Psycho-Babble Medication Thread 13823

Shown: posts 1 to 24 of 24. This is the beginning of the thread.

 

So much for stability (next med suggestions)

Posted by Bob on October 25, 1999, at 0:27:30

Let's do a quick recap of the story to date:
Been on meds for 2.5 years or so. Had a great initial reaction to Zoloft, went off it after six months, and have never responded well to an SSRI since. Wellbutrin's a no-go for me (didn't see "psychotic rage" listed as a side-effect). Currently have been on 200mg zoloft, 75mg nortriptyline (to augment), and 1 mg clonazepam (for panic).

Good points: rock solid emotional stability (since I went on nortriptyline), more assertive than I've ever been in my life (too bad for my boss ;^).

Bad points: the zoloft 40 (extra pounds) and 80 points to my cholesterol (which, I'm happy to say, is actually down a net 100 points to 180 thanks to lipitor).

Worse points: dead sex life, emotional baseline hovering a little below "numb", and a relationship that is in pieces because of it (the tragic thing about it, even though its keeping me from being quite dark about it, is that damned stability -- I know something's wrong, that I should feel sad, but I don't).

If you know my workplace difficulties, you'll understand why I need stability. But the cost of that stability at home could be too high. I don't know -- I can't feel if this relationship ending is the right or wrong thing.

I meet with my pdoc at 2:30 PM on Monday the 25th (eke! today already!). I'd appreciate suggestions on different combinations to consider.

Stuff I have considered, to start the discussion--oops, and before that I'd like to remind folks that yes, I know different meds affect different people differently, so much for the caveat:

I think it's time to convince my pdoc that SSRIs just ain't my cup of tea. The weight, the cholesterol, the Emotional Limbo ... and zoloft's still the one I've responded to best (besides prozac and paxil). Given that, I think celexa would be a waste of time.

I've read someplace that folks who don't respond to TCAs respond to SSRIs and vice versa. With the arrival of nortriptyline on my medication merry-go-round, I'm beginning to think I might be one of the vice versas.

One last bit: what do all y'all think of swapping remeron in for the zoloft? I'm already experiencing some daytime sleepiness (apnea? drug side effects? does it matter?) so should I also consider dexedrine? If remeron is going to make me sleepy and I'll need to take it in the early evening, then I'm going to have to figure out how to get through the evening classes I teach (7:40-10PM).

Thanks in advance
Bob

PS. While lots of my friends out there in Babbleland have a heckuva lot more expertise on meds than me, I *am* interested in my siamese-brain-twin-separated-prior-to-conception-probably Noa's response -- there's just too much overlap in the things we say for me not to be interested in how you're managing your meds (I just know you've got more than I can keep track of, I think... ;^)

 

Some thoughts (just remember I'm blonde...)

Posted by Racer on October 25, 1999, at 3:13:42

In reply to So much for stability (next med suggestions), posted by Bob on October 25, 1999, at 0:27:30

OK, so it's only the peroxide...

I experienced something similar to the deadened responses to life on Paxil, so my bet would be on the Zoloft for that. Nortriptyline put a ton of weight on me, like 70+ pounds, but I was anorexic then, too... There was no emotional deadening for me, though, on the TCA.

The doctor who prescribes my current drugs calls the deadening 'emotional constipation', which I think is a good name for it.

The best I've found for my depression are the SSRIs, so we're obviously different on that score. On the other hand, the side effects from SSRIs are too much for me, so I can't take them as the only drug. My current combo is Effexor XR/Prozac, and it seems to be great. The Effexor works on the Unholy Trinity of neurotransmitters, so it's not JUST seratonin related, which might help you? If you haven't tried it it might be worth a shot. If it didn't work on its own, augment with another drug. Since the drugs you're now on have had such an effect on your weight, this seems like a thought, since Effexor doesn't seem to be a weight gainer... It's also stimulating for a lot of people, which might be good, too.

That's my best thought on the subject so far. Serzone, of course, lowers blood pressure, so it might be a weight stabilizer, but my experience with it was so bad that it doesn't come to mind as a great choice first for me... I'm just funny that way... Still, there are people who swear by it, proving again that we all react differently.

The nice thing about Effexor for me, besides the fact that it's part of my miracle cure, is that I can FEEL on it. I can be happy. I can be sad. I can be excited. I can be bored. I can channel my inner cartoon character. Whoops! That's a whole nother story there...

