help me.
> >
> > Just got back on paxil after a horrid try to switch to effexor. At the max dose 60 mg, want to talk to dr about adjunctive meds, because I don't want to get off the paxil because it seems the only thing that has some positive effect, and am totally not willing to change meds at this time.
> >
> > What do they normally pair up with paxil?
> >
> > Am definitely not willing to try wellbutrin, it's too stimulating,
>
> Have you already tried it?
>
> "They" don't normally pair up anything with Paxil. It is still a psychopharmacological jungle out there. There is often very little consensus as to what to do when trying to augment antidepressants. You might want to perform a search on the Internet for relevant material written by Stephen Stahl, MD, PhD. He is considered one of the masters of polypharmacy in psychiatric medicine. He currently likes adding Geodon to some treatment regimes. He also likes to combine SRIs with TCAs; desipramine and nortriptyline being the drugs of choice.
>
>
> I think these might be worth looking into as adjuncts to Paxil:
>
> Remeron
> lithium
> nortriptyline
> desipramine
> Provigil
> Abilify
> Geodon
> Lamictal
>
> I am not as enthusiastic as some are to add stimulants, but they can help.
>
>

If bupropion and venlafaxine both seems overstimulating, i'd probably not add a tca, its likely to have a similar effect.

It depends on what problems you are facing, but if its a basic depression type symptoms, lithium would probably be a good first choice.

-d/r

 

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URL: http://www.dr-bob.org/babble/20081214/msgs/870072.html