Psycho-Babble Medication Thread 3661

Shown: posts 1 to 7 of 7. This is the beginning of the thread.

 

"It's a hard rain gonna fall"

Posted by Barry G. on March 13, 1999, at 10:26:08

Dear pej.

I think that you should get in touch with Wayne R.
He has had great success with adding Naltrexone with Prozac. This seems to enhance the effects of Prozac and avoids "poop out". I will be trying this approach after a one month drug holiday.

This approach was written up recently in several magazines.

Barry G.

 

Re: "It's a hard rain gonna fall"

Posted by Elizabeth on March 13, 1999, at 11:08:05

In reply to "It's a hard rain gonna fall", posted by Barry G. on March 13, 1999, at 10:26:08

> This approach was written up recently in several magazines.

Which magazines, Barry?

Pej: I know it sucks to play "musical meds" but it's worth it when you find something that works. Here are some other ideas which are less experimental:

* tricyclic - desipramine and nortriptyline have the fewest side effects\
* Luvox or Effexor + tricyclic - the tricyclics are antihistamines and may suppress the itching (be sure to use low doses of both drugs, though, as Luvox and Effexor have pharmacokinetic (metabolism related) and pharmacodynamic (additive effects) interactions with tricyclics
* Remeron
* anticonvulsant - Tegretol, Depakote, or Lamictal (these aren't just for bipolar disorder)
* MAOI - Nardil. Parnate, Marplan
* another benzodiazepine - Ativan. Librium, Serax, Tranxene, Valium, Xanax, etc.
* antipsychotic - Zyprexa. Risperdal, Seroquel (Seroquel would be my first choice)

What exactly is your diagnosis and/or specific symptoms you'd like to deal with, BWT? (The current definition of "depression" is awfully fuzzy, unfortunately)

-elizabeth

 

Re: "It's a hard rain gonna fall"

Posted by pej on March 13, 1999, at 12:32:24

In reply to Re: "It's a hard rain gonna fall", posted by Elizabeth on March 13, 1999, at 11:08:05

> > This approach was written up recently in several magazines.
>
> Which magazines, Barry?
>
> Pej: I know it sucks to play "musical meds" but it's worth it when you find something that works. Here are some other ideas which are less experimental:
>
> Elizabeth,

Major depression, moderate, recurrent. No life...staring at 3 white shirts in the closet and can't decide which to wear..you know-depression. Phil
>
>
>

 

Re: "It's a hard rain gonna fall"

Posted by pej on March 14, 1999, at 6:54:29

In reply to Re: "It's a hard rain gonna fall", posted by Elizabeth on March 13, 1999, at 11:08:05


>>Elizabeth,

I have had anxiety quite a bit along with dep.
This morning I added Wellbutrin to the clonazepam that I recently started (1.5 to 2 mg day).
Trying 150SR. Had not tried it without Paxil so doing a bit of an experiment. Ideas?

> > This approach was written up recently in several magazines.
>
> Which magazines, Barry?
>
> Pej: I know it sucks to play "musical meds" but it's worth it when you find something that works. Here are some other ideas which are less experimental:
>
> * tricyclic - desipramine and nortriptyline have the fewest side effects\
> * Luvox or Effexor + tricyclic - the tricyclics are antihistamines and may suppress the itching (be sure to use low doses of both drugs, though, as Luvox and Effexor have pharmacokinetic (metabolism related) and pharmacodynamic (additive effects) interactions with tricyclics
> * Remeron
> * anticonvulsant - Tegretol, Depakote, or Lamictal (these aren't just for bipolar disorder)
> * MAOI - Nardil. Parnate, Marplan
> * another benzodiazepine - Ativan. Librium, Serax, Tranxene, Valium, Xanax, etc.
> * antipsychotic - Zyprexa. Risperdal, Seroquel (Seroquel would be my first choice)
>
> What exactly is your diagnosis and/or specific symptoms you'd like to deal with, BWT? (The current definition of "depression" is awfully fuzzy, unfortunately)
>
> -elizabeth

 

