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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by fiat500 on October 22, 2013, at 23:32:01
I have been a treatment resistant depression/ocd case for 20 years. I struggle with chronic depression accompanying my ocd so it is difficult to do exposure therapy as my mood gets too low when my anxiety increases. I have somewhat of a partial response regime (the best I have been able to find) but still struggle when any pressure or new stress is added as my mood plummets from an already fragile state. Lamictal was the medication that was started that brought me some relief from my ocd/depression so my doctor and I have been working on trying to build on it for years. We are at
300mg lamictal
300mg seroquel
.75mg klonopin
150mg zoloft (can't tolerate 200mg)
30mg remeron (tried 45mg but of no robust help)Does anyone have any ideas as to what I could change? I would like to get off klonopin and I think remeron could be switched for something. My goal is to keep my mood stable enough so I can tough out my ocd. Don't know if any of this makes sense to anyone but any advise would be greatly appreciated.
Posted by jono_in_adelaide on October 22, 2013, at 23:47:58
In reply to Ideas to improve my med regime?, posted by fiat500 on October 22, 2013, at 23:32:01
Change the Remeron for Nortriptyline?
or
Drop the Zoloft and Remeron and take clomipramine in an adequate doseage (150mg/day +)
Posted by Fiat500 on October 23, 2013, at 0:01:28
In reply to Re: Ideas to improve my med regime?, posted by jono_in_adelaide on October 22, 2013, at 23:47:58
Thanks for the advice I will talk to my doctor about it. Nortryptaline could have more efficacy in what way do you think?
Posted by Phillipa on October 23, 2013, at 10:15:39
In reply to Re: Ideas to improve my med regime? » jono_in_adelaide, posted by Fiat500 on October 23, 2013, at 0:01:28
I know it's not popular but luvox is also an option. As well as benzos as ocd is in the anxiety sprectrum. Phillipa
Posted by doxogenic boy on October 24, 2013, at 10:30:34
In reply to Ideas to improve my med regime?, posted by fiat500 on October 22, 2013, at 23:32:01
> 300mg lamictal
> 300mg seroquel
> .75mg klonopin
> 150mg zoloft (can't tolerate 200mg)
> 30mg remeron (tried 45mg but of no robust help)
>
> Does anyone have any ideas as to what I could change?Drop the Remeron and add clomipramine. It works for both depression and OCD.
- doxogenic
Posted by Christ_empowered on October 24, 2013, at 12:14:38
In reply to Re: Ideas to improve my med regime? » fiat500, posted by doxogenic boy on October 24, 2013, at 10:30:34
I'm not an MD or anything, but......maybe up the Klonopin a bit, and switch out the Zoloft for something a little more activating, like Pristiq or Effexor XR or Cymbalta? SNRI drugs are supposed to have good synergy with Remeron. I think Effexor XR is the one they used to create "California Rocket Fuel," but I would imagine Pristiq or Cymbalta could help, too...
...do you find the Seroquel helpful?
Posted by Fiat500 on October 25, 2013, at 1:56:52
In reply to Re: Ideas to improve my med regime?, posted by Christ_empowered on October 24, 2013, at 12:14:38
Very much so. It definitely has some AD effects. Funnily enough I don't find it sedating and I am on IR version.
This is the end of the thread.
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