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Re: Update: treatment 37 days; regimen now thoughts? » Louisiana Sportsman

Posted by SLS on June 30, 2014, at 17:40:07

In reply to Re: Update: treatment 37 days; regimen now thoughts?, posted by Louisiana Sportsman on June 30, 2014, at 14:33:29

> > My current treatment regime for bipolar depression:
> >
> > Parnate 100 mg/day
> > desipramine 200 mg/day
> > Lamictal 200 mg/day
> > lithium 450 mg/day
> > prazosin 30 mg/day

> Will you increase the desipramine to 300mg.?

That's the plan. :-)

> That's about as high as I'd dose it with Parnate.

I am a rapid metabolizer of tricyclics. Still, 300 m/day is as high as I am willing to go with desipramine.

> Your lithium dosage is a bit low; I doubt it's even within the therapeutic blood serum level. Consider raising it?

For me, dosages of 300 - 450 mg/day produce a mild antidepressant effect. Higher dosages produce no further improvements, while cognitive effects become pronounced. Lithium is a poor anti-manic for me when mania is precipitated by antidepressants. I continue to take lithium in the hope that it will help to prevent Alzheimers Dementia.

> If you raise the lithium, perhaps you could lower the lamotrigine to 100mg.? It seems to have more of antidepressant effect at lower doses. Might help with cognition and overall sense of being to lower it too. You'll feel better, I didn't realize how strong it was until I went off of it.

That's a good idea. It was my intention to reduce the dosage of Lamictal to 150 mg/day, but I wanted to wait until the other treatment changes settle in.

> You know how the prazosin is working for your symptoms. How is that?

I tried to reduce the dosage of prazosin a number of months ago. I deteriorated quite a bit. I don't think anyone knows exactly how it works, but I came upon a few things that lead me to believe that NE alpha-1b receptors are involved.

Thanks for all of your help. I hope your changes in treatment produce meaningful results.


- 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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