Psycho-Babble Medication Thread 42844

Shown: posts 1 to 17 of 17. This is the beginning of the thread.

 

Question for AndrewB/Reboxetine augmentation

Posted by Anna P. on August 14, 2000, at 13:06:13

Hi Andrew,

Please help with the augmentation of Reboxetine. I'm currently
on 12 mg Reboxetine and 900 mg Neurontin. I have no side effects
besides extreme sweating. Neurontin works wonders on anxiety.
However, I got only the partial response on depression.

From your experience, what can be added to that combination besides Adrafinil?
Can I add sulpiride to it?
In your trial of Neurontin, did you use Reboxetine+Amisulpride combination?
I'm not shure about combining neuroleptic with the mood stabilizer.
Any other Reboxetine augmentation tips?

I appreciate any help.

Anna P.

 

Re:REBOXETINE/NEURONTIN AUGMENTATION- ANYONE?

Posted by Anna P. on August 14, 2000, at 18:20:03

In reply to Question for AndrewB/Reboxetine augmentation, posted by Anna P. on August 14, 2000, at 13:06:13

> Does anyone knows what to add to Reboxetine/Neurontin combo
if there is a partial response to depression?

I'm currently on 12 mg Reboxetine and 900 mg Neurontin.

I appreciate any suggestions,

Anna P.

 

Re:REBOXETINE/NEURONTIN AUGMENTATION- ANYONE?

Posted by JohnL on August 15, 2000, at 5:01:36

In reply to Re:REBOXETINE/NEURONTIN AUGMENTATION- ANYONE?, posted by Anna P. on August 14, 2000, at 18:20:03

> > Does anyone knows what to add to Reboxetine/Neurontin combo
> if there is a partial response to depression?
>
> I'm currently on 12 mg Reboxetine and 900 mg Neurontin.
>
> I appreciate any suggestions,
>
> Anna P.


Anna,

Here are some ideas to maybe consider...

Amisulpride (I don't know about Sulpride). Amisulpride is a good one. For me it mixes very well with Adrafinil, which in a way is kind of in the same class as Reboxetine.

Don't laugh...
SAM-e, St Johnswort, or both.
In my experience either or both of these seem to really do well as add-ons to other medications. They have both mixed well with Lamictal (same class as Neurontin), Adrafinil, or Amisulpride. Either SAM-e alone or SJW alone for me don't do much, but when added to something else they can be quite surprising. The only bad combo I've ever stumbled onto with these was Paxil+SJW.
They are easy, cheap, and it's something you could start today. Of the two, SAM-e would work the fastest if it is to work. Maybe start there. Don't rule out these 'natural' alternatives. They really can work wonderfully. It's worth a shot. Of the two I think SAM-e would be the better compliment to your ongoing meds.

But in the medication arena, I have to admit my favoritism to Amisulpride. It's a wonderful medication. It works on a broad array of symptoms (depression, psychosis, antisocial, anhedonia, lack of motivation) and has hardly any, if any, side effects.

In that same vein you could consider Zyprexa, though its side effects are more noticeable.

John

 

Re:JohnL

Posted by Anna P. on August 15, 2000, at 11:16:27

In reply to Re:REBOXETINE/NEURONTIN AUGMENTATION- ANYONE?, posted by JohnL on August 15, 2000, at 5:01:36

> > > Does anyone knows what to add to Reboxetine/Neurontin combo
> > if there is a partial response to depression?
> >
> > I'm currently on 12 mg Reboxetine and 900 mg Neurontin.
> >
> > I appreciate any suggestions,
> >
> > Anna P.
>
> Thank you, JohnL. I will consider SAM-e, but are you shure that
neuroleptic can be combined with mood stabilizer? That scares me
a little.
Also, I read in your earlier post you mention some internet site
for combinations with reboxetine.

What do you think about reboxetine combined with SNARI such as venlafaxine?
Plus Neurontin of course.

