Posted by JohnL on February 6, 2000, at 4:41:55
In reply to Luvox, posted by Carolyn on February 5, 2000, at 12:17:26
Hi Carolyn,
It sounds like a classic case of 'poop out' to me. Sometimes antidepressants destabilize and lose effect. Your doctor is suggesting the most common approach of raising the dose. But that may or may not work. With you it doesn't sound like it's working and may indeed be making things worse. The whys and hows of this phenomenon are a mystery.
Other than simpling increasing the dose, the most common approach among surveyed psychiatrists is to add Lithium or possibly another mood stabilizer. Another approach is to add a dopamine agent, like one of the psychostimulants. Ritalin or one of its cousins very often restore the effectiveness of an antidepressant.
Having said that, I think the most promising approach is a rather new and novel one that many psychiatrists haven't yet tried. The addition of 25mg to 50mg of Naltrexone is highly effective in restoring the effectiveness of SSRIs. Sometimes it even works better than it ever did the first time around. You can find out about this is Dr Bob's Psychopharmacology Tips by doing a search on Naltrexone. Of all the possible things you could try, I personally favor this one.
If you try it, Naltrexone can seem real nasty at first. You can break the 50mg pills in half, and then break the half into little chunks. Start with the smallest chunk first. Work your way up. In a couple days you'll be able to take a couple chunks spread out during the day. And within a week you can get up to 25mg. Once you get used to it, there are no side effects at all. It will seem like a sugar pill. But it's hard to imagine that at first, because it can seem harsh the first few days. Side effects do indeed go completely away. And in 2 to 5 weeks, the Luvox will likely return to full effectiveness and stands a good chance of working even better than it ever did previously. And at a lower dose to boot. So while you can raise the dose, add Lithium, add a stimulant, or some other augmentation, I would put Naltrexone at the top of your priority list. Print out what you find in the Tips section on Naltrexone for SSRI poopout and bring it to your doctor. JohnL
poster:JohnL
thread:20559
URL: http://www.dr-bob.org/babble/20000128/msgs/20603.html