Posted by jerrypharmstudent on November 16, 2009, at 18:24:06
In reply to Re: Need help choosing a new SSRI/SNRI, posted by bleauberry on November 16, 2009, at 18:01:09
> . Here's my current list of meds:
> >
> > Geodon 40mg x2daily
> > Adderall 20mg x3daily
> > Lexapro 15mg
> > Klonopin 1 mg 3xdaily then 2 at bedtime
> >
> > My current symptoms right now are severe anxiety/dread and depression. The Geodon was helping tremendously at first but petered out and I can't raise it because 60mg x2daily makes it hard for me to swallow food.
> >
>
> My take on this is a little different.
>
> First of all, with the severity of your symptoms at present, one of your meds is working against you...completely wiping out any good the others are doing...or they are all impotent. Either way, I think at this time it is very important to eliminate one. On that list of meds, the most likely to cause or worsen depression in the longterm...Adderall. Short term excellent, longterm different story.
>
> I would think adding a tricyclic to Lexapro would be a safer more effective option than replacing Lexapro. Especially considering you've been on the other ssris already. Why go backwards? Move forward. SSRI+TCA. I suspect the Lexapro could be restored to full efficacy with a TCA, and that neither a TCA or Lexapro will do much good on their own. And that one of the other meds is interfering in the whole thing. But I don't think Lexapro itself is the problem, and I do not think switching from it to another ssri/snri is going to make any difference at all.
>
> Different topic...snri...I don't know why they call them that...marketing I guess? Their action on NE compared to 5ht is negligible. For a true balanced NE/5htp, SSRI + TCA.
>
>I actually agree about the Adderall and have been giving it a rest for while now. But as for the TCA - which to choose? Nortriptyline? Amitriptyline? I'm lost? And at what dosages?
poster:jerrypharmstudent
thread:925936
URL: http://www.dr-bob.org/babble/20091107/msgs/925963.html