Psycho-Babble Medication Thread 1098610

Shown: posts 1 to 11 of 11. This is the beginning of the thread.

 

Add-ons to California Rocket Fuel?

Posted by Leah0982 on May 8, 2018, at 15:25:04

Hi, I am currently on the Effexor-Remeron combo, for many months now and at the highest dose possible for each med.

I am getting *maybe* only a minimal response..but I haven't responded to anything else at all. And running out of options.

Are there any meds that could augment this combo?

I would like to go to my doctor and say, hey, what about adding on x?

(I think my dr tends to think of one thing at a time, whereas some drs will do more add-ons here and there, possibly.)

Thanks for any help!

 

Re: Add-ons to California Rocket Fuel?

Posted by rjlockhart37 on May 8, 2018, at 19:15:38

In reply to Add-ons to California Rocket Fuel?, posted by Leah0982 on May 8, 2018, at 15:25:04

first thing comes to my mind is provigil but there's others but main add on would be abilify or rexulti

 

Re: Add-ons to California Rocket Fuel?

Posted by SLS on May 8, 2018, at 19:25:57

In reply to Re: Add-ons to California Rocket Fuel?, posted by rjlockhart37 on May 8, 2018, at 19:15:38

> first thing comes to my mind is provigil but there's others but main add on would be abilify or rexulti

Good ideas.


- Scott

 

Re: Add-ons to California Rocket Fuel?

Posted by Christ_empowered on May 8, 2018, at 19:50:48

In reply to Re: Add-ons to California Rocket Fuel?, posted by SLS on May 8, 2018, at 19:25:57

what are your current problems? provigil, nuvigil, ritalin, or focalin come to mind. I would think that there'd be something of an increase in the risk of serotonin syndrome, especially with ritalin or focalin, but...maybe not (?). Clearly, I'm not an expert, I'm just throwing stuff out there for you.

if anxiety and such is an issue, maybe a benzodiazepine? not klonopin, though...that might make the depression worse. xanax has an increasingly bad reputation, but it can help some forms of depression. there's an xr formulation out now, maybe your doctor might consider that. or ativan or valium.

Another poster mentioned Abilify or Rexulti. Those could be good options...but I'd caution against a tranquilizer/antipsychotic if you have problems with lethargy, fatigue, lack of motivation, apathy, etc. already. Oh, and the TD risk. That's...always an issue. I say that as someone who takes Abilify daily, btw.

I suppose the ultimate booster would be an amphetamine. Not a good idea if psychosis, agitation, mood instability, etc. are already on board or have been an issue in the past. Again, serotonin syndrome would be something to think about. The end of the day "crash" was more of an issue for me w/ amphetamines than with Ritalin, but I imagine that varies from person to person, dosage, formulation, blah blah blah.

I did read about a modified California Rocket Fuel that used Cymbalta instead of Effexor. I'm not an expert on the 2, but I think Cymbalta dosing is fairly easy...60mgs was standard, one could go up to 120...and maybe a switch would do you good?

Other than that, I don't have anything to suggest. Sorry about that. I hope things work out for you.

 

Re: Add-ons to California Rocket Fuel? » Christ_empowered

Posted by Leah0982 on May 9, 2018, at 14:50:19

In reply to Re: Add-ons to California Rocket Fuel?, posted by Christ_empowered on May 8, 2018, at 19:50:48

> what are your current problems? provigil, nuvigil, ritalin, or focalin come to mind. I would think that there'd be something of an increase in the risk of serotonin syndrome, especially with ritalin or focalin, but...maybe not (?). Clearly, I'm not an expert, I'm just throwing stuff out there for you.

Hi, thank you for your response. I'm still very depressed even on the drug combo. I react poorly to stimulants, very tense and angry. The same for abilify, for some reason.

> if anxiety and such is an issue, maybe a benzodiazepine? not klonopin, though...that might make the depression worse. xanax has an increasingly bad reputation, but it can help some forms of depression. there's an xr formulation out now, maybe your doctor might consider that. or ativan or valium.
>
I do take xanax prn.