 

Re: So much for stability (next med suggestions)

Posted by JohnL on October 25, 1999, at 5:14:26

In reply to So much for stability (next med suggestions), posted by Bob on October 25, 1999, at 0:27:30

Hi Bob. I can sure relate. I think I felt best (but not 100%) on Zoloft. But the same emotional numbness, apathy, and totally dead sex life. I would put my vote in that Zoloft is the problem. I also agree that Celexa is likely (though not definitely) a waste of time in your case.

I think Racer's suggestion of Effexor is a top choice. It can be harder than others to get used to early-on, often requiring smaller doses and slower titration to get used to it. But it is often more effective than SSRIs. I bet the Nortriptyline would go nicely with it. If you went with Effexor, just be aware that the undesirable effects of Zoloft will linger for up to a month after you're completely off it. That's how it was with me. So it could cloud the judgement of Effexor early-on. You'll have to give it some fair time to pass any judgements. It will take time for the sex to return and for the apathy to wear off.

Two more possibilities. There's been a lot of discussion on Selegiline. It would likely boost energy and sex and not have emotional numbness. It just doesn't have much of a track record in depression yet, so it probably wouldn't be viewed as a top choice by your doctor.

Finally, if you think you might want to take a more serious look at the TCAs, Vivactil (Protriptyline) is the black sheep of the family. It is activating, not sedating. It has been said that if Prozac hadn't been invented, Vivactil would be much more popular than it is. It is described as being "suitable for the apathetic withdrawn patient". And other sedating TCAs can be taken with it at night for sleep.

Just some thoughts to ponder.

 

Re: So much for stability (next med suggestions)

Posted by ChrisK on October 25, 1999, at 5:56:26

In reply to So much for stability (next med suggestions), posted by Bob on October 25, 1999, at 0:27:30

Bob,

I'm a lot like you in failure to respond to SSRI's. I've tried Paxil, Celexa, Effexor and Remeron within the past two years. My father reacted well to amitriptyline so I convinced my pdoc to give up on the SSRi's and try the TCA's. I started out on Nortriptyline and have been pretty happy with it ever since. At first I was still having suicidal ideations so after a while I started taking Zyprexa as augmentation. This helped greatly with the suicide problems.

I was still looking for that last little push to get me to feel "good" instead of just stable. Then along came Naltrexone. I had originally asked for it to help me stay sober (too much self-medicating with alcohol). Surprisingly to both my pdoc and me it augmented the TCA wonderfully. I actually feel OK going out and trying new things and I'm starting to enjoy the old things again.

I would strongly reccomend trying a TCA as your primary AD and then if that doesn't work completely work on augmenting that.

Good Luck, let us know how you do.

Chris

 

Re: So much for stability (next med suggestions)

Posted by S. Suggs on October 25, 1999, at 7:58:37

In reply to Re: So much for stability (next med suggestions), posted by ChrisK on October 25, 1999, at 5:56:26

Bob, The combination of Zoloft and nortriptyline is a good comboination. Have you considered lowering your dose of Zoloft to 100 mg and adding lithium 600-900mg/day to augment? Since you are having some typical side effects with Zoloft and a previous positive response, it may be an idea to capture that initial response without the negative side effects. Lithium is an excellent augmentation tool for ssri's and tca'a.

Blessings,

S. Suggs

 

Re: So much for stability (next med suggestions)

Posted by PL on October 25, 1999, at 9:15:15

In reply to So much for stability (next med suggestions), posted by Bob on October 25, 1999, at 0:27:30

Of course I can only give you my experiences.

I tried Remeron and it increased my sexual desire and response and was wonderful for the depression, but I could not stop eating. Plus there was terrific sleepiness in the beginning for me.

I am currently on Celexa 40 mg/day, Wellbutrin, 200 mg. 2x day, and BuSpar, 30 mg/day. My main complaint is not being cured. I have no interest in anything but sleeping and dreaming. Also I am very sleepy most of the day. I do work and have not had any crying jags or suicidal idealation lately, but I need a more motivating drug. I have an awful reaction to TCI's and am just waiting for Reboxetine to be approved because I have a feeling that may work for me.

 

Re: SSRI + Lithium ... been there, done that

Posted by Bob on October 25, 1999, at 12:18:26

In reply to Re: So much for stability (next med suggestions), posted by S. Suggs on October 25, 1999, at 7:58:37

Thanks S for the suggestion

I have tried lithium augmentation to first prozac and then zoloft (150mg of z at the time). It did give a bit of a boost, but then I couldn't tolerate more than 300mg/day of it. 600 felt like someone had set my nerves on fire, particularly in my arms and legs. The nortiptyline came in as a replacement for the lithium.

