Posted by SLS on August 15, 2009, at 5:40:59
In reply to Alertec added, posted by Justherself54 on August 11, 2009, at 20:28:50
> Just saw my GP before my pdoc appointment. Apparently I have Coccydynia and he's also arranging for me to be tested for sleep apnea.
>
> Then I saw my pdoc. As I'm not getting a whole lot of benefit from Paxil, he wants me to drop my dose to 20 mg. from 30 and is adding Alertec as I am not getting any response from Ritalin.
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> I'm retrying old meds that worked, hence the Paxil and I think he doesn't want to try an increase as that's what I was on when I had my first prolonged mania.
>
> Right now I'm not too badly depressed but very, very tired. It's not that I don't have interest in doing things..I'm so unfocused it takes me forever to get a task done. Add to that all the issues that come from fibromyalgia and now the Coccydynia, I'm avoiding anything that's going to raise my pain level.
>
> Any thoughts about the drop in Paxil and adding the Alertec.
>
> Sorry to ramble!So, at 30mg, Paxil is acting as an effective antidepressant? The only reason for lowering the dosage is to avoid fatigue and tiredness? It might help. I can't be certain enough about that to be able to enthusiastically recommend it. Since everyone is different in the way they react to psychotropics, I think lowering the dosage is a reasonable experiment to conduct.
Adding Alertec 200-400mg can help some people with drug-induced or fibromyalgia-related fatigue. For some lucky few, it acts as an antidepressant when added as an adjunct. I think this is another experiment worth conducting.
My doctors would love for me to get manic. For me, it is easily controlled using Depakote or Zyprexa. If you became manic at 40mg of Paxil, did you experience fatigue? Fatigue can be a symptom of fibromyalgia. It can also be a symptom of subsyndromal depression.
It occurs to me that taking Cymbalta instead of Paxil might relieve you of your pain conditions. The other thing you can do is to add nortriptyline to Paxil for the same purposes. The addition of nortriptyline might also resolve any residual depression that may exist.
I think the addition of Alertec makes sense. I am less convinced that reducing the Paxil will be productive. Again, it is reasonable to experiment with this in order to find out.
- Scott
poster:SLS
thread:911652
URL: http://www.dr-bob.org/babble/20090810/msgs/912217.html