Posted by SLS on November 29, 2001, at 19:00:52
In reply to Re: R a question for SLS, posted by Anna P. on November 28, 2001, at 14:51:42
Hi again, Anna.
> > Has VNS been approved for depression in Canada by any regulatory agency?> Yes, VNS has been approved as a treatment for depression in Canada.
That's great! The more options available, the better. That's why I'm all in favor of having crappy antidepressants continue to float around. Some people do respond amazingly well to trazodone, moclobemide, and reboxetine.
> That's true, VNS is expensive, but did you know there wil be a study around the spring at MUSC at North Carolina. I spoke with the nurse over there.
Thanks for the heads-up! I would guess that it's one of Dr. George's studies. (MUSC is in South Carolina). He has helped pilot studies of both rTMS and VNS. It would be nice to get his opinion as to which one he thinks is better. Even though I have friends down in Charlston, I doubt it would be feasable for me to live down there. I should start buying lottery tickets.
> I'm in a big dispair. Currently I'm on Reboxetine and Stelazine, but they don't work for my anergy. I have no more medications to try, and those that I tried in the past don't work anymore. I developed a resistence to them.
Which drugs worked? Which ones have definitely helped - even if only partially?
What is your current diagnosis?
Is Stelazine being used as an antidepressant? Some people have become manic while taking it, so I don't doubt that some doctors might choose it for unusual cases.
I guess you've already tried things like Dexedrine, Adderal, Ritalin, and Provigil. What about Mirapex? What about sulpiride or amisulpride? What about Parnate or Nardil. In the past, some doctors have used for their difficult cases combinations of high-dosage Parnate (120+ mg.) with a tricyclic along with either a stimulant or DA agonist. I did. I gleaned one of my better improvements with this combination. Parnate definitely does things at high dosages that it doesn't do at low dosages. MAOIs do more than just block the monoamine oxidase enzyme. I came across one abstract describing a study designed to compare low and high dosages of Parnate so as to investigate why the high-dosage treatment is sometimes found to be effective in TRD. It indicated that 5-HT2 receptor antagonism became evident at the higher dosages that was not apparant at the lower dosages. The study used rodents, but the dosage per body weight ratios were designed to reflect those used in human applications.
> I was in Atlanta to get some TMS, but I had to come back because my meds stopped working and my depression got worse.
Do you live near Atlanta? If not, what kind of arrangements did you use for lodging?
> I had only four sessions, but now I'm very sceptical whethet TMS works at all.
They're starting to play around with much stronger magnetic fluxes.
> How are you doing, Scott?
Right now, I'm not doing too well. But I'm not feeling as horrendous as I was a few weeks ago. I was a few weeks ago. I'm currently taking Lamictal 300mg., Effexor 300mg., and nortriptyline 75mg. My doctor just raised the dosage of nortriptyline after my blood level was shown to be too low. I will stay with this regimen for a minimum of 2 weeks, and probably 4 weeks if my blood levels reach the therapeutic range. I will keep my fingers crossed, but I'm not expecting much. One good thing that has come of this is that I am becoming more patient with drug trials. It is known that neuronal receptors take about 2 weeks to adapt to a change in the brain's environment (receptor-turnover). Therefore, to terminate a trial of a dosage adjustment before 2 weeks (3 is better) might allow one to pass right by their road to success. In my way of thinking, someone who has failed to respond to many drug trials doesn't have the luxury to not fully explore any given treatment. This means time. I seem to have "tickled" the brain a little with all three of the drugs I'm taking, so I am comfortable with the decision to continue with the trial for another month. My doctor wants to add Remeron next. If it doesn't work out, I'll probably head in the direction of using Nardil with Lamictal along with either nortriptyline or imipramine, and possibly add Zyprexa or Geodon.
Sorry if the post was too long.
I hope tomorrow offers you a smile. :-)
- Scott
poster:SLS
thread:84785
URL: http://www.dr-bob.org/babble/20011123/msgs/85555.html