Posted by JohnL on January 8, 2000, at 3:43:04
In reply to Re: To John L, posted by Peter on January 7, 2000, at 20:29:07
Yikes Peter. I see what you mean. I didn't mean to imply consultation here, but in the past other posters have brought up good ideas when I thought I was running out of options. Here are some options.
ECT. You were a candidate for ECT before half that list of drugs was tried.
The dopamine connection. SSRI or TCA augmentation with Methylphenidate, Desoxyn, Adderall, Bromocriptine, Amantadine. None of the drugs you've tried were in the dopamine agonist class. That is an angle that has been totally unexplored with you so far.
The borna virus connection. Amantadine, with or without SSRI or TCA. Some refractory depressive patients discovered by accident their depressions finally lifted after multiple failures when they took Amantadine for influenza. If your depression is virus related, nothing else will work. At this point, this is an option to look at seriously.
Check DHEA levels. I don't know your age, but DHEA supplementation to bring levels up to those of a young 20 year old or teenager is worth considering. Doses of 90mg have worked wonders, even when DHEA levels were normal to begin with. There are prostate risks with this. But regular medical checkups can monitor any problems early.
Other supplements that have worked in refractory depression are Chromium, Acetyl-L-Carnitine, high doses of precursor loading of DL Phenylalanine+Tyrosine, Phosphatidylserene, Pycnogenol.
High doses of vitamin B12 are sometimes used in combination with an AD. I know a lady who had horrible refractory depression who finally got it under control when her doctor had her start a program of taking B12 megadose injections 3 times a week with high dose oral supplements of folate. Matter of fact, high doses of folate can spark mania.
My pdoc tells me in the old days it wasn't uncommon to use MAOI+TCA+stimulant.
And of course, Lamictal, Neurontin, or any combination of two or three of the mood stabilizers WITHOUT an antidepressant. Sometimes the AD makes things worse, where a mood stabilizer or two alone would have worked.
So just when you thought choices were limited, there are actually a lot of things to try. Personally in your shoes I would first try Amantadine, then ECT. Then the dopamine connection. All the while working with the supplements as well.
I'm praying you'll catch a second wind and approach something here with renewed vigor. Wishing you well. Wishing you better days. JohnL
poster:JohnL
thread:18307
URL: http://www.dr-bob.org/babble/20000101/msgs/18358.html