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Medical Forum / General / General / March 2008anti-depressant augmentation needed
I was on Mirtazapine for about 9 months, and because it was not really working,my psychiatrist augmented it with Lamatrogine. The Lamatrogine has not really helped much, and has given me very bad insomnia. Recently I switched to Paxil, and am still augementing it with Lamatrogine. I am seeing my doctor soon and want to ask him to augment the Paxil with a different drug from Lamatrogine. I have read about Lithium and Depakote, and am not at all impressed by what other people have written about them. I have posted on this group before, and everyone said I should take a dopamine type antidepressant, like Selegline. But my doctor is refusing to allow such a type of antidepressant. I suffer from the type of depression where I don't feel any deep sadness, but have the following symtptoms: 1)no sexual feelins at all. 2)intense OCD. 3)no hunger pangs at all. 4)difficulty concentrating for any lenght of time 5)no emotions like anger or sadness. Thanks and I hope someone can suggest a drug other than Lamatrogine to augment the depression which is making my life so unpleasant. Bye friends. > I was on Mirtazapine for about 9 months, and because it was not really > working,my psychiatrist augmented it with Lamatrogine. The Lamatrogine [quoted text clipped - 17 lines] > augment the depression which is making my life so unpleasant. > Bye friends. give the paxil more time to work.been taking it for years.works great for me.ive never heard of lamatrogine so i cant say any thing about that one. hope you feel better soon. > > I was on Mirtazapine for about 9 months, and because it was not really > > working,my psychiatrist augmented it with Lamatrogine. The Lamatrogine [quoted text clipped - 24 lines] > > - Show quoted text - You could try increasing the dose too. But paxil lowers your sex drive, as do many anit-depressants. On 7 Feb, 00:27, Michelle la Belle 2nd <that-miche...@hotmail.com> wrote: > > > I was on Mirtazapine for about 9 months, and because it was not really > > > working,my psychiatrist augmented it with Lamatrogine. The Lamatrogine [quoted text clipped - 29 lines] > > - Show quoted text - So, besides Lithium and Depakote, there are no other drugs which I can suggest to my psychiatrist to supplement the Paxil? I'd even consider requesting my doctor to supplement the Paxil with newer drugs which have just recently been shown to have antidepressant effects. Thanks and bye. > On 7 Feb, 00:27, Michelle la Belle 2nd <that-miche...@hotmail.com> > wrote: [quoted text clipped - 39 lines] > have just recently been shown to have antidepressant effects. > Thanks and bye. there are more meds than i care to list , they're all about the same though , none of them will ever make you , giddier than a door mouse , none of them are the silver bullet out of depression , although there are meds that do that but , most of them have a high addiction potential > So, besides Lithium and Depakote, there are no other drugs which I can > suggest to my psychiatrist to supplement the Paxil? I supplemented my Zoloft (an SSRI like Paxil) with a norepinephrine reuptake inhibitor called desipramine. And have been on this combo for about 9 or 10 years. I'd stay away from lithium; too many adverse effects. And lithium requires blood levels periodically. Chip > > So, besides Lithium and Depakote, there are no other drugs which I can > > suggest to my psychiatrist to supplement the Paxil? [quoted text clipped - 7 lines] > > Chip Thanks for the tip Chip. Can I ask what benefits the desipramine brings to you which the Zoloft by itself doesn't do? >> > So, besides Lithium and Depakote, there are no other drugs which I can >> > suggest to my psychiatrist to supplement the Paxil? [quoted text clipped - 11 lines] > Thanks for the tip Chip. Can I ask what benefits the desipramine > brings to you which the Zoloft by itself doesn't do? I missed the original. You can augment Paxil with Wellbutrin. Welbutrin is often added to SSRIs.  