Anna P.
> Anna,
>
> Here are some ideas to maybe consider...
>
> Amisulpride (I don't know about Sulpride). Amisulpride is a good one. For me it mixes very well with Adrafinil, which in a way is kind of in the same class as Reboxetine.
>
> Don't laugh...
> SAM-e, St Johnswort, or both.
> In my experience either or both of these seem to really do well as add-ons to other medications. They have both mixed well with Lamictal (same class as Neurontin), Adrafinil, or Amisulpride. Either SAM-e alone or SJW alone for me don't do much, but when added to something else they can be quite surprising. The only bad combo I've ever stumbled onto with these was Paxil+SJW.
> They are easy, cheap, and it's something you could start today. Of the two, SAM-e would work the fastest if it is to work. Maybe start there. Don't rule out these 'natural' alternatives. They really can work wonderfully. It's worth a shot. Of the two I think SAM-e would be the better compliment to your ongoing meds.
>
> But in the medication arena, I have to admit my favoritism to Amisulpride. It's a wonderful medication. It works on a broad array of symptoms (depression, psychosis, antisocial, anhedonia, lack of motivation) and has hardly any, if any, side effects.
>
> In that same vein you could consider Zyprexa, though its side effects are more noticeable.
>
> John

 

Re:NEURONTIN, LORAZEPAM, AND...CAR ACCIDENT

Posted by Anna P. on August 15, 2000, at 16:14:51

In reply to Re:REBOXETINE/NEURONTIN AUGMENTATION- ANYONE?, posted by Anna P. on August 14, 2000, at 18:20:03

> >Hello fellow Babblers,

I just realized how much I don't know about the drug that I'm
currently taking - Neurontin. Yesterday evening I went with my
8-year old to the store. I took Lorazepam due to
temporary anxiety, and I was feeling fine. Well
on my way back I became kind of dizzy and drowsy, and hard to focus.
I had the car accident as a result of that feeling.
Now I know there is a drug interaction Neurontin and Lorazepam.
I'm doing fine, just my face is bruised. My litte one is fine.
My car is trashed and needs repair.
Beware of drug interactions.

Anna P.

 

Re:NEURONTIN, LORAZEPAM, AND...CAR ACCIDENT » Anna P.

Posted by Greg on August 15, 2000, at 16:57:14

In reply to Re:NEURONTIN, LORAZEPAM, AND...CAR ACCIDENT, posted by Anna P. on August 15, 2000, at 16:14:51

Anna,

I won't debate drug interactions with you as in this case and many others, you are absolutely right. I did want to say that I thank God that you and your little one are OK. I have 3 children of my own and don't know what I would do I if was to ever lose one. Cars can be replaced, our lives cannot.

Take good care of yourself,
Greg

 

Re:JohnL

Posted by JohnL on August 16, 2000, at 4:51:58

In reply to Re:JohnL, posted by Anna P. on August 15, 2000, at 11:16:27

I will consider SAM-e, but are you shure that neuroleptic can be combined with mood stabilizer? That scares me a little.

....Sure they can be combined. Psychiatrists mix all kinds of weird things. Neuroleptics+mood stabilizers isn't weird at all. The main thing to be aware of is that one or the other med might increase the blood levels of the other. So a reduced dosage of one or the other, or both, would be wise just to be safe. I'm not concerned with various combinations, but rather with how they affect blood levels of ongoing medication. For example, let's say you are taking 100mg of XYZ. Then you add another med. If the second med interferes at all with the meabolism of XYW (it almost surely will, but how much we don't know), then that 100mg of XYZ may accumulate to a blood level of perhaps 125mg or 200mg or whatever. It's metabolism and elimination is slowed down by the second drug, and thus accumulates. Did you know that adding a tricyclic antidepressant to an SSRI can increase the blood levels of the SSRI anywhere from 2 to 9 times? In any combination, that is my main concern...dosage adjustment.

Also, I read in your earlier post you mention some internet site for combinations with reboxetine.

....I was browsing doing research on Reboxetine some time ago, and sure enough, there have been studies combining Rebox with SSRIs and other meds. It has been and is being done.

What do you think about reboxetine combined with SNARI such as venlafaxine? Plus Neurontin of course.

....I don't see any problem with that, especially if Effexor was a low dose. It would primarily work on serotonin at a low dose. At a high dose its NE reuptake might be too much in light of the fact that Rebox is already doing that.

But I have to admit, if the hefty dose of Rebox you are already taking isn't working all that well, that you need to consider an add-on, then I would question if NE deficiency is even a concern in your case. That's why I tend to feel a gut instinct of looking at something that works from a totally different chemistry angle...like SAMe or Amisulpride. Effexor will sort of in a way just kind of be the same as things you're already doing, have done. But SAMe or Amisulpride would attack your symptoms from a brand new completely different angle, and likely be much more complimentary to your ongoing REbox/Neurontin. Am I making any sense?
John
>
> Anna P.
> > Anna,
> >

 

Re:JohnL one more question, please!

