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Re: Switching from Pristiq to Effexor HELP PLEASE! » Roslynn

Posted by SLS on July 18, 2013, at 17:32:38

In reply to Re: Switching from Pristiq to Effexor HELP PLEASE! » SLS, posted by Roslynn on July 18, 2013, at 16:46:29

> > Your depression sounds like a hybrid between melancholic and atypical depression. There might be some bipolarity involved.
> >
> > How do you respond to tricyclics?
> >
> > You may need to combine medications.
> >
> > 1. How do you define mood-reactivity?
> > 2. What is your family history of mental illness?

> Oh, dear. Well, my parent is bipolar. But the docs go back and forth on whether this makes me bipolar simply due to having a first-degree relative who has it.

Your mood illness probably has the same biological underpinnings as your parent has. One can have a bipolar spectrum disorder and not display mania.

> I guess mood reactivity would be refer to my mood changing out of proportion to the precipitating event.

Mood reactivity is a phenomenon in which someone will feel significantly improved in response to a positive experience. It doesn't sound like this pertains to you.

> I have responded in the past to a combo of prozac+clomipramine (weird, I know) as well as desipramine. Hard for me to tolerate nortriptyline, could not tolerate protriptyline.

As I suspected. You are a tricyclic responder. You may yet respond to Effexor. If you respond to it, but only partially, you might ask your doctors about adding a second antidepressant to it rather than switching. It would have been nice if your doctors had tried adding lithium to the clomipramine and Prozac.

What was it about nortriptyline that you had trouble tolerating? How long did you take it for, and at what dosage?

If you are not a nortriptyline responder, it may be that you respond only to the imipramine series of drugs (imipramine, desipramine, clomipramine, trimipramine). In this case, amitriptyline would not be your next choice.

How do you respond to Wellbutrin?

Which mood stabilizers have you tried?

Which antipsychotics have you tried? Some of them have antidepressant properties and are known to treat bipolar depression.

I feel confident that you will find a treatment that works. You are not completely areactive to medication. It might take some time, 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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