Are there any ADs that can be added on to Calif. Rocket Fuel or is that too dangerous?

 

Re: Add-ons to California Rocket Fuel?

Posted by linkadge on May 9, 2018, at 19:27:19

In reply to Re: Add-ons to California Rocket Fuel? » Christ_empowered, posted by Leah0982 on May 9, 2018, at 14:50:19

You might try lithium, folic acid and/or omega 3.

I currently take low doses of Effexor and venlafaxine (higher doses actually make me more depressed).

I have responded well to lithium augmentation.

Do you have any anxiety, or is it purely depression?

Linkadge

 

Re: Add-ons to California Rocket Fuel? » Leah0982

Posted by bleauberry on May 10, 2018, at 5:56:13

In reply to Add-ons to California Rocket Fuel?, posted by Leah0982 on May 8, 2018, at 15:25:04

Yes. Add Ritalin. Try that and if there is any dislike after a month, switch to Adderall instead.

I could spend the next hour explaining why. I don't have an hour.

Ritalin. Don't add another antidepressant.

> Hi, I am currently on the Effexor-Remeron combo, for many months now and at the highest dose possible for each med.
>
> I am getting *maybe* only a minimal response..but I haven't responded to anything else at all. And running out of options.
>
> Are there any meds that could augment this combo?
>
> I would like to go to my doctor and say, hey, what about adding on x?
>
> (I think my dr tends to think of one thing at a time, whereas some drs will do more add-ons here and there, possibly.)
>
> Thanks for any help!

 

Re: Add-ons to California Rocket Fuel?

Posted by Leah0982 on May 10, 2018, at 14:40:05

In reply to Re: Add-ons to California Rocket Fuel?, posted by linkadge on May 9, 2018, at 19:27:19

Thank you for your input! I may look up the folic acid supplementation. Right now my only supplement is Vitamin D3 5000 IU.

 

Re: Add-ons to California Rocket Fuel?

Posted by Christ_empowered on May 10, 2018, at 16:15:35

In reply to Re: Add-ons to California Rocket Fuel?, posted by Leah0982 on May 10, 2018, at 14:40:05

hi. again; I'm not any sort of expert or anything, I'm just...you know, some dude from The Internet. Keep that in mind, LOL.

It dawned on me that BuSpar (buspirone) might be OK. Its cheap, generic, not a controlled substance. It's FDA approved for some forms of anxiety. I forget the details, but it has some overlap with low dose 'atypical' tranquilizers...w/o the TD, metabolic risk, and high costs.

anyway, its actually not the most effective thing ever, used alone, but it can be used to boost under-performing antidepressants. I don't know if its the best idea, since you're on 2 full dose antidepressants, and you'd also have to somehow factor in drug-drug interactions, but...

I guess just ask the shrink and see what he or she says. If I remember correctly, its dosed 3x daily, with a total dose of 15-60mgs.

good luck!

 

Re: Add-ons to California Rocket Fuel?

Posted by linkadge on May 20, 2018, at 15:05:50

In reply to Re: Add-ons to California Rocket Fuel?, posted by Leah0982 on May 10, 2018, at 14:40:05

You might experiment with a little less vitamin D? I know high vitamin D made me feel more depressed, whereas lower doses seemed to help.

Linkadge

 

Re: Add-ons to California Rocket Fuel?

Posted by JohnBoy2000 on June 11, 2018, at 16:16:32

In reply to Re: Add-ons to California Rocket Fuel?, posted by linkadge on May 20, 2018, at 15:05:50

I was on this combo before with similar response

I also took ritalin with it which helped a little

Duloxetine has a far greater enzymatic inhibition that Effexor - btw

You may consider Atomoxetine - as it combines well with mirtazapine and effexor - in terms of enzymes, protein binding etc

That would enhance noradrenaline

I don't think you could saturate serotonergic transmission more - but you could boost noradrenergic transmission - which is what atomoxetine would do.

You can also consider substituting mirtazapine for mianserin - the response may be subjective.


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