Posted by Peter on October 8, 2003, at 18:05:35
Hi:
Today was day 33 total on lex, and 27 on 10mg (started first 6 days on 5mg).
It seems that everytime I feel that the lex might be beginning to kick in, and I think I'm beginning to feel better, I end up falling again into a pit of depression, social withdrawal, and irritability. Today I got so depressed that I was totally uncaring and unresponsive to anything or anyone around me. And a few days ago, I thought I was feeling better! Then the depression hit again. I'm also waking up at wierd hours of the night, unable to fall asleep again.
I spoke with my pdoc today. Last week he said I should decrease my adderall dose and that we would probably end up INCREASING the lex dose if I didn't feel better by this week.
But when I told him today that I've been really depressed and low, but that I'm also having trouble sleeping, etc., he said that it seems as if the lex is having a dual effect on me - it is activating me (thus the sleep trouble and irritability), but it is also 'flattening' my mood (thus the depression, social withdrawal, etc.). He said that I seem to react that way to SSRI's and even often to stimulants. And he said that, given this info, I should REDUCE the lex to 5mg instead of INCREASE it.
I've been taking every type of med imaginable for 8 years in different combinations - all the SSRI'S, mood stabilizers, benzos, effexor, wellbutrin, dopamine agonists, stimulants, etc. But I never really responded robustly to any of these treatments - if I had, I wouldn't still be constantly changing med regimes still after 8 years.
The only class of Antidepressant that I have not yet tried are the MAOIS, mostly because I was always anxious about their risks and interactions. But my pdoc said today that it would really be worth my consideration to switch to an MAOI, as my seeming lack of response to SSRI's, etc., make me a good candidate for an MAOI. Although there are some diet restrictions you have to follow, I've heard that, with people for whom the MAOI's work well, the benefits far outweigh the risks. An MAOI might very well be the long-awaited 'silver bullet' for me.
But, I'm still very hesitant to undergo this change for a few reasons: Firstly, I am so sick of going from one pharmacological roller-coaster to the next; my body can only take so much. To switch to an MAOI, I'll need to first taper off the lexapro and adderall, then wait 2 weeks after the lex is out of my system; then, of course, I'll have to undergo waiting for the MAOI to kick-in, if it ever does, and again endure all the side-effects that come with starting a new med. I have 33 days of lex under my belt, and it was really hard to get this far; I've seen many posts describing people who felt NOTHING from lex until as far into treatment as week 7,8 or even 9.
So, I don't know if I should go down to 5mg of lex, and then proceed to taper it and go the MAOI route. Or, if there might be a slim chance still, even after this long and feeling this bad, that the 10mg lex might all of a sudden kick in and start working better than any other AD I've taken before. The chance of this happening seems very unrealistic to me, but I just don;t know if it is worth hanging on for a few more weeks. Then again, I'll always be wondering and anxious about if an MAOI would have ever worked for me if I DON"t just try one.
I'm very confused, and would really appreciate some advice/insight. Thanks a lot,
Peter
poster:Peter
thread:266889
URL: http://www.dr-bob.org/babble/20031004/msgs/266889.html