Posted by SLS on June 10, 2006, at 11:00:59
In reply to What does this mean when this happens...., posted by blueberry on June 10, 2006, at 9:09:45
> This happened three times in a row, first with prozac, then with lexapro, then with cymbalta...the first day or two I get a decent bounce and I think I'm on the right track. But between day 2 and day 4 I become much worse and start crying with no reason and no control, much more depressed than I had been to start with.
What do you feel when you get more depressed?
I think your idea regarding downregulation has merit. When I was a patient at the NIH, the doctors there claimed that having an initial blip improvement was a good prognosticator of eventual response. Perhaps you could use pindolol, a 5-HT1a antagonist, as a buffer and accelerate your response. There was quite a bit of interest in using pindolol to augment antidepressants a few years back.
Have you ever managed to get to a therapeutic dosage of any SRI?
Buspar?
I'm sure you noticed that the three drugs you tried are all potent serotonin reuptake inhibitors. Perhaps you ought to look at drugs that don't do that. Something like desipramine or Remeron perhaps?
- Scott>
> All doses had been very low since I seem very sensitive for some reason. That did not used to be the case in previous years. I have never had trouble starting an antidepressant before. Lexapro was 2.5mg, prozac was 2.5mg, cymbalta was 5mg.
>
> I'm wondering...am I having a super difficult time getting through the initial down-regulation stage? Or does this reaction mean I am bipolar? Were the doses too low and I should have just braved normal doses right from the start? Your thoughts?
>
> If the consensus is that it is a down-regulation stage, then I may have to go to the hospital or a partial day-hospital program to get through it. If the consensus is bipolar, then I need to look at mood stabilizers without antidepressants.
>
> I ask all of you here because both of my doctors don't know what's going on. They keep saying, "that's odd, I've never seen that happen before". Or one doctor said suicidal ideation comes from too much serotonin squashing out norepinephrine and that cymbalta won't cause worsening of depression...but it did.
poster:SLS
thread:655187
URL: http://www.dr-bob.org/babble/20060610/msgs/655224.html