Posted by bob (I hate server back-ups) on March 4, 2000, at 21:34:30
In reply to Re: Glad to hear it works for so many..., posted by Phil on March 4, 2000, at 17:09:01
You know, of all the times for me to get back on Babble, I pick five minutes before they must have backed up the server last night, since all of a sudden NONE of my posts were going thru ... anyway...
Noa, I got something I'm going to post for you that I saved from last night down on your thread.
Michael -- good question about why didn't I get back on paxil and wellbutrin together. The bottom line is I've had numerous bad experiences the second time around on a gave a fair trial to in the past. It was more in retrospect than a realization at the time that the wellbutrin/paxil combo was actually working well for me ... really, it was months after that time had passed and I was in a much worse place before I could see how well things had been working out. But...
-- just how much paxil was left in my system? At "therapeutic" dosage levels, that drug was a nightmare for me. I felt like an extra left over from Night of the Living Dead Part Whatever.
-- On its own or in combo with another AD, twice now, wellbutrin has been a disaster as well.For some short time, two wrongs made a right for me. But right now, the meds I'm on have me stable, clear, and on a slight but noticable upward trajectory. I don't have the time or the energy to give those two disasters the chance to work again -- given the mess they make of me individually, if a second "trial" of the two together failed I don't think I could stand the consequences. The risk of failure is just too great. If the first "trial" had been a true trial, rather than an overlap between starting one and washing the other out, then I might be able to get a better feel on whether they'd work together ... but with the info I have, calling it a crapshoot would be overly optimistic.
As for the minimalism, for me it came in my recent addition of ritalin to my nortriptyline/klonopin mix. My pdoc wanted to push my dosage even higher on the nortrip instead of augmenting. Hell! I'm at 150mg/d right now ... he wanted to take it up to 175. I don't understand the logic behind working on one med and pushing til you're red-lining on the dosage limits and THEN trying something else.
I mean, for a lot of us, maybe most of us ... particularly those who get that "refractory" tag added to their depression ... the simple, straight forward approaces have failed. So how will more of the same approach make things any better?
If, on the other hand, what is going on is some subtle mix of imbalances between several different systems -- not seratonin alone, not norepinephrine alone, not thyroid or opiates or dopamine alone -- then maybe what we need is a more subtle cocktail of a few meds rather than maximum dose of A, then add B and push it to its maximum dose, then add C ad infinitum ad absurdum.
Anyway, for me, my klonopin is at a fairly low level andits working fine on my panic. My nortrip is moving me along to a better place than I've been for a long time, but not fast enough and not in all areas. Four days on ritalin, again at a low level, and it's working very well with the other two, but very subtlely.
bob
poster:bob (I hate server back-ups)
thread:10786
URL: http://www.dr-bob.org/babble/20000302/msgs/25997.html