Posted by Anna P. on August 16, 2000, at 10:16:12

In reply to Re:JohnL, posted by JohnL on August 16, 2000, at 4:51:58

> I will consider SAM-e, but are you shure that neuroleptic can be combined with mood stabilizer? That scares me a little.
>
>
> Hello John L.

I appreciate your suggestions. I'm considering what my options are at this point.
Since I've tried almost everything, my Dr sees only one choice for me - MAIO's. I'm a little bit reluctant because of a heart and chest pain I was getting after dexedrine, and amineptine. I know that Parnate is amphetamine, highly stimulating medication.
He suggests taking Parnate for my anergic depression. I know this is an excellent choice if not that heart pain. He suggest one week break between Reboxetine and Parnate.
I am wondering is one week really neccesary, as I've read that Parnate shouldn't really interact with Reboxetine (cheese effect).

What about switching into Parnate from Rebox/Sulpiride combo?
(Sulpiride works better for me than Amisulpiride).

I appreciate your help.

Anna P.

 

Re: one more question, please!

Posted by JohnL on August 17, 2000, at 5:29:55

In reply to Re:JohnL one more question, please!, posted by Anna P. on August 16, 2000, at 10:16:12


> I appreciate your suggestions. I'm considering what my options are at this point.
> Since I've tried almost everything, my Dr sees only one choice for me - MAIO's. I'm a little bit reluctant because of a heart and chest pain I was getting after dexedrine, and amineptine. I know that Parnate is amphetamine, highly stimulating medication.
> He suggests taking Parnate for my anergic depression. I know this is an excellent choice if not that heart pain. He suggest one week break between Reboxetine and Parnate.
> I am wondering is one week really neccesary, as I've read that Parnate shouldn't really interact with Reboxetine (cheese effect).
>
> What about switching into Parnate from Rebox/Sulpiride combo?
> (Sulpiride works better for me than Amisulpiride).
>
> I appreciate your help.
>
> Anna P.

Hi again Anna,
Wow, I had forgotten how many different meds you've already tried. Who knows, an MAOI could end up being the magic. As for the washout period, I have read that this is probably not a major concern as it would be if switching from an SSRI to an MAOI. I would definitely stick to your doctor's advice with anything MAOI-related. Having said that, I wouldn't doubt it if you could even overlap the meds while switching without any washout at all. If I were to do that myself, I would start the MAOI at a very small dose and work it in gradually while tapering off the others. Sometimes we accidentally find a sweet spot during these transitions. But even if not, I think it's possible to avoid a washout in your case, using extra caution by keeping doses very low and being on the lookout for anything troublesome so if there are any problems, you can catch them early.

I also wonder what chemistries have been overlooked in your treatment. Probably not many! Let's see...low serotonin. Nope. You've already been there. Low NE. Nope. Treating that now. Low dopamine. Nope. You've tried stimulants and sulpride/amisulpride. Failed NE/dopamine. Nope. Stimulants again. Electrical instability. Nope. Treating now with Neurontin. So what's left? Chemical instability...Lithium? How about EXcess dopamine...antipsychotics???

It just seems to me you've been on all kinds of meds that increase neurotransmitter levels, but haven't been all that successful. An MAOI is going to accomplish the same thing, though in a different way. Maybe that different way will make a good difference. But I wonder. I might instead be inclined to turn my eyes to chemistries that have been missed up to this point. Like excess dopamine for example. We so often think of depression as a neurotransmitter deficiency. But excess levels cause depression too. That's why some people, like me, actually get worse, almost suicidally depressed, when neurotransmitter levels are increased (mainly NE, dopamine somewhat, serotonin somewhat). As we know, people sometimes find a cure for their depression in an antipsychotic when antidepressants failed. That is a chemistry of excess dopamine. Might be worth considering.

So, just one more alternative to add to your short list...perhaps lower the Rebox and Neurontin a little bit, but add in Zyprexa or Risperdal. Zyprexa would be my top choice. Personally I REally like the combination of Adrafinil + Amisulpride. I know you've tried sulpride and amisulpride. But I don't know if you've tried Adrafinil. Regardless, if you've tried either alone, you would be amazed how differently and wonderfully they work together instead of singularly.

