Posted by Sad Panda on April 29, 2004, at 5:18:15
In reply to Re: What to do if you don't respond to SSRI/NDRI/SARI? » Sad Panda, posted by greywolf on April 28, 2004, at 19:03:12
> Sad Panda:
>
> Thanks for your thoughts. I have tried both Zoloft (about 3 months) and Effexor (a little over a month), but stopped because the sedation SE was so strong. I write all day (and many nights), so that SE is particularly bothersome. Both meds also had significant sexual SEs.
>
> I was on a course of either clomipramine or imipramin about 4 years ago. I believe it was clomipramine directed in part at OCD symptoms. It also had serious sedating effect, and after 4-5 months I had to stop because the SE had not dissipated and even a relatively high dosage (I can't recall exactly, but it was close to max dose) did not produce a significant therapeutic benefit. I also took 3 months off from work around that time and weaned myself off of everything to try an exercise and diet approach to my problems. I ended up with a nice tan, a better jump shot, and caught up on my reading, but apparently exercised my demons instead of exorcizing them. Long story short, it ended up being just a break from treatment instead of a realistic approach to these illnesses.
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> My experience suggests that I am resistant to treatment with SARI, SSRI, NDRI, SNRI, trycyclics, you name it. Trazodone did have some effect, but it was so damn sedating that even taking it only at night wiped me out the next day. My doctor is not a fan of stimulants, so the only thing he has been willing to suggest along those lines is Wellbutrin. Unfortunately, Wb seems to be the weakest of the bunch (at least of those I've tried over the last year). I seriously have not observed any effect of the Wb other than some initial anxiety that disappeared after a few days. Since then, I've felt exactly zero in the way of any effects, positive or negative. I might as well be popping Tic Tacs.
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> I think a good sign of things to come was the recommendation that the only really effective course of treatment for me would be ECT. That is simply a road I don't want to go down. So now I would like to know whether there are pharmaceutical options other than MAOIs that I have not yet tried, particularly for the depression. I can shut myself in on the manic days and try to channel the euphoria into some productive writing, and I can handle people looking at me oddly when the OCD habits and tics become too obvious, but the depths of these 2-3 week depressive episodes are reaching lows that resemble some very bad times I've had in the past. I handle these circumstances better now after years of treatment, and having people like you on Babble is immensely helpful (particularly in keeping perspective), but the misery is still consuming.
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> I think I'm wasting my time with the Wb, but I'll do it for a little while longer simply because my doctor has asked me to give it the ol' college try. I just fear that the longer I spend on an ineffective med, the worse the depression gets. The floor for me is making it to work everyday and meeting the majority of my obligations. If I cannot find something that actually works, there's nothing between me and rock bottom if I start missing work. That's what I want to avoid.
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>Desipramine is the last TCA for you to try, then it's time for an MAOI. If my current meds fail me I will be pushing for a trial of Parnate. I can't see any reason not to try MAOI's except phobia.
You mention euphoria & mania? When do you get them? Have you tried any of the AED/Mood stabilisers?
Cheers,
Panda.
poster:Sad Panda
thread:340951
URL: http://www.dr-bob.org/babble/20040429/msgs/341204.html