Posted by Mr. Scott on February 5, 2002, at 19:25:15
In reply to Re: Broken brain rxs » Mr. Scott, posted by medlib on February 5, 2002, at 0:09:37
> Hi Scott--
>
> Just a few comments on your combo:
>
> --Effexor at low levels affects only seratonin, so it probably should be d/ced (discontinued) as soon as practicable (given your reaction to SSRIs). Many people have difficulty ditching that last (37.5) dose. If you do, ask your pdoc for a few lowest-dose Prozacs. P's extremely long half-life eases withdrawal effects of the shorter-acting E.
> --Many pdocs don't prescribe Xanax (except for emergencies) because it's much shorter-acting than Tranxene or Klonopin. Short-acting rxs lead more quickly to tolerance (requiring increasing dose to achieve same effect). They're also more difficult to withdraw from.
> --Some bipolars find that Wellbutrin triggers mania or hypomania. If your pdoc is anywhere near as difficult to contact as mine, it would be useful to have a "quick response" protocol in place before you begin the Wellbutrin. Check with your pdoc re specifics.
> --Manufacturer recommends that initial dose of Lamictal be taken for 2 weeks before first increase.
>
> I hope that this combo works for you; it *sounds* good, anyway. I presume that you'll remember to add (and ramp up) only 1 rx at a time, so effects and side effects will be clear. If you're still depressed on this combo, there are neuroleptics (Geodon, Zyprexa) waiting in the wings (presuming you haven't tried them already).
>
> Well wishes---medlib
>
> > Lithium CR 450mg
> > Lamictal 12.5mg (raise 12.5mg every 1-2 weeks)
> > Xanax or Klonopin or Tranxene(whichever whenever)
> > Wellbutrin SR (start low)
> > Effexor XR 37.5mg (stop trying to tolerate 75mg and eventually ditch unless helpful)
Thanks Medlib for your suggestions and advice!Scott
poster:Mr. Scott
thread:92893
URL: http://www.dr-bob.org/babble/20020131/msgs/92998.html