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Re: Other options besides AAP for depression?

Posted by psychobot5000 on November 14, 2011, at 17:56:12

In reply to Re: Other options besides AAP for depression?, posted by jono_in_adelaide on November 14, 2011, at 17:10:05

> Oh, final option would be Effexor XR 150mg in the morning, and Remeron 30-45mg at bedtime
> All are very good combos, that hit depression through multiple effects on different neurotransmitters, and are all well worth trying.

I agree with both the options suggested by jono--those are good combinations. However, I do not agree with the use of Lamictal in unipolar depression. I have not been active in reading the research the last few years, but the last time I checked, the evidence was very much against any such use. It offers the possibility of quick improvement in first weeks, followed by a gradual return to baseline mood, and possibly below, and with the addition of any side-effects you may end up with (it's a relatively low-side-effect med for an anticonvulsant, but that's not saying all that much).

A quick check of the internet confirms that there have been no changes in the state of the research since I last checked, not for unipolar depression. Stay away. Though there may be a role for it, particularly in rapidly cycling bipolar disorder, lamotrigine has failed to show any positive results on its primary endpoint in seven major studies (!), and shown a semi-positive result only once, and then only on a secondary endpoint (the CGI).

Here's a useful blog on the subject. Take note that the positive study (on bipolar, not unipolar) at the end occurred in a study that was deliberately done on a short time-scale.




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