Posted by BrittPark on October 10, 2002, at 19:57:18
In reply to antidepressant resistance, posted by john-paul on October 9, 2002, at 19:53:06
First let me ask some questions; how long were you on and how much did you take of each antidepressant; if trazodone didn't work one time what makes your doctor think it will work now?
Here are some suggestions: try a new class of AD, a TCA or an MAOI or Remeron. Find the AD that gives you the best response even if not very satisfactory and either add another antidepressant (from a different class, preferably) or augment. Some reasonable augmentation strategies might be an atypical anti-psychotic like Risperdal, Zyprexa, or Seroquel (sp?), or another AE like Topamax or Lamictal. (If lamictal, be very careful in titrating it up as it interacts strongly with depakote, or consider swithching to it instead of depakote. Lamictal seems to be more antidepressant than any other mood stabilizer). Substitute Xanax for Ambien. Xanax has a certain amount of antidepressant effect on its own for some people.
This is just a set of beginning ideas. There are dozens and dozens of possible drug combinations. One of them will almost certainly work for you. Oh, and if your medication is being handled by a GP, find yourself a psychiatrist, preferably an expert in psychopharmacoloy.
Don't get discouraged, with a good doctor you'll be able to find the right medication regime fairly quickly, some number of months. That may seem like a long time, but be patient, you will get better. When I was 19 and was first diagnosed with Major Depression the only drugs available were TCAs, MAOIs and benzos. But even then my psychiatrist and I found a combination, imipramine 200mg and serax prn, that worked well enough for me to start and finish college.
I'm currently going through a truly refractory depressive episode myself right now and have been working on it for months. It's frustrating but I'm sure my psychiatrist and I will find a way through. You will too.
Feel better,
Britt
poster:BrittPark
thread:122977
URL: http://www.dr-bob.org/babble/20021006/msgs/123119.html