Bob

PS. Thanks to all so far (and later), this is generating a number of interesting possiblities I wouldn't have come up with. =^)

 

Re: So much for stability (next med suggestions)

Posted by Julie on October 25, 1999, at 12:33:49

In reply to Re: So much for stability (next med suggestions), posted by PL on October 25, 1999, at 9:15:15

Bob,
I have similar responses to you in some ways... Moody but ok most of the time until age 27, when a really bad depression knocked my socks off. It took a year to find the right med. Prozac made me too anxious, so I had to stop after a week; Wellbutrin made me nutty but still depressed; nortryptiline semi- worked, half of the time, and I gained no weight on it; lithium augmentation with the nortrypt didn't seem to do much except make me slur words and trip over my own feet when the dose got too high. No weight gain there either. Finally, I tried Zoloft. It worked well for many years in that it helped me feel completely undepressed, fairly content most of the time in fact. (And I got very assertive at work, too- I just didn't worry about telling off my boss!) But I did have that emotional numbing effect, too. I couldn't cry, even when i wanted to. And the numb sexual response thing. Oh yeah, and the Zoloft 40, my least favorite side effect ever. Work out like a crazed weasel, eat sensibly, and still look 25 lb bigger than I want to. Anyhow, I switched to Effexor 5 months ago and it's been interesting. No depression, thank goodness. More emotional range. I can cry again. I feel extremely happy sometimes, damn sad other times.( When I'm sad, this doesn't feel like such a good thing.) Much better sexual response-- a lot less numb "down there." I notice more self-consciousness in myself. There doesn't seem to be any change in the weight, unfortunately. One thing I'm dealing with today: an occasional missed day of Zoloft never felt like a big deal, but I forgot to take my Effexor yesterday and feel yucky today: buzzy-feeling head, a weird combo of tired and wired, messed-up stomach. If you go for Effexor, remember to take it every day, I guess!

I'm pretty content with the Effexor, but my doc has suggested I might want to try Serzone at some point; he thinks it might help bring the weight down. Any comments from Babblers on Serzone and weight?

 

Re: So much for stability (next med suggestions)

Posted by JohnL on October 25, 1999, at 12:51:07

In reply to So much for stability (next med suggestions), posted by Bob on October 25, 1999, at 0:27:30

Hi Bob. Just a follow-up. Lowering the dose of Zoloft is a logical option. However, in my experience it may relieve some of your complaints but it will do nothing for the dead sex. If Zoloft affects your sex, I think you'll find even 25mg or drug holidays will be no help at all. It really takes about 3 or 4 weeks for the sex stuff to come back after being completely off Zoloft. It would seem logical that a smaller dose would help in this regard, but it doesn't work that way. Therefore since this is a concern, whatever you do I think will involve ditching the Zoloft.

 

Ditching the Big Z

Posted by Bob on October 25, 1999, at 13:02:46

In reply to Re: So much for stability (next med suggestions), posted by JohnL on October 25, 1999, at 12:51:07

Thanks, JohnL, I had much the same thoughts.

Well, I'm off to the pdoc, but please keep posting, folks. I know this won't be settled for me in the next hour or so, so I still need your opinions and suggestions ... besides, this sort of crash-course thread seems to be quite generative ....

Bob

 

Re: Ditching the Big Z

Posted by Adam on October 25, 1999, at 14:31:01

In reply to Ditching the Big Z, posted by Bob on October 25, 1999, at 13:02:46

Does ANYBODY prescribe MAOIs anymore?

Bob, I had major lack of affect on Zoloft. I got a bit too free with my tongue too, and I can
be a mighty sarcastic little prick when I'm in the mood. Wasn't good. Plus weight gain, plus
sexual problems. And I just wasn't all that happy.

Nothing else has done much either, except selegiline for me. Have you tried any MAOIs?

Just a thought...

> Thanks, JohnL, I had much the same thoughts.
>
> Well, I'm off to the pdoc, but please keep posting, folks. I know this won't be settled for me in the next hour or so, so I still need your opinions and suggestions ... besides, this sort of crash-course thread seems to be quite generative ....
>
> Bob

 

Re: Ditching the Big Z

Posted by Bob on October 25, 1999, at 14:50:50

In reply to Re: Ditching the Big Z, posted by Adam on October 25, 1999, at 14:31:01

> Have you tried any MAOIs?

