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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by med_empowered on July 30, 2005, at 2:23:33
hey! So, my mood has been a little better later, thankfully, but I still have been researching potential treatments for my depression/anxiety. Basically, my exact diagnosis is up in the air; some docs lean toward severe, recurrent depression (sometimes atypical) with occasional psychotic features...others lean towards an odd variant of Bipolar II, other BP I, sometimes BP NOS...its frustrating. Anyway, what about Surmontil? It seems to have a kind of Clozapine-esque profile, so it looks like it'd have very *minor* neuroleptic-like effects, without true anti-psychotic efficacy (and without the EPS and TD that goes along with it). So, I'm kind of thinking that since I respond well to micro-doses of Abilify (which is an oddball neuroleptic anyway) along with an anti-depressant, maybe this would be like a combination of the two, only for lower cost and with fewer overall side effects? I'm EXTREMELY sensitive to EPS, which makes me avoid neuroleptics since I (understandably) fear that my EPS-sensitivity and mood disorder would put me at a greater risk of TD. I've considered amoxapine/Asendin, but it seems like there are some real problems with it...namely, lots of people quickly develop tolerance to it and no one really knows the likelihood of EPS/TD development, even though its been used as an antidepressant for years (and there's research into using it for schizophrenia). Surmontil, on the other hand...seems like a sedating, calming antidepressant with mild neuroleptic effects...apparently the neuroleptic effects don't reach full-fledged antipsychotic potency until the dose jumps to 400mgs or so (that's the dosage used in one study I read about using it for schizophrenia), and even then the symptom control (and presumably D2-receptor occupancy as well) is kind of spotty compared with other available neuroleptics. Soooo...is it worth trying? Does anyone have suggestions or experiences? I know it may seem odd that I'm researching my own treatment instead of placing myself in the hands of a doc right away, but...I've had bad experiences with shrinks. Plus, docs around here aren't terribly creative or innovative...visiting a local shrink is more like going to an automechanic for a tune-up than anything else. I need to have a plan of action before I go see someone if I really want to get better. Thanks again for all your help!
Posted by ed_uk on July 30, 2005, at 4:20:55
In reply to What about...Surmontil?, posted by med_empowered on July 30, 2005, at 2:23:33
Hi Med,
Surmontil is a weird TCA because it doesn't inhibit the reuptake of NE or 5-HT. I wouldn't expect Surmontil to induce mania very often, which is a good thing since you're (probably) bipolar.
Surmontil is often very effective for insomnia. Do you suffer from insomnia?
Kind regards
~Ed
Posted by linkadge on July 31, 2005, at 21:05:13
In reply to Re: What about...Surmontil? » med_empowered, posted by ed_uk on July 30, 2005, at 4:20:55
My mother tried surmontil. Although she said it helped her sleep, she said it was very dirty and had like no antidepressant properties.
Linkadge
This is the end of the thread.
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