Posted by SLS on November 26, 2004, at 12:39:37
In reply to Re: To Scott, posted by denise1904 on November 26, 2004, at 9:23:50
Dear Denise,
Unfortunately, it is quite common for one to become more and more resistant to responding to medication with each subsequent usage. If you do find something that works, stay with it. If you must, think of medication as a temporary bridge to a future cure.
> Yes I agree with you there, the only thing is I can't get any of my doctors to prescribe Wellbutrin for me and I tried asking one of them to prescribe Wellbutrin he said no too dangerous and they don't use it for depression so I went back to another doctor and tried asking him for Zyban, again he said no, too dangerous.
Are they saying that Wellbutrin is dangerous to combine, or is it that it is dangerous to use even monotherapeutically? There is an interaction between Paxil and Wellbutrin that results in a significant increase in the levels of Wellbutrin and its active metabolite. This complicates matters somewhat, however, one can simply titrate more slowly on the Wellbutrin and initially target a dosage of 150mg. Perhaps your having reported a prior seizure dissuades them from Wellbutrin. I believe the risk of seizure on Wellbutrin has been greatly exaggerated. Perhaps it does make sense, as Ed suggests, to switch from Paxil to another drug and reserve Wellbutrin for later if it becomes necessary. I know one person who does well when combining Wellbutrin with either Effexor (venlafaxine) or Lexapro (escitalopram). Effexor + Remeron is sometimes useful.
The only time I was ever well was at age 27 when I combined Parnate 60mg + desipramine 150mg. I would still be well today if the doctor had not have me discontinue it. I had become manic on the combination after about 6 months of euthymia. This was his reason for discontinuation. I don't fault him on that. I do, however, blame him for being too stubborn to return to the same combination as soon as I relapsed into depression. It had already been established that I was extremely treatment-resistant. Part of the problem was that Prozac had just been approved, and the first thing he wanted to do was to play with the new toy. When I eventually returned to the combination, it no longer worked. Unfortunately, combining Parnate + imipramine + Lamictal is now the best I can do to keep me at least minimally functional. I still can't read more than a few sentences at a time. Unfortunately, I can't really keep up with all of the new research. Because of this, I need to rely on other people to inform me as to what's going on. I don't like that. Cognitively, I am very much impaired - believe it or not. During the time I was well, I read my first and only book cover to cover as an adult and understood it. It was "Dance of the Wu Li Masters".
Don't worry, Denise, you will definitely find something that works. It may take some time though, so you will need to be both resolved and patient.
Take care.
- Scott
poster:SLS
thread:419278
URL: http://www.dr-bob.org/babble/20041123/msgs/420513.html