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Re: Residual depression, which med should I stop?

Posted by ChicagoKat on October 4, 2012, at 18:25:55

In reply to Re: Residual depression, which med should I stop? » JONO_IN_ADELAIDE, posted by ChicagoKat on October 4, 2012, at 18:17:32

> > Add mirtazepine 30mg at night to control the anxiety
> >
> If you add mirtazapine, I'd do so at a lower dose b/c it has better sedating/anxiolytic properties at lower doses. But then, why add another med when the other two can be easily switched to alternatives?
>
> > If you want to drop the benzo, do it slowly, and increase the Lyrica to 300mg per day.
>
> I would not recommend increasing the Lyrica; it truly can worsen depression and may well be the culprit. And the benzo can simply be changed to a different one.
> >
> > If you want to drop the Lyrica, then consider changing your benzo to Xanax, same dose, 1.5mg per day.
>
> IMO, Ativan is a much better choice, fewer drug interactions, fewer adverse effects, no hangover effect, eg, and no interaction with smoking. Frankly, Xanax is the worst benzo of all, IMO, except for those with panic disorder b/c it has the quickest onset of action.
>
> Sorry to be so contrary, Jono, but I had to call it the way I see it, and besides, you didn't respond to any of my posts today :(
> Kat
>
>

I take part of it back, re-read the original post and the poster sounds pretty down. Adding an AD would be a good idea, and Remeron (mirtazapine) is a good choice...start at 15mg/day, see how that goes, go up to 30mg/day only if not responding well enough to 15. May not need a benzo or Lyrica/Neurontin on Remeron. But if had to pick one would pick a benzo, Ativan would be my choice.
Kat


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URL: http://www.dr-bob.org/babble/20121001/msgs/1027626.html