Re: "It's a hard rain gonna fall"

Posted by Carol on March 15, 1999, at 7:59:31

In reply to Re: "It's a hard rain gonna fall", posted by pej on March 14, 1999, at 6:54:29

pej wrote:
> I have had anxiety quite a bit along with dep.
> This morning I added Wellbutrin to the clonazepam that I recently started (1.5 to 2 mg day).
> Trying 150SR. Had not tried it without Paxil so doing a bit of an experiment. Ideas?


pej: I agree that "medication roulette" is a royal pain. Unfortunately, I went through several years of that.
I'm currently on Wellbutrin that is augmented with a little Desyrel (trazodone) and some lithium. I've been variously diagnosed as having aborderline personality disorder, dysthymia, and atypical depression. Combinations seem to be my best solution, to balance off all the symptoms. This combination also seems to keep me functional and working. I vary the trazodone a little bit at night to balance being able to sleep vs. not being too "druggy" in the morning.

My Dr. has suggested that Wellbutrin (at somewhat high levels) has worked well for him for patients with med-resistant types of depression. I'm very careful with timing the dosage during the day to minimize the side effects.

Good luck. E-mail me if you'd like any more info.

Carol

 

Re: "It's a hard rain gonna fall"

Posted by Barry G. on March 16, 1999, at 14:19:22

In reply to Re: "It's a hard rain gonna fall", posted by Carol on March 15, 1999, at 7:59:31

> pej wrote:
> > I have had anxiety quite a bit along with dep.
> > This morning I added Wellbutrin to the clonazepam that I recently started (1.5 to 2 mg day).
> > Trying 150SR. Had not tried it without Paxil so doing a bit of an experiment. Ideas?
>
>
> pej: I agree that "medication roulette" is a royal pain. Unfortunately, I went through several years of that.
> I'm currently on Wellbutrin that is augmented with a little Desyrel (trazodone) and some lithium. I've been variously diagnosed as having aborderline personality disorder, dysthymia, and atypical depression. Combinations seem to be my best solution, to balance off all the symptoms. This combination also seems to keep me functional and working. I vary the trazodone a little bit at night to balance being able to sleep vs. not being too "druggy" in the morning.
>
> My Dr. has suggested that Wellbutrin (at somewhat high levels) has worked well for him for patients with med-resistant types of depression. I'm very careful with timing the dosage during the day to minimize the side effects.
>
> Good luck. E-mail me if you'd like any more info.
>
> Carol

Dear pej,

The write up was in New York Mag some time in Jan or Feb I believe. You could e-mail a doctor Lee Dante in Philly. He has alot of experience with the use of Naltrexone as an enhanser of antidepressants. Also talk with Wayne R. (on this chat net)who is using this along with Prozac and seems to be doing OK. Let me know how you are doing

Barry G.

 

Re: "It's a hard rain gonna fall" - Phil, Barry

Posted by Elizabeth on March 17, 1999, at 21:17:44

In reply to Re: "It's a hard rain gonna fall", posted by pej on March 14, 1999, at 6:54:29

Phil: For some reason, that picture says "tricyclic" to me. I have a couple more questions but I think it might be worth a try.

Do you tend to be visibly slowed-down? Are you able to cheer up sometimes when something good happens, or do you feel depressed no matter what? What are your eating and sleeping like? The apathy/loss of enjoyment/don't care thing, do you have that?

Desipramine and nortriptyline are probably the best ones in terms of side effects and safety (I believe there are 10 of them - I'm assuming you're in the U.S., if you're not, tell me). You can combine them with other things, though if you do then you should have the tricyclic levels monitored. I found that desipramine was not at all sedating, while nortriptyline made me pleasantly relaxed when I first started it. Desipramine probably has the fewest anticholinergic side effects, nortriptyline has mild ones. Those are the main differences I think.

I hope the Wellbutrin goes okay, but this is something to think about if it doesn't pan out, or if it works partially.

Barry: from what I understand, adding naltrexone to an SSRI is for poop-out, not for augmentation as such.

-elizabeth


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