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Re: I don't think I have any options left » g_g_g_unit

Posted by SLS on June 13, 2016, at 14:01:16

In reply to Re: I don't think I have any options left » SLS, posted by g_g_g_unit on June 13, 2016, at 8:29:41

> > It might be worth considering yourself as being bipolar temporarily - at least for the sake of experimentation with different drugs. Have you ever combined Lamictal, Abilify, and low-dose lithium?

> I've never tried any of the drugs you listed, and would probably avoid Abilify because of akathisia (which I'm currently experiencing anyway)

Rexulti (brexpiprazole) has less of a liability for causing akathisia than Abilify (aripiprazole).

Have you tried Saphris (asenapine)?

Viibryd (vilazodone)?

Brintellix (vortioxetine)?

Which drugs caused you experience akathisia? How about Zoloft?

> My general concern is how I will tolerate anything at this point due to the HPA-axis dysfunction, given my reaction to e.g. Reboxetine.

My guess is that more people with depression have HPA-axis stuff going on than there are who don't. Also, there is probably some degree of dysautonomia. I almost committed suicide on reboxetine. I respond well to desipramine. It is difficult to predict in the real world according to what we see on paper. Too many theories. Some work, some don't. In your case, I would play dumb and not to be quick to exclude drugs from consideration. What do you think? You know your body and mind best.

> > Which antidepressants have provided you with the most improvement? I am particularly interested in how you react to Wellbutrin. Did it help, or did it make you feel worse with anxiety and anger?

> I only really had luck on Parnate, but it was horrible for anxiety. I didn't like how I felt on Nardil (too disinhibited) and I felt spacey.

I responded amazingly well to Nardil the first time I took it. I believe that the disinhibition would abate and the spaciness disappear altogether. How did you titrate the dosage? Lots of people feel euphoric or hypomanic when they first start Nardil. Perhaps this is where your sense of disinhibition comes from. This euphoria is almost a passing startup effect when treating unipolar MDD. However, this is not necessarily true of people with bipolar disorder. In this case, Nardil can trigger true mania.

> I tried Wellbutrin about 10 months ago when my symptoms began; it did not improve my physical fatigue at all, which surprised me .. I think it had some modest effects on mental energy, but no, I don't recall feeling angrier.

This is good. You might want to try combining Wellbutrin with Effexor, and perhaps adding Lamictal if necessary.

> > Intranasal administration of ketamine works for a great many people. IV admistration is not always necessary.
> >
> > "Intranasal Ketamine Produces Long-Lasting Antidepressant Effects"
> >
> > http://bipolarnews.org/?p=3791
> >

> There is a trial for intranasal Ketamine underway but again, there's the question of whether I would tolerate it, or even qualify for the trial, given my symptoms.

What symptoms of yours would you be disqualified for?

I had my doctor prescribed ketamine to be prepared for intranasal administrating using a local compounding pharmacy. If you react badly to it, you can either adjust the dosage or stop taking it completely. Ketamine leaves the body very quickly. You could start with "subtherapeutic" doses of intranasal ketamine to test the waters.

Feeling "weird" or "spacy" on a drug in the beginning is not always a bad thing - as long as it does not making you feel worse. For me, this was true of Nardil. It was also true of adding desipramine to Parnate.

I hope something here helps you.


- 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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