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Re: Depression sucks.

Posted by LouisianaSportsman on July 22, 2017, at 18:26:14

In reply to Re: Depression sucks., posted by SLS on July 22, 2017, at 8:37:25

> Hi!
> > I'm doing well on:
> >
> > Zoloft 200mg
> > Forfivo 450mg bupropion
> > Rexulti 2mg
> > Buspar 15mg TID
> > Remeron 30mg QHS
> That's great news. Your treatment shows logic and enlightenment. I really like it. What role does Buspar play?
> > Have you tried Rexulti? It works better than aripiprazole 10mg for me.
> I did try switching from Abilify to Rexulti. Rexulti was neutral. It did not help me as much as Abilify does. After restarting Abilify, I tried pushing the dosage higher than the 10 mg/day I had been taking. I went to 20 mg/day, but found that in impaired my cognitive and memory funtions. It also caused some dysphoria. I have settled on 15 m/day, and I feel better.
> I also tried Vraylar (cariprazine), another D2/3 partial agonist, in place of Abilify. It immediately made me feel horrendous. The increase in the severity of my depression was terrifying. I aborted the trial as soon as possible. I didn't want to get stuck fighting for my survival for the months it would take Vraylar to leave my system. The half-life of Vraylar and its active metabolite can be as long as 2 weeks.
> Overall, I'm feeling moderately improved, and remain encouraged by the trajectory of my antidepressant response. I am currently trying to remove prazosin from the mix. It totally wipes-out my sex drive. It might also be making me feel lazy. I find that I must taper prazosin in order to retain a treatment effect and prevent rebound nightmares.
> - Scott

Very interesting. D3 receptor partial agonism gave you a dysphoric response. I could see it doing that. I bet compulsive behaviors could occur on Vraylar compared to other atypicals. It's unfortunate that your response to brexpiprazole was inadequate. Apparently, it has more antagonistic activity vs aripiprazole? I too have been on seriously every dose of Abilify. I found 10 worked the best. Dosage changes like you reported did temporarily improve symptoms. 2mg thinking it would act as an agonist with 71% stratial D2 binding was worthless in my case. 10mg was more and beyond that point, diminishing returns for me.

My PDOC and I figured a little 5ht1a hit from buspirone would augment nicely with mirtazapine and my SSRI. I never trialed it at a higher dose. My PDOC put me on 15mg three times daily from the jump. I will report when it reaches therapeutic levels. I'm tolerating it well. Concomitantly dosing hs with mirtazapine has lead to "cool" dreams. It also makes me feel more clearheaded, but I'm attributing that to the Rexulti swap from Abilify.

Have you thought about increasing the nortriptyline to 150mg? What if you just took say 5-10mg of the prazosin at night? Are you dosing it during the day?




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