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Re: a question for dr.Bob and experts...

Posted by Toby on December 30, 1998, at 9:31:03

In reply to Re: a question for dr.Bob and experts..., posted by racer on December 26, 1998, at 14:57:03

First: Don't monkey with your antidepressant dose and don't let anyone else doso either unless it is your doctor taking you completely off it to change to something else. We used to think that depression could be treated with a high dose of medication for 2 or 3 months and then the dose could be lowered dramatically for another few months and then stop it and the depression would not return. We now know that the dose that gets you well is the one that keeps you well. We also know that if depression returns more than once in a person's lifetime that it will most likely continue to return over and over unless the person stays on medication forever (hate that word but it is true).

Second: You need a careful evaluation to determine if this cycling is due to an inadequate dose of medication (and that is common) or is due to a less severe form of bipolar disorder called cyclothymia (just means you never get real high). If you don't have bipolar or cyclothymia, the depakote is probably not helping very much in the way of augmenting the MAOI. Some treatment recommendations to talk with your doctor about: add lithium up to 900 mg per day and if no response add synthroid up to 50 mcg per day and if no response stop both of those and add a tricyclic and if no response change to a different MAOI and if no response go to ECT.


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poster:Toby thread:1743
URL: http://www.dr-bob.org/babble/19990101/msgs/1880.html