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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by rubyjay on July 14, 2011, at 20:54:30
Hi all:
Thinking about adding in Riluzole to my cocktail of nuvigil, abilify, levothyroxine, klonopin, prazosin and trazodone--for treatment resistant bi-polar depression. I had great success with lamictal except I kept getting a rash with it (though not THE rash). Been through lots of other meds and ECT two years ago.
Recently we tried to lower the trazodone and it was a disaster, even dropping from 200mg to 175mg. My pdoc thinks I'm not protected enough with the meds I'm on, doesn't think I should have been knocked off balance so much by the traz drop. So we're thinking about riluzole. I'm worried about the liver problems and a bit worried cause I only have one kidney. I have seen warnings about kidney disease, which I don't have, but I do want to be careful with the one I've got. We did bloodwork and I'm seeing my regular doc tomorrow for a physical and to talk about the rilluzole with him as well
ANd I'm wondering if anyone is having success with riluzole? Thanks in advance for any help you might be able to give me!
Ruby
Posted by SLS on July 15, 2011, at 5:22:07
In reply to Recent riluzole experiences?, posted by rubyjay on July 14, 2011, at 20:54:30
> ANd I'm wondering if anyone is having success with riluzole?
No. For me, it was completely inert. I am treating bipolar depression.
- Scott
Posted by rubyjay on July 15, 2011, at 6:55:00
In reply to Re: Recent riluzole experiences?, posted by SLS on July 15, 2011, at 5:22:07
>
> No. For me, it was completely inert. I am treating bipolar depression.
>
Hmm. Sorry to hear that--on both our parts. I hope you've found something else that works.
Posted by SLS on July 15, 2011, at 7:04:52
In reply to Re: Recent riluzole experiences?, posted by rubyjay on July 15, 2011, at 6:55:00
>
> >
> > No. For me, it was completely inert. I am treating bipolar depression.
> >
> Hmm. Sorry to hear that--on both our parts. I hope you've found something else that works.
>
>I have been recovering from depression, albeit slowly.
I am currently taking:
Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 10mg
Lithium 300mg
- Scott
Posted by Phillipa on July 15, 2011, at 10:47:58
In reply to Re: Recent riluzole experiences? » rubyjay, posted by SLS on July 15, 2011, at 7:04:52
Scott glad to hear you are still slowly getting better. Phillipa
Posted by SLS on July 15, 2011, at 12:52:02
In reply to Re: Recent riluzole experiences? » SLS, posted by Phillipa on July 15, 2011, at 10:47:58
> Scott glad to hear you are still slowly getting better. Phillipa
Thanks.
- Scott
Posted by linkadge on July 15, 2011, at 20:36:54
In reply to Recent riluzole experiences?, posted by rubyjay on July 14, 2011, at 20:54:30
what about adding zinc supplements? Zinc is cheap, augments antidepressants, and works in a similar fashon (inhibition of NMDA, boosts BDNF, etc).
Linkadge
Posted by rubyjay on July 15, 2011, at 21:41:08
In reply to Re: Recent riluzole experiences?, posted by linkadge on July 15, 2011, at 20:36:54
Don't know anything about zinc, except that it makes me pretty nauseated. Will pass it by my pdoc who is pretty informed about alternative treatments and such. She's got me on NAC and fish oil in addition to the traditional meds. thanks.
Posted by SLS on July 16, 2011, at 4:57:35
In reply to Re: Recent riluzole experiences? » linkadge, posted by rubyjay on July 15, 2011, at 21:41:08
> Don't know anything about zinc, except that it makes me pretty nauseated. Will pass it by my pdoc who is pretty informed about alternative treatments and such. She's got me on NAC and fish oil in addition to the traditional meds. thanks.
There is a rationale for adding phosphatidylserine to fish oil in that it helps direct the incorporation of fish oil into neuronal membranes. Unfortunately, I react poorly to both of these substances as they exacerbate my depression. This seems to be atypical from what I can see.
- Scott
Posted by rubyjay on July 16, 2011, at 8:24:26
In reply to Re: Recent riluzole experiences? » rubyjay, posted by SLS on July 16, 2011, at 4:57:35
> There is a rationale for adding phosphatidylserine to fish oil in that it helps direct the incorporation of fish oil into neuronal membranes.PS did nothing for me, so you not be missing much.
>
>
> - Scott
Posted by Roslynn on July 18, 2011, at 16:25:08
In reply to Re: Recent riluzole experiences? » rubyjay, posted by SLS on July 15, 2011, at 7:04:52
Scott,
So it IS possible to combine a TCA and an MAOI? I was told they could never be combined.
Does that mean my pdoc is uneducated about combining the meds or is he just extremely cautious?
Roslynn
> >
>
> I have been recovering from depression, albeit slowly.
>
> I am currently taking:
>
> Nardil 90mg
> nortriptyline 150mg
> Lamictal 200mg
> Abilify 10mg
> Lithium 300mg
>
>
> - Scott
>
>
Posted by SLS on July 18, 2011, at 20:02:52
In reply to Re: Recent riluzole experiences? » SLS, posted by Roslynn on July 18, 2011, at 16:25:08
> Scott,
>
> So it IS possible to combine a TCA and an MAOI? I was told they could never be combined.I have had this strategy prescribed for me as early as 1983 by Columbia Presbyterian.
> Does that mean my pdoc is uneducated about combining the meds
Yes.
> or is he just extremely cautious?
I guess the degree of caution exercised on the part of your doctor when considering this combination will be a liability to you and your pursuit of mental health.
You can safely add desipramine and nortriptyline to a MAOI. You might even be able to safely add doxepin or trimipramine. I would advise avoiding imipramine, and especially clomipramine when combining a TCA with a MAOI. This is to avoid precipitating serotonin syndrome.
- Scott
Posted by Roslynn on July 19, 2011, at 11:03:19
In reply to Re: Recent riluzole experiences? » Roslynn, posted by SLS on July 18, 2011, at 20:02:52
Thank you Scott, you are always helpful.
Roslynn
> > Scott,
> >
> > So it IS possible to combine a TCA and an MAOI? I was told they could never be combined.
>
> I have had this strategy prescribed for me as early as 1983 by Columbia Presbyterian.
>
> > Does that mean my pdoc is uneducated about combining the meds
>
> Yes.
>
> > or is he just extremely cautious?
>
> I guess the degree of caution exercised on the part of your doctor when considering this combination will be a liability to you and your pursuit of mental health.
>
> You can safely add desipramine and nortriptyline to a MAOI. You might even be able to safely add doxepin or trimipramine. I would advise avoiding imipramine, and especially clomipramine when combining a TCA with a MAOI. This is to avoid precipitating serotonin syndrome.
>
>
> - Scott
This is the end of the thread.
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