Posted by petters on November 2, 2001, at 12:39:49
In reply to Re: Bupropion poop out Scott ŧ petters, posted by SLS on November 1, 2001, at 15:26:55
> Hi Petters.
>
> I am sorry that I haven't been responding regularly. I do appreciate your concern for me.
>
> > I have some experience, that are similar yours. I had an trial on Bupropion, as an add on to: Venlaflaxine + Mirazepine + Litium, because anergia. The first four days on 150mg I was eutymic and felt pleasure, witch I havenīt felt for years. On day five the effect was lost.
>
> I know. It is like a cruel joke.
>
> Many people have the same 3-4 day response to amphetamine, methylphenidate, and dopamine agonists (bromocriptine and pergolide). Methylphenidate did not help me at all when I added it to tranylcypromine and desipramine.
>
> > I couldenīt raise the dosage because of raised bloodpreasure. I probably go back to Ziprasidone.
>
> A friend of mine is doing well with a combination of venlafaxine 150mg + bupropion 300mg. How much venlafaxine are you taking? Do you think bupropion would raise your blood pressure without venlafaxine?
>
> If you respond partially to venlafaxine, maybe you would respond well to an MAOI like tranylcypromine or phenelzine. I know you have tried moclobemide, but these two drugs are much more effective.
>
> Why did you stop taking ziprasidone? Have you ever tried sulpiride or amisulpride?
>
> > I have had trial on Bromcriptin, Mirapex, Amantadin. On Amantadin I had the same effect that you describes. The first tre hour very energic, and after that sedation. If I only could have the states, that I had the first four days on Bupropion.
>
> It is good that you can remember. You now have something to hope for. You know how good life will be when you find a treatment that works for you.
>
> > What about you, Scott? I really hope you are not to bad.
>
> Things are not too bad today. I am having trouble finding a dosage of nortriptyline that will keep me stable. I am going to ask my doctor to switch to imipramine. A small percentage of people who are partially responsive to nortriptyline do not have a therapeutic window for it. No single dosage works consistently.
>
> > What about the Citalopram strategy, to your current regime - I hope you donīt mind Iīm asking.
>
> I don't mind. I am happy that you ask.
>
> My doctor seems to like citalopram. However, I want to try phenelzine first because I know I respond partially to it. I have never combined phenelzine with imipramine, lamotrigine, and an atypical neuroleptic (olanzapine or ziprasidone).
>
> I reduced my dosage of lamotrigine from 300mg to 100mg to prevent cognitive side effects. I am going to wait a month to allow my system to stabilize. Next, my doctor wants to try adding mirtazepine again. I think mirtazepine will make me feel worse again, but he wants to see to be sure.
>
> > By the Way have you tried Clomipramin infusion? We use it here in Sweden in refractary cases. Unfortunately I couldnīt tolerate it.
>
> No, but I have heard of it being done. It is an old strategy that I don't think ever became popular in the US. Maybe I should read more about it.
>
> Thanks.
>
> > What about Yohimbin?
>
> Right now, I am afraid to try yohimbine because I think it will make my depression worse like mirtazepine. Both drugs are NE alpha-2 antagonists. Dr. Andrew Nierenberg had recommended that I try yohimbine when I saw him in 1992. However, when I asked him about it again last year, he didn't think it was a good idea.
>
> > I hope you can stand my sometimes horrible spelling.
>
> You write English very well. I wish I could speak and write another language as well as you do. I sometimes feel very selfish that I don't.
>
>
> - Scott
Hi Scott...To be frank honest, I am very imperessed of your farmakological knowleged. I Will take your tips under consideration, and talk it over with my doc.
I went off Ziprasidone because of a little feeling of numbless. But I will start it again because of the fail trial on Bupropion. I didnīt know that one could fell so great that I did the first four days on it. Specially the feeling sensation of pleasure, I mean realy plesure, and this was not a form of hypomanic states. Iīm sure about that. But what can one do. Just keep on struggle. Itīs dammed that the dopaminergic receptors so fast changes.I know you somwere write that you have a form of bipolar depression. Iīm think that I am bipolar 2. But you see, in my country, we donīt have bipolar 2, and not 3. only bipolar 1 disorders.
Have you tried combination therapies with Venlafaxine , to a tricycklic ( where therapeutic blood levels can be followed and used to advantage)? You can recruit different receptors with different meds, and What I have seen sometimes as many as 3-4 different antidepresants.
Have you tried Topipramate. I know there is not mutch data on it yet. I have seen one bipolar depression, witch was consider to be refractary. But When they made a trial on Lamotrigine + Topamax she had a great response. Of cours this is on case.
Have you tried the more convention treatment of Sodium divalporoex) Litium + Carbamazepine. Superb data of those, compered to poor data on Lamotrigin, Gabapentin... What about Nefazodone, or risperdone.
We have had Citalopram in my contry for 8 years. And its great for anxiety, and some depression. But keep in mind. The maximal recommeded dosage is 60 mg. I know severel cases that go as high as 100 - 120 mg, even in combination. without any server side effect, more than sexual side effect.I donīt remember if you have tried tryptofan. In my country some clinical treat refractary depression with clomipramin infusion + Tryptofan. They say it has the same potential that ECT.
By the way. Do you have Maprotilin in US? tricycklic. An risk in this meds are that it can trigger an manic states.
Another strategi I have seen in extreme serve refractary bipolar depression is: Amitryptilin + Clomipramin + Tryptofan + Litium.
Stay Well
Sincerely
Petters
poster:petters
thread:82786
URL: http://www.dr-bob.org/babble/20011025/msgs/82977.html