Just more stuff to think about. Sorry, I'm just wanting to help, but instead might be making it even more confusing than it already is.
John

 

Re:Greg

Posted by Anna P. on August 17, 2000, at 15:52:18

In reply to Re:NEURONTIN, LORAZEPAM, AND...CAR ACCIDENT » Anna P., posted by Greg on August 15, 2000, at 16:57:14

> Anna,
>
> I won't debate drug interactions with you as in this case and many others, you are absolutely right. I did want to say that I thank God that you and your little one are OK. I have 3 children of my own and don't know what I would do I if was to ever lose one. Cars can be replaced, our lives cannot.
>
> Take good care of yourself,
> Greg

Hello Greg,

Thank you for caring. How are you doing on Lithium? This may be my next step.
How does it feel to be on Lithium?

Anna

 

Re:JohnL - THANK YOU!

Posted by Anna P. on August 17, 2000, at 16:18:58

In reply to Re: one more question, please!, posted by JohnL on August 17, 2000, at 5:29:55

>
> > Hello again John,

Thank you for analyzing my case. I was thinking in a similar way regarding starting the Parnate with no washout in small doses. As to
Neurontin, I was positively surprised by it's effect. I was expecting the sedating, brain-numbing effect and instead I got the energy, and no side effects. But after a while, I began to slide back into depression.
I was wondering wheter it may be receptors desensitisation, or rapid metabolizing.
For example, Aurorex and Revia. Revia was a miracle for me at 6 mg. After 6 months, the dose of 50 mg wasn't helpful anymore.
Anyway, how are you doing John, and what do you take for now?

>
> Hi again Anna,
> Wow, I had forgotten how many different meds you've already tried. Who knows, an MAOI could end up being the magic. As for the washout period, I have read that this is probably not a major concern as it would be if switching from an SSRI to an MAOI. I would definitely stick to your doctor's advice with anything MAOI-related. Having said that, I wouldn't doubt it if you could even overlap the meds while switching without any washout at all. If I were to do that myself, I would start the MAOI at a very small dose and work it in gradually while tapering off the others. Sometimes we accidentally find a sweet spot during these transitions. But even if not, I think it's possible to avoid a washout in your case, using extra caution by keeping doses very low and being on the lookout for anything troublesome so if there are any problems, you can catch them early.
>
> I also wonder what chemistries have been overlooked in your treatment. Probably not many! Let's see...low serotonin. Nope. You've already been there. Low NE. Nope. Treating that now. Low dopamine. Nope. You've tried stimulants and sulpride/amisulpride. Failed NE/dopamine. Nope. Stimulants again. Electrical instability. Nope. Treating now with Neurontin. So what's left? Chemical instability...Lithium? How about EXcess dopamine...antipsychotics???
>
> It just seems to me you've been on all kinds of meds that increase neurotransmitter levels, but haven't been all that successful. An MAOI is going to accomplish the same thing, though in a different way. Maybe that different way will make a good difference. But I wonder. I might instead be inclined to turn my eyes to chemistries that have been missed up to this point. Like excess dopamine for example. We so often think of depression as a neurotransmitter deficiency. But excess levels cause depression too. That's why some people, like me, actually get worse, almost suicidally depressed, when neurotransmitter levels are increased (mainly NE, dopamine somewhat, serotonin somewhat). As we know, people sometimes find a cure for their depression in an antipsychotic when antidepressants failed. That is a chemistry of excess dopamine. Might be worth considering.
>
> So, just one more alternative to add to your short list...perhaps lower the Rebox and Neurontin a little bit, but add in Zyprexa or Risperdal. Zyprexa would be my top choice. Personally I REally like the combination of Adrafinil + Amisulpride. I know you've tried sulpride and amisulpride. But I don't know if you've tried Adrafinil. Regardless, if you've tried either alone, you would be amazed how differently and wonderfully they work together instead of singularly.
>
> Just more stuff to think about. Sorry, I'm just wanting to help, but instead might be making it even more confusing than it already is.
> John

 

Re:Anna

Posted by Greg on August 17, 2000, at 17:31:38

In reply to Re:Greg, posted by Anna P. on August 17, 2000, at 15:52:18

> > Anna,
> >
> > I won't debate drug interactions with you as in this case and many others, you are absolutely right. I did want to say that I thank God that you and your little one are OK. I have 3 children of my own and don't know what I would do I if was to ever lose one. Cars can be replaced, our lives cannot.
> >
> > Take good care of yourself,
> > Greg
>
> Hello Greg,
>
> Thank you for caring. How are you doing on Lithium? This may be my next step.
> How does it feel to be on Lithium?
>
> Anna

Anna,

The first few days on the Lith were...interesting. One time I'd get a loaded feeling, the next my anxiety would go crazy. But now it seems to have mellowed out and is giving me a little peace of mind. My other meds just aren't doing the trick though and I need to find something to stabilize the moodiness and rage. There's lot of things I haven't tried yet so I'll keep searching. If you do end up on Lith drink a lot of water, it can become toxic in your system very easily.

