Posted by SLS on November 4, 2014, at 7:22:12
In reply to Re: Restarted Abilify - Feeling better. » SLS, posted by phidippus on November 3, 2014, at 21:01:16
> Which helped you more? The 5ht1a agonism or the dopamine partial agonism? Or did both help?
It may be that DA receptor partial agonism is essential. However, this does not indicate that 5-HT1a receptor partial agonism is unecessary for Abilify to produce an improvement in my depression, since Abilify is also a 5-HT1a partial agonist. At no time have I tried taking a 5-HT1a partial agonist in the absence of DA partial agonism, so I can't parse the importance of either mechanism.
> I think your running out of pill options, Scott.I have not tried Brintellix, nefazodone, or Luvox. However, at this juncture, I am not inclined to discontinue Parnate in order to try them. If I were to see Brintellix produce magic for people, I would consider it. So far, I haven't.
> Maybe DBS is the way to go.
My doctor will offer it as an alternative occasionally. I have been reluctant to go with DBS. What if they screw up? The idea is nice, but the reality is less than impressive for depression. The numbers aren't there, and they are not even sure what brain structure to target. There are too many variables with depression - more than with Parkinsons.
> Unless you're going to wait for all those fancy new NMDA antagonists. Why don't you do Ketamine infusions?
Good idea. Thanks. This is the direction I will probably head in next. I would first try intranasal ketamine. It is convenient, inexpensive, and effective. I have seen it work. Deep TMS is something that I would consider trying if ketamine fails.
> How have you held on so long?
Early on, I decided to live rather than die. The next decision was to choose to live with a positive attitude rather than a negative one in order to get the most out of life. I then chose to fight to be constructive in order to nurture this positivism rather than to passively allow my depression to create a mind infected with a malignant perpetual negativism. Optimism? I really can't account for it. Perhaps it is the inevitable result of the choices that I described above. Alternatively, it might be the result of some sort of genetic disposition that facilitates resilience. I am very grateful for this.
> ps. you have a tendency not to answer my replies to your posts.
Sorry. If this is true, I cannot account for it. It is not selective or purposeful. In general, I am less apt to post stuff lately. I don't fully understand why. Please don't take it personally.
> If you don't answer this I'll start being mean.
Uh oh. I definitely don't want that!
:-)
I always click on your posts, regardless of what thread you participate in. I am always grateful for the generous attention that you pay to me. I acknowledge the expertise with which you apply your efforts to help me get well.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1072466
URL: http://www.dr-bob.org/babble/20141017/msgs/1073172.html