Posted by gpznos on January 26, 2013, at 7:13:30
At the end of November 2012 I went to the hospital because of a fast worsening depressive episode including suicide thoughts/plans one of the bad periods did not change back to normal as it normally does. At the time my meds were 110 mg Nortriptyline, 37,5 mg Valdoxan and 5 mg Mirtazapin. The doctors at the hospital raised the dosages to 145 mg Nort (I was within but at the low end of the therapeutic window w. 110 mg) and 15 mg Mirtazapin and also 750 mg Lithium was added which I agreed to earlier my regular p-doc and I had already considered Lithium as an augmenting possibility.
I was really supposed to be a simple case: First major depressive episode 5 years ago, stress-released, unipolar, but since then never really gotten to a point of constant relief for more than a couple of weeks/days, then a couple of depressed weeks/days, then back to normal again, then a bad period etc. Never any real reason for the shifting in my mood, even on 2 weeks summer vacation, one week can be good/normal, the other bad.
But I have learnt to sort of accept this, not letting it influence my work- or social life too much. Over the time we (p-doc and I) have tried to augment with Lacmital for almost a year, Abilify for 3 months (small dose).After 2 weeks time the doctors at the hospital convinced me to go into ECT treatment and I had 12 sessions over 5 weeks duration, from mid December to mid January. My mood improved a lot (but my short-term memory suffered a great deal) and I was discharged from the hospital 10 days ago.
I now have a feeling that I do not recognize from earlier (from the past 5 years of ups and downs). I cant get real happy/normal, nor do I become very depressed, I feel sort of numb or grey in a disturbing way. This might sound as a step forward compared to being very depressed or suicidal but this feeling of NO joy/happiness at all has now gotten to me so I am now beginning to feel depressed also.
I have no drive to do anything more than small, routine like tasks.I went to my p-doc 2 days ago and we agreed to lower the Lithium from 750 to 600 mg as he said the Lithium could cause this feeling, we would then make a blood sample on next Wednesday. So for the last 2 days I have gone to 600 mg but the situation has only gone in a worse direction.
I have been reading a lot on this forums posts and wondering if my medicine need a change and I am desperate to hear anyones opinion about this.
Please consider these things:
- My original medicine regime (110 mg Nort, 37,5 mg Valdoxan and 5 mg Mirtazapin) failed me seriously for no good reason (but have it ever really been working?)
- I remember reading that when Nortripyline is working well, the patient would be taking approx. 75 mg I am now taking almost 150 mg and still not doing well.
- Should I add Sertralin to the Nort as it has been mentioned recently in other postings?
- Should I switch to something else like Clomipramine or Imipramine instead of Nort?I am really hoping for some inputs, thanks!
poster:gpznos
thread:1036514
URL: http://www.dr-bob.org/babble/20130124/msgs/1036514.html