Nope, and that's a tad more radical a step away from what I'm doing now than I can afford to take ... so maybe, someday down the road. I've followed a few of the threads on MAOIs to pique my interest -- all the stuff I'd seen about it (mostly those "you're on X so don't take an MAOI because it can kill you" and little else) gave it this boogey-monster treatment profile, right alongside ECT. ;^)

One thing I can say about my pdoc, he wants to KNOW what is causing any change. Therefore, one variable at a time. I'll be tapering off the Z, and after a month or so of washout (and maybe a slight increase on the nortriptyline) we'll see if I need something to augment the TCA. Right now, he's partial to wellbutrin over the other non-SSRI/TCA/MAOI meds. While I had a problem with it solo, I do have to admit that it did help me under a very special circumstance. I was trying to washout paxil from my system prior to starting wellbutrin. The withdrawal from paxil, tho, was quite unbearable (that's what Noa annointed as my Chicken Little story in a thread above). He had me start on wellbutrin 300mg/day immediately. For about one month, I had my best response to meds while still in control. Once the paxil HAD cleared, tho, that's when the little red Bob with the horns, pitchfork, and barbed tail that sits on my left shoulder started whispering nasty nothings in my ear. In retrospect and in reference to the response of other patients of his, he thinks jumping into the "deep end" may have been the source of my problem with wellbutrin. He's had patients respond quite well to wellbutrin as an augmentor at dosages of 50mg or 100mg per day.

Remember those rages puts a fright into me that's really hard to face, but I'm trying to keep an open mind.

So, in the interest of keeping that mind open, feel free to put in your two cents, folks. I've got a month to decide.

Bob

 

Re: Ditching the Big Z

Posted by Noa on October 25, 1999, at 21:23:31

In reply to Re: Ditching the Big Z, posted by Bob on October 25, 1999, at 14:50:50

Bob, I don't know what to tell you. Effexor works better for me that Prozac, Paxil, or Wellbutrin, if only because I tolerate it better. But there is still: sexual dysfunction, sleeplessness, motoric "twitches" (myoclonus) and at higher doses, word retrieval problems. Regular effexor also caused buckets of sweat, from my head of all places. And yep, I am on a boatload of meds, effexor plus augmentors (Serzone, ritalin, synthroid, and cytomel). My doc talks about going to either lithium or an anticonvulsnant next, if needed, although I think he would prefer I try an MAOI, which I am loathe to do because of fears about what I would do if I have a cold and can't take decongestants (remember, I am dependant on the nasal CPAP machine to sleep, and having the ability to sleep without starving my brain of oxygen is something that once accomplished, I am loathe to risk losing again). There are long threads above about some of the MAOIs that you probably should check out, as well as those on neurontin and lamictal as augmentors to ADs. BTW, you are under a lot of stress right now. Job, relationship, etc. Also BTW, that was one damn long episode of labor for the mama that bore us separated at birth conjoined brains--something like 4 years or so, no??? Even more BTW, when our conjoined brains were separated, I think you got the assertive side. Been looking for it all these years.....

 

Re: Ditching the Big Z

Posted by Noa on October 25, 1999, at 21:25:35

In reply to Re: Ditching the Big Z, posted by Noa on October 25, 1999, at 21:23:31

PS, how does your thyroid check out?

 

Re: Ditching the Big Z

Posted by Noa on October 25, 1999, at 21:28:15

In reply to Re: Ditching the Big Z, posted by Noa on October 25, 1999, at 21:25:35

Damn that impulsivity of mine. I should have thought all this through....more PS..
BOB, are you still SNORING????? If you have apnea, it doesn't matter much what *%#$@* AD you are on, you gotta take care of that apnea.

AND, are you in therapy--to process all the &@#$&^$%# you are going through????

 

Re: Ditching the Big Z

Posted by Cindy on October 25, 1999, at 21:45:50

In reply to Re: Ditching the Big Z, posted by Noa on October 25, 1999, at 21:28:15

> Damn that impulsivity of mine. I should have thought all this through....more PS..
> BOB, are you still SNORING????? If you have apnea, it doesn't matter much what *%#$@* AD you are on, you gotta take care of that apnea.
>
> AND, are you in therapy--to process all the &@#$&^$%# you are going through????
Bob, Noa, and everybody on this thread...have you tried Serzone? (I guess you said you are taking it, Noa,along with lots of other stuff!).It initially made me feel moody, angry, tense, tired, but that WENT AWAY after about a week! And it has no sexual side effects (unlike Prozac, Luvox, Zoloft). I need to ask the psychiatrist about adding something for OCD but all the SSRI's seem to cause sexual side effects. I'm not willing to take anything that makes me more depressed than I started out...so I ditched the Big Z recently (I'm not giving up the Big O for the Big Z!)--C

