Posted by SLS on August 18, 2004, at 7:39:23
In reply to Re: Shouldn't there be a limit to this, tried rTMS » SLS, posted by iris2 on August 17, 2004, at 22:41:59
Hi Irene.
Thanks for the self-esteem boost. I really needed to hear all the nice things you had to say.
> I do not completely agree with you in that feeling nothing is better than something.
I don't completely agree with me either. :-) I guess I was just trying to provoke a little existential thinking. I think it helps make for a more informed decision.
> I agree in your previous post, what else is there.
It makes for quite an excruciating trap.
> If one chose life than there really seems to be no choice but to try and improve it. At least from my own perspective. After a recently failed suicide attempt I find myself left with no choice but to "try".
I pray you never regret your decision to continue with life. I guess what I really mean is that I want you to get well and be happy. It would be a hell of an enraging thing to happen to reach the end in old age and realize that your gamble didn't pay off.
I am an advocate of autoeuthanasia. However, I like to encourage a full appreciation of the finality involved. I don't commit to preclude it as an alternative. I just keep committing to putting it off for awhile.
> My pdoc only sent a script for amisulpride which I started today. How long (I saw you did a little survey) do you anticipate I might see a change? ( I a taking 50mg/day.
Within a week, believe it or not. It often occurs that someone feels an improvement within a day, or even hours. Of course, the goal is to make it stick. Sometimes, amisulpride goes well with a stimulant like Adderall and perhaps even a low dosage of selegiline. Although I do have Mirapex on my list of things to try, I am becoming increasingly discouraged by the lack of stories describing long-term success with it. It seems to be very helpful over the first few months, but then loses its positive effect or has it replaced by profound somnolence. I would not discourage you from trying it, but just offer the suggestion that you not be terribly upset should it not work out for you. It might, though. Actually, you might very well find that the amisulpride prevents poop-out. I'll be watching you on that one.
> I am going to see him soon and get scripts for mirapex, requip and milnacipran. Depending on the result of the amisulpride I will decide what to add or try alone next.
I think you are doing the right thing. I would definitely start with the amisulpride and then build on it. 50mg is the perfect target dosage. Milnacipran is something I would be very interested in if I respond only partially to Cymbalta.
> One direct question (I implore you respond to any of this post) is that I was on amineptine for several weeks and it was probably the most mood elevating med I have ever taken. I had to discontinue it because of interstitial cystitis.
> I began it 3 times since and had no response, but also no effects on my bladder. My question is then if the amisulpride has an effect should I combine it with amisulpride in the hopes it will make the amisulpride work again or should I combine it with Milnacipran as I had originally thought to do?
I know one person for whom the only thing that ever worked well was a combination of sulpiride + amineptine. I thought it was a brilliant combination on paper. Amisulpride would probably work that much better. What a difficult decision. I would be afraid to recommend a course of action except to perhaps flip a coin. Do you have a reliable supply of amineptine should it work? What was your experience with Effexor, by the way. A partial response might argue well to continue to look at milnacipran or Cymbalta - but you know that already.
> I understand it is just an opinion, but it will be more informed than mine.
I'm not so sure about that. You've got a good handle on all of the variables I think you need to know to make a good decision. I think that if amineptine is going to work, you will see it work within 2-3 weeks. What were you taking before, 200mg? Maybe you should give it a quick trial if you have enough on hand.
Just to throw a monkey-wrench into the works, I had a doctor give what I thought was good advice if you could afford to take it. He counseled me to stay as "clean" as possible between drug trials. He didn't want me to expose my brain to so many compounds chronically unless there was a good chance that one was different enough from the others to be worth a trial. In other words, he didn't want me to continue to revisit things that didn't work well enough to be worthwhile. But how can you afford to do this if you are so severely ill to be unable to get out of bed and shower? However, I think he would encourage you to go ahead with the milnacipran (or Cymbalta) rather than revisit the amineptine. The only time anything ever worked well for me was after an extended period of being drug-free - about a year. It was a combination of Parnate 60mg + desipramine 125mg. Unfortunately, the doctor decided to discontinue this treatment because I became manic on it. It never worked again. With 20/20 hindsight, he should have continued me on the medication and simply treated the mania as it developed.
You might consider playing with an anti-glutamatergic drug to see if it helps make some of these other things stick. These would include Namenda (memantine), Lamictal (lamotrigine), Campral (acamprosate), and Rilutek (riluzole). I am currently taking Lamictal 150mg + Namenda 20mg in the hopes that it will act synergistically with the next few antidepressants I try. I am even considering revisiting Parnate + TCA now that I'm taking these things. I am waiting to try Cymbalta next, though. Have you tried adding lithium 300-600mg?
Gosh, what a bunch of disorganized crap I've thrown out at you. I guess that's my way of being non-committal on recommending something that I'm afraid might not work for you. I hope it helps, though.
Among the other things I'm looking at are mifepristone and rTMS.
Can I borrow your crystal ball after your done with it?
- Scott
poster:SLS
thread:378449
URL: http://www.dr-bob.org/babble/20040817/msgs/379027.html