Posted by SLS on February 16, 2012, at 4:02:20
In reply to To SLS..a question please, posted by Roslynn on February 15, 2012, at 16:10:50
> Dear Scott,
>
> I have a question, wondering if you can answer? This is from my question (from above on the board..)
>
> "...all the add-ons my pdoc is trying, such as cytomel, Deplin, Strattera make me tired rather than more alert. I'm having zero luck as my pdoc tries to augment my current meds with what ever he can think of.
>
> Why would the "augmenting" drugs make me tired, spaced out, reflexes slower, nauseous, dizzy, etc.?Do you know which drug is producing which side effect?
Some people report being "med-sensitive". They seem to get intolerable side effects to even low dosages of drugs. For you, "brain-fog" might be one of your med-sensitive reactions.
To keep things simple, except for the Ativan, any of the other drugs you are taking can produce fatigue and brain-fog. I found Deplin to be somewhat depressogenic. I did not do well on it. If Deplin is making you feel worse in any way, I would consider discontinuing it.
You are taking 5 drugs. Someone suggested that this was too big a number. On what scientific grounds? None. I take 6 drugs, and have experimented with all of them to determine that each produces a contributory effect to my current improvement. More recently, I tried discontinuing Abilify. I relapsed after 2 weeks. Fortunately, I was able to recapture the antidepressant effect, although I lost a month in recovery time. My grandmother took 11 drugs to treat hypertension and heart-failure. So what?
> Here is my med combo in case anyone is interested:
>
> Anafranil 50mgToo low.
> lithium 600mg
Too high.
> ativan prn
> seroquel 100mg
Perhaps 25 mg twice a day if used for anxiety?
> Deplin 15mg (day 11 of trial) "
Perhaps counterproductive?
> Scott,
>
> Do you have any insight into this?None that I would call definitive.
> Is it possible the augmenting agents are interacting with the seroquel, lithium, etc and thus my side effects are magnified?
Yes. Sometimes, there are synergisms in the production of side effects.
> Does this make any sense?
It doesn't have to.
Empirical observations based upon trial-and-error is sometimes all we have to work with. For the sake of increasing therapeutic effect, I think it makes sense to explore higher dosages of Anafranil, to be increased very gradually. For the sake of reducing side effects, you could reduce the lithium, as long depression is the only consideration in its selection. I do well with 300 mg and avoid the sedative or mood flatteing side effects. You could try discontinuing the Seroquel if it is being used for depression, and consider restarting it if you deteriorate. You can always revisit it at a later time, but I think you really can't test any of these drugs as augmentors if the drug that is meant to be augmented - Anafranil - is not being used properly. You are probably being underdosed with Anafranil at 50 mg. You can go as high as 250 mg, but might find that a dosage between 100 - 150 mg works well.
Feel better!
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1010358
URL: http://www.dr-bob.org/babble/20120212/msgs/1010420.html