Posted by JohnL on July 15, 2001, at 6:32:31
In reply to Different drugs for different symptoms?, posted by adamie on July 14, 2001, at 14:56:21
You ask some real good questions, and I can sure relate to them. I have been battling depression similar to yours for years. I am now about 98% well. I've never felt better in my life. What I discovered through years of trial and error with dozens of psychiatric drugs is that there are indeed certain drugs categories for certain symptoms. This is not fact, but then, nothing in psychiatry is, but is based on my own experiences and results.
Paxil is likely to make the numb emotion and numb creativity symptoms worse, not better. That's because the SSRIs (except Prozac) tend to anesthetize emotions. No more lows, but no highs either. That is a welcome relief to someone who has been drowning in despair and crying, but not welcome to someone who is trying to gain back the emotional and creative spectrum. While all the SSRIs share similarities, Prozac is the one that stands out as being quite different. It is also the most time-tested workhorse in the group.
In my own experience drugs that work on norepinephrine and/or dopamine are the ones better suited for your symptoms. It is my guess, based on your description of the situation, that you would respond much better to Prozac, one of the anitpyschotics, one of the stimulants, and/or the European mailorder stimulant Adrafinil.
After years and years, my magic combo right now includes 20mg Prozac a.m., 300mg Adrafinil a.m., and 5mg Zyprexa p.m. I have tried removing each, one at a time, to see which does what, and I've discovered that they are all working in harmony. I cannot remove any one of them. All three are working together, and doing so in a way where the sum is greater than the total of the parts, if that makes any sense. It's like Prozac is ok, Zyprexa is ok, and Adrafinil is ok, but combined they are super.
For symptoms like yours I believe best results will be found in the antipsychotic category and the stimulant category, not the antidepressant category. That's because they work mostly on dopamine and norepinephrine. Don't let the word antipsychotic scare you. You do not have to be psychotic or crazy to respond well to one of them. Zyprexa is the top performer in my opinion, but Risperdal works for some when Zyprexa doesn't. There are clinical studies showing the profound effectiveness of these two antipsychotics in treating depressions like yours. The most profound success is with a combo of Prozac plus Zyprexa. If there is to be an antidepressant in the mix, I would suggest Prozac instead of Paxil. Paxil will likely make your emotions and creativity numb. It squashes the emotional spectrum with many people.
With dozens or hundreds of drugs to choose from, in your case you could narrow the field down to the most likely successful performers. The list, in my opinion, would include trials of:
Prozac
Zyprexa
Risperdal
Amisulpride (European antipsychotic, mailorder)
Adrafinil (European stimulant, mailorder)
Ritalin
AdderalI would not at all be surprised if you found magic somewhere within that list. It would take some trial and error, but the results could well be worth it. Much better than feeling numb the rest of your life.
These are just my thoughts and opinions based on years of fighting a depression very similar to yours. Mileage will vary. But I think you are on the right track by thinking in terms of norepinephrine and dopamine instead of serotonin.
John> I am currently suffering from a major depression which limits my emotions, severely limits my ability to concentrate, my memory, and generally my intelligence. Also I have lost most of my creativity. My depression doesn't really have an anxiety component and I am able to sleep well and eat well. I have been on Paxil for 19 days. Perhaps that has helped with previous symptoms of not being able to eat, and difficulty falling back to sleep after waking in the middle of the night, which have been solved.
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> What I am wondering is do different classes or types of anti depressants better suited for different symptoms? I have very little of the guilt and feelings of worthlessness. I eat and sleep okay. I just have severe lack of emotions and the ability to think and concentrate. Would certian types of drugs be better suited for these particular symptoms?
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> Would drugs that work for norepinephrine and dopamine perhaps be better suited than an srri for my specific symptoms? Thanks for reading
poster:JohnL
thread:70128
URL: http://www.dr-bob.org/babble/20010714/msgs/70173.html