Posted by hemingwaykitten on October 1, 2009, at 20:54:37
In reply to Re: HELP! 10 years on Effexor XR - now it quits on me!, posted by psych chat on September 30, 2009, at 23:20:05
> Sorry to hear about your troubles. I was once on the SSRI/SNRI merry go round for way too long.
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> If I understand correctly, for atypical depression, after Effexor, it's common protocol to try a second trial of Wellbutrin as an augment, before moving on to another drug class. If that doesn't work, you might want to check into Remeron or a MAOI. Ensam may be a good MAOI to start with, but that alone may increase your anxiety.
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> For depression that's not atypical, Lamictal may be worth exploring as a next step.
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> Go to this algorithm chart and click on "consultation" or "flow chart" to check your options if you don't want to go through numerous, time-consuming, miserable SSRI/SNRI trials that seem to causing adverse effects to your education endeavors.
>
> http://mhc.com/Algorithms/ver4/startDep.html
>
> Good luck to you. Maybe starting school led to your symptom changes and they will subside in time?
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>
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>Thanks for the info, the algorithm is great! I followed the steps and came up with Effexor XR augmented with Prozac and Wellbutrin.
Today a new Pdoc at the local nuthouse ER took me off the BuSpar and gave me Prozac 20mg/dy and Neurontin titrating up from 100mg/dy to 300/dy. Could not sway her to give me Wellbutrin.
Did a short trial of Remeron several years ago with terrible side effects, limb heaviness and unable to move much. Let's hope I don't have to go to an MAOI. Lots of contraindications with those.
The Prozac makes sense to me, even if only to ease the withdrawals if I end up going off Effexor. The Neurontin makes no sense--it didn't work in conjunction with Effexor 4 years ago. However, with my Effexor at 450mg/dy it appears no one wants to prescribe Wellbutrin because it is another stimulant. I'll keep my head up and hope to function well enough not to fail my classes.
If there are other opinions out there, PLEASE share! There's no such thing as too much information when you are faced with going down the rabbit hole!
poster:hemingwaykitten
thread:919213
URL: http://www.dr-bob.org/babble/neuro/20090701/msgs/919337.html