Let me know how it works out for you. I hope everyone is doing OK on your end!

Greg

 

Re:Anna

Posted by JohnL on August 18, 2000, at 4:50:54

In reply to Re:JohnL - THANK YOU!, posted by Anna P. on August 17, 2000, at 16:18:58


Yours is a frustrating story to hear. I mean, even Revia pooped out? That's the one, you know, that is supposed to prevent poop-out. But it pooped. Yikes. Not sure what to make of that. Except that since you did have a good response for several weeks, that indicates there was some involvement of the opiate system. If you ever wanted to return to Revia for a second try, I have heard that doses up to 100mg are sometimes used. 50mg was not the highest. Some people need 100mg.

Anyway, not much to add here. Just babbling. You asked what's going on with me? I'm doing fine for the first time in many years. On a 1 to 10 scale I'm about a 9. For the last 10 years I've bounced between 1 and 4. My magic potion is:

300mg Adrafinil
25mg Amisulpride
200mg SAM-e
7.5mg Remeron

I too responded well to Revia at first, but then it faded. I wonder if our chemistries are similar. But then again, I responded badly to Reboxetine. So maybe we're not that similar. I came to realize I was actually suffering mainly from one powerful symptom of depression--anhedonia. Only my current cocktail has been successful in treating that primary symptom. Strangely, not one of the ingredients alone was all that effective. But miniscule amounts of all of them combined must work in some exaggerated synergistic way, because it sure works. But I admit, it's taken a lot of tweeking, fine tuning, and experimentation to get here. Strangely too, higher doses were not as good. Only when I started lowering doses did I get better.

This is all in agreement with ideas I have come to believe--ideas that are somewhat in contrast to generally accepted psychiatric principles. That is:
The closer a med or cocktail is to treating the real underlying problem, the smaller the dose is needed. When a med is farther away from the real problem, there is a chain reaction trickle down effect--versus a target bullseye--that requires higher doses.
The closer a med is to the real problem, the fewer the side effects.
The closer a med is to the real problem, the faster the results.
The closer a med is to the problem, the more complete the response.

I'm cheering for you. I want your next experimentations to hit a bullseye!
John

 

Re:JohnL. you have been great!

Posted by Anna P. on August 18, 2000, at 17:35:53

In reply to Re:Anna, posted by JohnL on August 18, 2000, at 4:50:54

> JohnL. Thank you for the support - that means a lot to me.
I will try my best. At least my response to Neurontin provides
some clues, as you've mentioned early, maybe to look into different
class of medications. It's nice to hear that you are doing great. You deserve it!

Anna


> Yours is a frustrating story to hear. I mean, even Revia pooped out? That's the one, you know, that is supposed to prevent poop-out. But it pooped. Yikes. Not sure what to make of that. Except that since you did have a good response for several weeks, that indicates there was some involvement of the opiate system. If you ever wanted to return to Revia for a second try, I have heard that doses up to 100mg are sometimes used. 50mg was not the highest. Some people need 100mg.
>
> Anyway, not much to add here. Just babbling. You asked what's going on with me? I'm doing fine for the first time in many years. On a 1 to 10 scale I'm about a 9. For the last 10 years I've bounced between 1 and 4. My magic potion is:
>
> 300mg Adrafinil
> 25mg Amisulpride
> 200mg SAM-e
> 7.5mg Remeron
>
> I too responded well to Revia at first, but then it faded. I wonder if our chemistries are similar. But then again, I responded badly to Reboxetine. So maybe we're not that similar. I came to realize I was actually suffering mainly from one powerful symptom of depression--anhedonia. Only my current cocktail has been successful in treating that primary symptom. Strangely, not one of the ingredients alone was all that effective. But miniscule amounts of all of them combined must work in some exaggerated synergistic way, because it sure works. But I admit, it's taken a lot of tweeking, fine tuning, and experimentation to get here. Strangely too, higher doses were not as good. Only when I started lowering doses did I get better.
>
> This is all in agreement with ideas I have come to believe--ideas that are somewhat in contrast to generally accepted psychiatric principles. That is:
> The closer a med or cocktail is to treating the real underlying problem, the smaller the dose is needed. When a med is farther away from the real problem, there is a chain reaction trickle down effect--versus a target bullseye--that requires higher doses.
> The closer a med is to the real problem, the fewer the side effects.
> The closer a med is to the real problem, the faster the results.
> The closer a med is to the problem, the more complete the response.
>
> I'm cheering for you. I want your next experimentations to hit a bullseye!
> John