 

Re: Ditching the Big Z

Posted by Phil on October 26, 1999, at 6:44:24

In reply to Re: Ditching the Big Z, posted by Bob on October 25, 1999, at 14:50:50

> > Have you tried any MAOIs?
>
>
>
>
> So, in the interest of keeping that mind open, feel free to put in your two cents, folks. I've got a month to decide.
>
> Bob

>>Hey Bob,
I had great luck with Amitrip. years ago, side effects weren't much fun. I could sleep through anything and wake up feeling GOOD. Even with the SE, I may go back to a TCA. My experience with
Serzone-Worthless-Made me mean!
Luvox-Trip to ER, heart racing
Effexor-Worked, then the itching started-HIDEOUS
What I have read about Rebox. sounds very promising but I know the paradox about these
little pills. I will probably wait to drop ZOloft
when Rebox is available. If that sucks...back to TCA's. Good luck, Bob.
Phil


 

Long labors lost and glandular regularity

Posted by Bob on October 26, 1999, at 9:05:05

In reply to Re: Ditching the Big Z, posted by Noa on October 25, 1999, at 21:25:35

> PS, how does your thyroid check out?

Just fine. Can't blame it on that. When I first heard about thyroid being a problem, I ran off to my GP and asked. He said that's the first thing he tested, and its been fine from the beginning.

As for the labor bit, I dunno about the age -- I'm 37. But who knows, maybe it took that angel responsible for brain implants up in the baby factory to saw our two minds apart. I didn't get the assertiveness, tho, it's drug-induced. Or, perhaps, I did and its drug-enabled.

The surprising thing about both the job and the relationship thing for me is that they aren't all that stressfull. If I hadn't taken any action and allowed myself to become victimized by it all, then I;m sure I'd be buckling under it all. Instead, I feel empowered. I am making decisions to improve my life and to give up accepting bad things as what I deserve. On top of that, I have a conservative, thorough pdoc who has made sure I have strategies to get back to my current safe zone if need be.

Bob

 

zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

Posted by Bob on October 26, 1999, at 9:17:59

In reply to Re: Ditching the Big Z, posted by Noa on October 25, 1999, at 21:28:15

> Damn that impulsivity of mine. I should have thought all this through....more PS..
> BOB, are you still SNORING????? If you have apnea, it doesn't matter much what *%#$@* AD you are on, you gotta take care of that apnea.

Yes, mom! =^P
The steroid inhalent my GP prescribed is doing a pretty good job at keeping my nasal passages open wide. Plus, I've been managing to sleep on my side, which helps considerably, and stay that way since my 70lb German Shepard like to curl up behind my legs.

> AND, are you in therapy--to process all the &@#$&^$%# you are going through????

Yep, for about 4 years now, and it drives my girlfriend nuts all the time. She, being a classical Freudian to the bone, seems to think that therapy should be a jousting match. I get the feeling that her definition of when enough is enough is when the "student" has learned to unhorse the "teacher" 9 out of 10 falls or something like that. My therapist, on the other hand, has a far more holistic, even spiritual, approach. My girlfriend challenges me with cynicism as her lance ... well, I can't complete the analogy because my therapist isn't in to fighting.

Cheers,
Bob

 

Re: Ditching the Big Z ... gimme an O!

Posted by Bob on October 26, 1999, at 9:24:11

In reply to Re: Ditching the Big Z, posted by Cindy on October 25, 1999, at 21:45:50

> (I'm not giving up the Big O for the Big Z!)--C

HAH! My psychodynamic partner also criticises my therapist for being more of a cheerleader than a therapist ... but maybe that's exeactly what I (maybe well all) need -- a cheer team.

Gimme an O! Gimme another O! Gimme another!

Bob

 

Re: zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

Posted by Bob on October 26, 1999, at 21:35:59

In reply to zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz, posted by Bob on October 26, 1999, at 9:17:59

> > Damn that impulsivity of mine. I should have thought all this through....more PS..
> > BOB, are you still SNORING????? If you have apnea, it doesn't matter much what *%#$@* AD you are on, you gotta take care of that apnea.

And another thing ...

