Posted by europerep on January 24, 2010, at 10:39:58
In reply to Re: switching from venlafaxine/mirtazap to moclobe, posted by West on January 20, 2010, at 8:37:56
hmm, well she told me that lithium augmentation and quetiapine augmentation were the only possibilites left that would not require a washout-period, i.e. stopping venlafaxine.. she didn't even mention bupropion and lamotrigine, but I will certainly try these before stopping venlafaxine..
I will go with lithium for now, since it is a quite well documented augmentation, also the CANMAT (Canadian Network for Mood and Anxiety Treatment) psychopharmacological guidelines of 2009 give it as the first augmentation strategy to be tried.. I'm a little scared about it, from what I've read here on the board, but then, some people (in the studies) achieved remission with it, so who knows..
i do still have a prescription for zolpidem from a while ago, and my doc certainly wouldn't hesistate to give me another one if I asked for it, but I have to say I'm a little wary of these "Z-substances".. I mean I know they are not benzos, but I try to stay away from anything that has an abuse or dependency potential, because I really do not want to add a substance issue to my already quite f##ked up situation..I believe - it's what my doc suggested - that I have a very fast metabolism, which does also make sense seeing how much i eat without gaining weight (well, on mirtazapine I have, but I think that is just the typical side effect).. that might explain why I do not show symptoms associated with high dose venlafaxine (as you said, twitchiness etc., high blood pressure, and so on)..well, anyway..
on sciencedirect.com i found an article on four cases of resistant depression with partial response to venlafaxine, which was treatable by adding a SSRI (sertraline, paroxetine, citalopram) to the venlafaxine.. sounds strange, but it did actually work, one patient even had ECTs before, and with the combo she was in remission for nine months or so when the article was written.. maybe that would be an option, too.. I'll see, first I'll try the lithium anyway..
oh btw, west, I thought you were a doctor who gave his advice to people on the board :) , but now I see you are "only" a patient too, right?..
poster:europerep
thread:930533
URL: http://www.dr-bob.org/babble/20100122/msgs/934856.html