 

Re: Question for AndrewB/Reboxetine augmentation

Posted by AndrewB on August 18, 2000, at 17:45:29

In reply to Question for AndrewB/Reboxetine augmentation, posted by Anna P. on August 14, 2000, at 13:06:13

Anna,

My personal experience is that there is no problem combining rebox., amisulpride and neurontin. I had a liver test recently and it came out ok, for what that is worth. I don’t think either reboxetine or amisulpride present a risk of liver toxicity when taken alone or in combo with other drugs. It is my layman’s impression that reboxetine has no identified significant interactions with other psychiatric agents.

When you say you had a partial AD response to neurontin/rebox., are you referring to the transitory response of improved mood and energy you had with neurontin? Is the reboxetine only providing improved arousal? How has the rebox. made you feel. How has the neurontin made you feel recently.

I had a short period of improved mood and energy on neurontin. I think Dr. Bobs Tips section also notes similar responses to neurontin. Some would say such a response is induced mania.

Of course, the question with you is whether your initial responses and poop out to a wide variety of ADs indicates an induction of mania and, therefore, prolonged AD response will not come before effective mood stabilization is achieved.

Dr. Goldstein on his website notes that energy improvement when taking neurontin is common with his CFIDs patients. He ascribes this to the fact that neurontin is an indirect NMDA antagonist. He notes that lamotrigine (another mood stabilizer----- did you already try that one?) and neurontin is often an effective combo. He apparently has had the best results with ketamine nasal spray, an NMDA receptor antagonist, for glutamate hyperactivity induced mood and energy deficits. I wonder whether a transitory positive response to neurontin would indicate that ketamine nasal spray may be effective. Anyway, you may want to check out his site or give his office a call. http://www.drjgoldstein.com/frames/05artbook.html

One final note, never combine two agents with a potential sedative (inhibatory) effects except with extreme caution. This includes alcohol and neurontin, lorazepam and alcohol, and so on. To combine a novel combo of sedative agents and go for a drive is of course a big No No. Anyway, it sounds like you have learned this lesson the hard way. I am so very glad you are alright. I’ve said this before, possibly to your displeasure, but I would feel more comfortable for you (Yes, you scare me) if you trialed your med combos in closer coordination with a qualified psychopharmocologist.

Best wishes ,

AndrewB

 

Re: AndrewB

Posted by Billb on August 18, 2000, at 20:57:48

In reply to Re: Question for AndrewB/Reboxetine augmentation, posted by AndrewB on August 18, 2000, at 17:45:29

Andrew, glad you are back.
Billb.

 

Re:AndrewB

Posted by Anna P. on August 21, 2000, at 15:22:06

In reply to Re: Question for AndrewB/Reboxetine augmentation, posted by AndrewB on August 18, 2000, at 17:45:29

> Hi Andrew,

First of all, I take my meds under the supervision of the excellent psychopharmacologist. Unfortunately, because of high fees, I'm able to see him only about four times a year - I need to travel.
Secondly, about my response to reboxetine/reboxetine-neurontin combo - there was a big difference to bring me to a functional state, I can't say it was mania. It provided energy and no more negative thoughts, and I was finally able to get out of bed, go for a walk and feel normal. Adding Neurontin simply brought back the response, and also Neurontin was excellent for anxiety, and no more oversleeping.
As I know, mania is characterized by pressure to talk fast, racing thoughts and ideas, and decreased need for sleep. Nothing like that happened in my case. However, with time there was coming back of pure depression (no anxiety), especially at the evening every day.

I'm looking to augment my current combo rather then to switch to something else, as it is partially effective.
Unfortunately, I'm allergic to Lamictal, so I can't try that. I will see my Pdoc in three months. This is a long time to cope, so I need to find some help. Of course, my local Pdoc has no clue. He was so much against the combo I tried in the past which was Aurorex + Dexedrine. He is very traditional.
One of the doctors I saw in Mexico mentioned something about rapid metabolizing which can explain why I quickly loose the response. For example, when I took the 4th daily doze of Rebox/Neurontin - the response came back.
I did it only once though, just to see what happens.
Anyway, I still look for options to augment my combo.

Anna


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