SignatureNom dePlume, Ph.D. Why, yes, in fact, I am a rocket scientist. Find my book, Medicines for Mental health, and free drug information, at www.MentalMeds.org ===== > > > So, besides Lithium and Depakote, there are no other drugs which I can > > > suggest to my psychiatrist to supplement the Paxil? [quoted text clipped - 10 lines] > Thanks for the tip Chip. Can I ask what benefits the desipramine > brings to you which the Zoloft by itself doesn't do? Desipramine blocks the reuptake of norepinephrine. Zoloft blocks the reuptake of serotonin. So you're affecting two different neurotransmitters thought to be involved in the pathophysiology of depression. These days a psychiatrist might be more likely to add Wellbutrin to an SSRI, cause Wellbutrin blocks the reuptake of both norepinephrine and dopamine. So you're hitting three neurotransmitters involved in depression. Theoretically, Wellbutrin would be a better med to augment an SSRI. But there have been no head to head comparisons between Wellbutrin and desipramine in clinical trials as far as I know. It seems like the more neurotransmitters you manipulate, the better the response to a combo of antidepressants. Electroconvulsive therapy is very effective for treatment resistant depression, and ECT causes the release of many many neurotransmitters. Chip > > > > So, besides Lithium and Depakote, there are no other drugs which I > can [quoted text clipped - 33 lines] > > - Show quoted text - Have any anti-psychotics been shown for treatment resistant unipolar depression? Wellbutrin is not lisenced for antidepressant use here in the UK. My doctor is against using dopamine type antidepressants like Selegeline because he states that they lead to manic-type behaviour, and other bizzare acts like grinding your teeth. So are there any mild dopamine acting type antidepressants similar to Wellbutrin that are lisenced for use in the UK that I might be able to ask my psychiatrist to try? Thanks again and bye. > Have any anti-psychotics been shown for treatment resistant unipolar > depression? The combination of Prozac and Zyprexa has been used for this in the US. However, I would be very cautious about taking an antipsychotics (which are dopamine blockers) if you believe you have a dopamine deficiency. (In other words, start small, and be prepared to stop if you go downhill quickly.) > Wellbutrin is not lisenced for antidepressant use here in the UK. My > doctor is against using dopamine type antidepressants like Selegeline [quoted text clipped - 3 lines] > for use in the UK that I might be able to ask my psychiatrist to try? > Thanks again and bye. I don't know what is licensed in the UK. I suppose you could try dopaminergic foods. I believe fava beans are said to increase dopamine levels, but I haven't looked into this area. You might try doing a Web search on the subject of foods and dopamine. SignatureNom dePlume, Ph.D. Why, yes, in fact, I am a rocket scientist. Find my book, Medicines for Mental health, and free drug information, at www.MentalMeds.org ===== >> Have any anti-psychotics been shown for treatment resistant unipolar >> depression? [quoted text clipped - 16 lines] >levels, but I haven't looked into this area. You might try doing a Web >search on the subject of foods and dopamine. Fava beans with Keven Thompson's liver. SignatureNom dePlume, Ph.D Why, yes, in fact, I am machinist. Guide to Medications for Mental Illness: http://www.geocities.com/nomdeplume1001 ===== > Have any anti-psychotics been shown for treatment resistant unipolar > depression? Like Nom dePlume, I don't have any knowledge on what is available in the UK but...I reside in the US and have used Zyprexa for augmentation purposes and had a positive change that lasted a bit so that may be worth checking into for you. I know Seroquel has also been used for the same purpose. There are plenty of meds other than anti-psys that can work well for augmentation purposes as well (Effexor,Remeron,Pamelor,Cymbalta come to mind). Also, you can just google "treatment resistant depression" and lots of articles will come up. I've found some very interesting pharmocologic ideas from reading research journal articles from such a search and then talking with my psychiatrist about them. Good luck! > I was on Mirtazapine for about 9 months, and because it was not really > working,my psychiatrist augmented it with Lamatrogine. The Lamatrogine [quoted text clipped - 17 lines] > augment the depression which is making my life so unpleasant. > Bye friends. Ironically, you may want to consider, along with finding the proper med(s), chiropractic help and/or yoga. Both of these provide holistic means of putting the body into proper alignment so that there is as much energy going through the body as possible. This will assist in the strengthening of the body and the emotional system and may add to your joy at being alive.
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