Posted by SLS on May 28, 2003, at 22:49:34
In reply to Re: Running out of med options... » SLS, posted by jemma on May 28, 2003, at 10:01:12
> For the moment, I'm back on a modafinil ritalin sr cocktail. I hate the rebound off the ritalin, though, and I get bruxism and muscle tightness. When I see my pdoc in a week, I'm going to suggest trying wellbutrin again along with 200 mg modafinil. I tried wellbutrin before - all the way up to 450 for eight weeks - and felt nothing, no side effects, just a bit of sleepiness. I'm wondering if modafinil might work synergistically with it, as it seems to do with almost everything.
Have you tried Parnate? It doesn't usually produce edema, and there is no reason why you couldn't combine it with Provigil. You can even combine it with amphetamine, Ritalin, or a tricyclic. Parnate is usually chosen over Nardil for bipolar depression.
> What meds are you on these days? If I recall, don't you also suffer from anergic bipolar depression?
My depression is indeed anergic. There are times when the psychomotor retardation leaves me motionless in a chair. Fortunately, I am gleaning a mild benefit from combining Lamictal 250mg + imipramine 300mg. I am just beginning to take trimipramine (Surmontil). It occasionally works when other tricyclics fail. The only time I ever sustained a remission beyond a week was during a trial of Parnate 60mg + desipramine 150mg. I felt alive (normal) for at least 6 months. Unfortunately, my doctor at the time had me discontinue the combination due to the precipitation of mania. He should have continued it and simply added antimanic agents. I am now resistant to that combination. 20-20 hindsight.
I am looking forward to the FDA approval of duloxetine (Cymbalta). Hopefully, it will pack a more potent punch than Effexor. I found Effexor somewhat helpful when combined with imipramine.
- Scott
poster:SLS
thread:550
URL: http://www.dr-bob.org/babble/20030525/msgs/229862.html