Posted by Ant-Rock on November 16, 2000, at 18:38:35
In reply to Re: ZYPREXA OR AMISULPIRIDE? » Ant-Rock, posted by SLS on November 15, 2000, at 19:46:36
>
> Dear Anthony,
>
> I do not believe that it is time for you to go to ECT, although I have no real aversion to using it if it is indicated given your position in your treatment algorithm or current mental status. I had 12 treatments in 1991. 6 unilateral left followed by 6 bilateral. Bilateral sucks for memory and cognitive side effects, but it was my experience that they were gone completely within a few weeks. The experience would have been worthwhile had it worked. In my recent correspondence with Max Fink, he was reluctant to divulge with certainty his position regarding unilateral right versus bilateral. His position in this issue is not in accord with many experts, including my own doctor at NYU. A while back, someone posted a study, the results of which indicated that *high-dosage* right unilateral was as effective as bilateral, but somewhat inferior to high-dosage bilateral. In addition, in my estimation, the difference in cognitive side effects between both high-dosage treatments was negligible. My suggestion would be to decide first whether you want to try low-dosage right unilateral or high-dosage bilateral. I don't see any advantage to high-dosage right unilateral.
>
> I also have experienced diminishing returns with Parnate over the years. It was a combination of Parnate 60mg + desipramine 150mg that got me nearly 100% well in 1987 for over six months. I don't want to go into it here, but my doctor at the time discontinued this treatment in favor of Prozac, which had just come out. I have not responded to this combination ever again.
>
> If I were you...
>
> * Remain on lithium 300mg - 600mg (unipolar augmentation dosages)
>
> * Keep praying
>
> * Keep hoping - you haven't tried a whole bunch of stuff - I guarantee it.
>
> * Keep smiling.
>
> :-)
>
>
>
> 1. Add:
> - sulpiride 50mg - 200mg or amisulpride 50mg - 100mg if you are not averse to procuring foreign drugs. You will get an answer witching 7 days.
> - Zyprexa or Risperdal or Zeldox (when it come out - spring?)
>
> 1. Add desipramine or nortriptyline to the above.
>
> 2. Do not add an SSRI, Effexor, or Serzone
>
> 3. Add a combination of stimulants along with the the above: one from group A and one from group B
>
> Group A:
> - Adderal
> - Dexedrine
> - Ritalin
> - Cylert
>
> Group B:
> - Mirapex
> - Parlodel
> - Permax
>
> 4. Add thyroid hormone with the above:
> - Cytomel T3
> - Synthroid T4 (my preference)
>
> 5. Switch to Nardil or, perhaps later, Marplan: all other medications remain in place.
>
> 7. Try other things your doctor suggests
>
> 8. Switch back to Parnate and combine it with what you have found most successful.
>
> 6. Ask JohnL about the usage of Remeron in this algorithm.
>
> 7. Ask AndrewB about the usage of Eldepryl (selegiline) in this algorithm.
>
> 8. Brainstorm some more
>
> 9. ECT - when you are ready to try it. Last or sooner.
>
>
>
>
* The band had a hard time keeping up with the Vice-President as he waltzed across the stage. They had no algorithm- Scott
Scott,
I too lost my algorithm.
Now it's on to Adderal monotherapy, which I find kind of strange, but the doc wants me to get off the parnate/lithium and give this a shot. I'm kind of pessimistic of any monotherapy, but I'll have to give it a try. Do you know if mirapex can be combined with adderal? They have mirapex for sale on the libertarian solutions web, and it's very cheap. Just a thought. Anyway, hope things continue to be well with you.Sincerely,
Anthony
* Would this be considered a treatment-resistant election ?
poster:Ant-Rock
thread:48787
URL: http://www.dr-bob.org/babble/20001115/msgs/48930.html