I have an appointment with one of those doctors that specialize on your nose, sinuses, etc. Can't remember what they're called, but I heard they get paid by the syllable so I bet it's long. Anyway, I'll be in to get my head inspected (in a different manner than usual) to look for structural defects. My gp thinks that most apnea cases get down to structural issues, so he doesn't see the point in doing a sleep study yet.

Bob

(man, I just read through some of those mid-day posts of mine ... I was fighting off a sleep attack ... I vaguely remember typing it in, but I thought I caught all the typos ... [shrug])

 

Re: Ditching the Big Z

Posted by torchgrl on October 27, 1999, at 20:19:45

In reply to Re: Ditching the Big Z, posted by Phil on October 26, 1999, at 6:44:24

I'm not really awake enough to get into a supremely in-depth discussion on this, but had to put my 2 cents in on the Remeron issue--specifically that when I gave it a try, I not only couldn't stop eating, almost literally, but was so comatose that I couldn't move my arm enough to hit the snooze button when my alarm filtered through to my brain the next morning. Both got a little better at the higher dose, but if you're susceptible to the sedation, you might want to be wary of this one--I still cringe in fear when I see the name. Needless to say, it didn't survive very long in my medication arsenal. I'll let you all know how the reboxetine study goes, since I know I'm not the only one who's been waiting and waiting for it to be available in the U.S.--maybe it would be a good thing for you to look into once it's more readily accessible...

> > > Have you tried any MAOIs?
> >
> >
> >
> >
> > So, in the interest of keeping that mind open, feel free to put in your two cents, folks. I've got a month to decide.
> >
> > Bob
>
> >>Hey Bob,
> I had great luck with Amitrip. years ago, side effects weren't much fun. I could sleep through anything and wake up feeling GOOD. Even with the SE, I may go back to a TCA. My experience with
> Serzone-Worthless-Made me mean!
> Luvox-Trip to ER, heart racing
> Effexor-Worked, then the itching started-HIDEOUS
> What I have read about Rebox. sounds very promising but I know the paradox about these
> little pills. I will probably wait to drop ZOloft
> when Rebox is available. If that sucks...back to TCA's. Good luck, Bob.
> Phil

 

Re: So much for stability (next med suggestions)

Posted by saint james on October 29, 1999, at 4:27:10

In reply to So much for stability (next med suggestions), posted by Bob on October 25, 1999, at 0:27:30

> Let's do a quick recap of the story to date:
> Been on meds for 2.5 years or so. Had a great initial reaction to Zoloft, went off it after six months, and have never responded well to an SSRI since.

James here....

Hmmm.... generally TCA's are more effective for severe depression and and SSRI's work beter for less severe depressions. I get the feeling you did best on the TCA ? If so work on augmenting it, or what ever worked the best. How about Pindolol + TCA or something else ? I can't remember if you tried opioids, like Naltrexone and others ? I have been off the net for a week due to a major computer overhall (with several choice works to Mr Gates ! ) so I have forgotten peoples Hx.

Effexor XR + TCA or Remeron is a big gun, too. Seems to cover all the bases, neuro transmitter wise. When I was on Effexor + TCA I found I could get the TCA down to a small dose so it had less of an effect on sex drive.

j

 

Re: TCAs

Posted by Bob on October 29, 1999, at 12:31:46

In reply to Re: So much for stability (next med suggestions), posted by saint james on October 29, 1999, at 4:27:10

> Hmmm.... generally TCA's are more effective for severe depression ...

When I made the switch to nortriptyline from lithium as an augmentor for zoloft, particularly after a few months of letting it settle in, I really did feel it was the TCA that was giving me the biggest boost ... my pdoc and girlfriend/doc disagreed given how swiftly I'd crash even reducing my dose of an SSRI. I'm finally getting a chance to check that out. Immediately after starting the nortrip, I dropped to 150mg on zoloft and it hit me immediately ... but who's to say whether that was less zoloft or a new med causing the trouble? Now, I'm close to a week in dropping from 200mg to 100mg of Z and not much in terms of effects ... a little leg bouncing, a little spaciness, that's it. Well, as my pdoc said, we'll see how its going when we get down to 25mg every other day....

Anyway, as a number of you have mentioned (most recently torchgrl and st. james), I'm putting my money on the TCA plus some augmentation if needed (and it probably will be). I'm also keeping a close eye on the Rebox posts to see how those go. My pdoc is methodical, so it will be at least a month (barring a major crash) before I check on aumentation.

Thanks again for all y'all's support ... it's given me a lot to think about and, as usual, you've all taught me quite a bit.
Bob


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.