Posted by Racer on May 6, 2008, at 10:00:21
As those of you familiar with me already know, I don't have a great history of medications working well for me. Right now, my good and trusted friends are letting me down -- Wellbutrin XL 450 and Concerta 36 with the addition of 5 to 10 mg Methylin PRN.
And I spent hours trying to decide whether it was worth fighting on, or if it was time to lay down my sword. I'd say something really has to change.
So, I wrote my beloved pharmacologist, and told him I was in bad shape and didn't think I could wait until mid-June for something to change. He wrote back suggesting one of two things: rTMS or Effexor. He said that he knows Effexor causes one of the side effects I find most intolerable, but it's "predictable and quite effective." I wrote back, telling him that I wouldn't consider Effexor, because it wasn't effective for me until a low dose of Prozac was added, and that I'd be more willing to consider a low dose of Prozac -- but that I would be reluctant, based on past performance and because I thought I needed something which would kick in faster. I haven't heard back from him yet, but I thought I'd ask around about temporary options which might kick in faster?
There are a lot of options which aren't on the table here, for a variety of reasons. To begin with, we're talking about trying tianeptine in June, after he gets some questions answered. From the reading we've both done, I'm eager to try it, so I am not looking for a long term fix right now. Just a stop-gap measure. And I have had a lot of bad reactions to medications, so the following are off the table entirely:
MAOIs
TCAs
Remeron
Serzone
Effexor
Benzos
Zyprexa
LamictalThe following are mostly off the table, but I'd reluctantly consider them:
SSRIs
Seroquel
BetablockersI'd consider:
Provigil, but doubt he would, since I'm already on Concerta
Dexamethasone, since I've read of it kickstarting serious depression relief in small doses for a short course
Maybe a heavy tranquilizer, or even a heavy painkiller -- bring on the Percodan!I don't know -- and I'm afraid of sounding so recalcitrant about all this with him. But there are some things I just couldn't handle trying again -- and Effexor is one of them. Maybe I should write back and offer to try a low dose of Cymbalta as a compromise?
I hate this so much.
Any ideas for a jump start?
poster:Racer
thread:827471
URL: http://www.dr-bob.org/babble/20080430/msgs/827471.html