Posted by Cam W. on May 3, 2000, at 21:51:41
In reply to Re: Wellbutrin Update - Cam, posted by JohnB on May 3, 2000, at 20:21:26
John - I never really felt the need to augment. I did have my Paxil dose (2nd drug) raised to 40mg for a while, but it made me really tired, emotionally labile and confused. I really think my first 2 SSRI attempts (other was Zoloft; too much stomach upset) were half-hearted tries, not really believing that I was depressed and I probably stopped them too soon (around 6 months). I did not like the way they made me feel. Being a guy, the sexual dysfunction was not really a problem (sorta felt like I was 18 again).I never did consider augmentation and at the time (1992 - 93) augmentation was not being used as much as it is today. With the Wellbutrin I am fine using it as a monotherapy. Some days I am bitchier than I should be (can you figure it out from some of my posts?), but other than that, no real funks or crawl-into-a-corner-and-curling-up blues, anymore.
If I had to choice, I would probably like to mix an SSRI with a drug like Reboxetine (kinda like a TCA without the anticholinergic and alpha-adrenergic blockade).
Second choice, perhaps Zyprexa with a partial responding antidepressant. Perhaps another mood stabilizer, like lamotrigine.
Third choice, depending on residual symptoms (esp. if lethargy and sloth still present) an AD with a stimulant like Adderal. I have seen too many problems with people coming out of hospital taking Dexedrine (eg taking a month's worth in a week or chewing up the sustained release caps - Did you know that they work better, but don't last as long, when you chew up the long-acting - duh). Ritalin is a weird drug; maybe because I don't use it in my practice very often, but I don't think I'd like to use that one.
Take care - Cam W.
poster:Cam W.
thread:32031
URL: http://www.dr-bob.org/babble/20000429/msgs/32164.html