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Re: Pharmokinetic similarites between Lithium\Risperal » schleprock

Posted by SLS on August 14, 2012, at 0:48:14

In reply to Pharmokinetic similarites between Lithium\Risperal, posted by schleprock on August 13, 2012, at 16:20:54

Hi.

Why did you try and how did you react to:

1. lithium
2. risperdone

Do you also have panic attacks?

You might have better luck by adding a drug that is more potent as a serotonin reuptake inhibitor for a more balanced action. Also, I have seen Nardil used in combination with a tricyclic as an experimental treatment of PD with AG. The report indicated positive results. I spent a great deal of time combining Nardil and nortryptyline. If you titrate the dosage of Nardil slowly enough, you might be able to avoid postural hypotension. Retaining the benzodiazepine in your treatment regime is important.

I agree with Eric that psychotherapies like CBT and exposure-therapy are very useful, if not critical, for treating agoraphobia. However, if panic attacks are present, an antidepressant is often employed. Imipramine had been considered the standard treatment for many years for panic disorder with agoraphobia. More recent work indicates that several SRIs work, too. You might be able to optimize your treatment by adding Zoloft to nortriptyline in order to maintain both NE and 5-HT mechanisms. With Zoloft, there would be no need to adjust the dosage of nortriptyline downward. I think sertraline has been well studied for treating PD with AG. It seems to really work. Keep clomipramine somewhere on your list.

> I had very similar bad reactions to a trial of both drugs, and am looking for similarities between the two so that I may eliminate some other possible drugs for the treatment of depression\anxiety.

Can you describe your adverse reactions to each drug?

I'll need to ponder this one. Each drug has multiple properties. Both drugs can attenuate dopaminergic activity, albeit through different mechanisms. That might not explain things, though.

For complex agoraphobia without panic attacks, antidepressants are probably less useful than benzodiazepines. I think a few of the antipsychotics could be useful. I haven't looked into it, though.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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