Posted by med_empowered on July 13, 2005, at 3:07:26
In reply to Lithium antidepressant augmentation?, posted by Emily Elizabeth on July 12, 2005, at 20:13:51
hey! I have bipolar, so I havent taken a mood-stabilizer for unipolar depression. Some relatives and friends of mine have taken mood-stabilizers and/or antipsychotics as add-ons for severe depression, with mixed results. Sometimes the depression goes away and everything is awesome. Sometimes you feel better, but the lithium makes you feel kind of stupid. Sometimes nothing happens. And...worst case scenario...sometimes the add-on drug actually deepens the depression. Have you tried Lamictal? The reseearch on it for unipolar depression is scant, but it seems to pack a punch against depression. Lithium, depakote, etc. all pretty much function as anti-manic agents; although there may be fewer depressive episodes and the rate of successful suicide attempts is decreased by the use of mood-stabilizers, they arent really mood brighteners in the conventional sense. Plus, speaking from experience, they can cause some bad side effects--cognitive dulling, emotional numbness, lethargy, over-sedation, weight gain, hormonal problems, skin problems, hair loss, so on and so forth. This isnt to say they dont work for some people--they do, and the side-effects dont hit everyone and they can usually be managed--but please realize that Lithium is a pretty hardcore medication. Lamictal can cause weird rashes and what not, but it seems to have a mood-lifting effect, almost like an antidepressant or stimulant. Its more expensive than lithium, but there arent any blood tests and, assuming you dont get "the rash," the side-effect profile is a lot more user-friendly than that of lithium. Other options would be...stimulants (desoxyn, dexedrine, adderall, ritalin, provigil--maybe cylert, but I'd avoid it b/c of the liver problems), buspar (anti-anxiety and some anti-depressant effects at higher doses), antipsychotics (with old ones, low dose perphenazine used to be a standby; zyprexa is the most popular antipsychotic for this use, but abilify is gaining popularity since it has a nicer side-effect profile), amoxapine (weird tricylic/antipsychotic in one: good for treatment resistant depression, psychotic depression, "moody schizophrenia"/schizoaffective, etc...chemically related to loxapine), and some others. Then, there are some creative, VERY "off-label" uses of meds for antidepressant effects. Painkillers seem to have some antidepressant effects; Ultram, for instance, seems to help some people (if you read old medical documents, you find that opium used to be the antidepressant/anxiolytic/sedative/antipsychotic of choice). Marinol, the THC pill, is sometimes used for depression, bipolar, ADD, etc., but few docs are willing to try it (for some reason, its OK to RX amphetamines, but not pot. Go figure). Drugs used in Parkinsons and Alzheimers are also sometimes used, usually in addition to more standard treatment. Good luck!
poster:med_empowered
thread:526899
URL: http://www.dr-bob.org/babble/20050708/msgs/527032.html