Posted by AlexCanada on September 8, 2012, at 18:17:56
In reply to Re: Modafinil Issues Ugh. Also need help w Memory!! » AlexCanada, posted by SLS on September 7, 2012, at 8:07:57
> You are very badly afflicted. I am guessing that you are experiencing psychomotor retardation. I doubt that I would have much to offer regarding treatment alternatives for you. For melancholic depression, tricyclics seem to be more effective than SSRIs. However, I would not rule-out combining a noradrenergic tricyclic (desipramine, nortriptyline) with SRI (Zoloft, Effexor). In my way of thinking, you would be a candidate for treatment with Parnate combined with a tricyclic (desipramine or nortriptyline). Parnate + desipramine is rather harsh with respect to autonomic side effects, particularly elevated heart rate. Nortriptyline is less harsh. However, it is not uncommon that someone will respond to one TCA, but not another. It was Parnate + desipramine that brought about a full remission for me. Adding low-dose lithium (300 - 600 mg/day) to these two drugs (separately or together) sometimes triggers a robust response. I continue to take 300 mg/day for its antidepressant effects and neuroprotective and neurogenensis properties. I am also motivated to take lithium for its potential to reduce the risk of developing of Alzheimer's Dementia. Otherwise, depression increases this risk by a factor of 2 - 3.
TCAs I been considering. Ixel isn't available in Canada but I've read many promising things. Desipramine also is a candidate but I been trying to recall if I tried it before. I don't think I have. Nortipiline did not work well for me. I don't recall the details of the experience. Lithium I've tried in the past as an add-on for paxil I believe, and I felt worse. Possibly my dose was too high since I respond better to low doses.
>
> What has been your experience with Wellbutrin? This is another drug that can produce good results when combined with SRIs. Combining Abilify and/or Lamictal is worth considering, especially if you were responsive to Wellbutrin. Dopaminergic activation seems to be a common thread amongst these drugs.Wellbutrin made me worse the longer I took it. I could not handle a full 4 week trail.
Abilify rapidly made me worse as an add-on for parnate. I felt a lot of anxiety among other symptoms which I can't recall right now. Much of this is buried in my journals somewhere.
I wonder if abilify may still be worth trying again, if it's one of those cases of ''worse before it gets better''. Since risperadal helped me a long time ago in terms of interest and bit motivation but I felt very dull and not quite ''connected'' to the world. Risperadal wasn't used as an add-on though. it was a mono therapy with likely a benzo back then many years ago.
prazosin i will have to read up on.
i been wanting to try memantine from various positive things i've heard (especially for cognition + memory) but my doctor wants me to convince him w studies. i only been able to find one indicated for depression. DLPA also been considering
>
> I have found prazosin 6 - 12 mg/day to be remarkably helpful. This drug seems to be effective for people who have developmental PTSD as well as acute PTSD. More recently, I have started taking minocycline. It seems to be working such that I was able to discontinue the prazosin and am contemplating the discontinuation of Abilify. Minocycline might work particularly well when combined with Lamictal. Both drugs are antiglutaminergic, and may work synergistically. Minocycline also displays anti-inflammatory and neuroprotective properties. Among the tetracyclines, minocycline is uniquely active in tests screening for antidepressants. Its antibiotic property, which is unrelated to these others, may not be contributory to its therapeutic effect when treating depression, although it would be helpful when Lyme disease is present.
>
> My current regime:
>
> Parnate 80 mg
> nortriptyline 150 mg
> Lamictal 200 mg
> lithium 300 mg
> Abilify 10 mg
> minocycline 200 mg.
>
>
> - Scott
>
>Minocycline I haven't tried either. I'll have to read up on it.
Thanks for your input. It's difficult to piece things together.
Oh and here is a summary list of what I tried. Likely not complete.
Treatments Tried:
Benzo- Valium, Ativan, Klonopin, Xanax
SSRI- Celexa, Paxil, Zoloft,
SNRI/Other/Alternative- Wellbutrin, Effexor, Stablon, Remeron, Lithium, Adrafinil, Gabapentin, Narproxen, Vivarint, Buspar, Trivistal LA, ECT, rTMS, Reboxetine, Mirapex,
NRI- Reboxetine,
MAOI- Parnate, Nardil
Stimulant- Ritalin, Dexedrine, Provigil
Anti-Psychotics- Zyprexa, Risperidal, Abilify (as a low dose add-on), Seroquel,
Natural/Herbal- Rhodiola Rosea, Omega 3, Omega Complex, Korean Ginseng, Magnesium Glycinate, Royal Jelly, Niacin, Gingko Biloba, Bee Pollen, L-Arginine, Resveratrol, D3, Maca Root,Sensitivities: Vitamin A, Sunlight,
----Treatment Results:
Worse: Celexa (gradual worsening of depression and burning pain), Effexor (rapid worsening of depression and burning pain), Abilify (rapid worsening of depression when taken w Parnate), Cymbalta (gradual worsening of depression), Seroquel, ECT (Severely damaged my long term memory and overall cognition perminently), Nortriptyline, Lithium,
Better: Risperidal (some ability to enjoy things but overall would still be largely lacking), Parnate, Ritalin (first time this or Dexedrine was taken I was able to feel a bit like my old self, ability to experience pleasure, positive outlook, return of old hobbies, Was able to appreciate being alive), Dexedrine (similar to ritalin), Valium (some mood improvement, some anxiety improvement, most benzos have had similar effect), Ativan (was more social on this than other benzos while also on Paxil), Rhodiola Rosea (herbal similar to an MAOI) (A small miracle for mood, energy, cognition, general well being, would still be lacking pleasure. Has lost much effect over time), Gabapentin (tremendous cognitive improvement, imagination, more emotions, less cloudy thought process, feeling of greater intellectual capacity. Some improvement to mood, ability to be social. Although rapid tolerance onset, inconsistent, ironically sometimes cognitive impairment.), Vivarint (some mood improvement, massive improvement to sex drive),
Mixed Results: Remeron (sluggish on low doses, more active on higher doses, very mild mood improvement, impulsive spending), Zyprexa (some mood improvement, lot of lethargy, cognitive slowness, food tasted wonderful), Stablon, Modafinil (increased Cognition, Energy, Motivation but may compound dysphoria)
Negligible or Unsure: Zoloft, Nardil, Adrafinil, Narproxen, Buspar, rTMS (could not access any tangible improvement), Reboxetine, Mirapex, Piribedil, Klonopin, Wellbutrin,
Needs confirmation (not sure if taken): Prozac,
poster:AlexCanada
thread:1024774
URL: http://www.dr-bob.org/babble/20120830/msgs/1025169.html