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Re: complex med situation after poop out

Posted by ben on August 15, 2009, at 9:45:17

In reply to Re: complex med situation after poop out, posted by ben on July 19, 2009, at 2:00:46

now I am on 60mg Remeron, 375mg Efexor, Lithium, 200mg Lyrica and 240mg Noveril (dibenzepine = TCA). I had realy good days up topne week or maybe 10 days then I fail back in depression for some days. this pattern is repeating. Remeron plasma level is 117nmol/l (reference range 150 -300nmol/l). Lithium is at 0.8mmol/l and Efexor is in the upper range. Noveril is in the lower range. I have several options now:

1) increasing the Remeron
2) increasing the TCA
3) adding Thyroxin
4) adding a third mood stabilizer (quetiapine /valproic acid) or replace the Lyrica with another. Lamictal probably doesnt work for me because I had to get off it due headaches.

I am bipolar II and was stable over the last 3 years on Lithium and Noveril but this spring Noveril pooped out and I am in depression again. what should I do?


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