Posted by bleauberry on December 23, 2009, at 17:36:58
In reply to Where do we go from here? Help and ideas please, posted by inanimate peanut on December 23, 2009, at 14:41:33
What about a switch to Nardil?
What about a switch to Effexor+Nortriptyline, Zoloft+Nortriptyline. Regardless of any past experience with these meds, they work distinctly different and usually a lot stronger when partnered together. For example a Nortriptyline + Effexor situation won't feel like some of the Nortriptyline stuff and some of the Effexor stuff together at the same time. It will instead feel like a totally different drug not like either one of them.
I would dump the ones that aren't doing anything significant for you. IBS can be dealt with in other ways. That med you are taking for it is counter productive for depression. Usually makes things worse. Any med or supplement that is not providing you clearcut benefit should be weaned out. There is the distinct possibility one of them is actually hindering the way the others might work better. In other words, get the underperformers out the way so the rest will have a clear path to do their thing.
In my view, infectious disease is a common unsuspected cause of psychiatric symptoms, most evident when treatment is very resistant. There is a good deal of new evidence now, along with hot debate from both sides, that D3 is NOT a good thing to be doing with infectious disease. This is counter to all the previous held notions. And thus heated debate. I am in the camp that says the average person is getting plenty of D from a little bit of sun and dairy and other foods. Fortified cereals for example, almost all of them. If there is a documented D deficiency, it is not that way due to lack of intake. One side of the debate says it is that way because it is major food for the metabolic activity of a variety of infectious organisms. D3 can worsen symptoms and dig a much deeper hole, despite a short-term boost when first starting supplementation with it. My take is in agreement with this view, primarily because two doctors I have dealt with strongly told, "try D3 but if you start to feel worse in a couple weeks STOP it". Infectious experts now use low D3 lab reports to further solidify their hunch of an hidden inner infectious situation. Low D3 says a lot, if you know what to look for.
Back to the IBS, it has to be considered there is an infectious variable going on here. Why do I say that? Because almost everyone with IBS who tried the Low Dose Naltrexone protocol (1.5mg-4.5mg bedtime) experienced remission. Improved energy and mood is common too. LDN basically supercharges a weakened immune system and boosts opioid peptides several fold. Somehow IBS symptoms resolve this way.
I don't know how long you've been on Parnate. If less than 3 months, let it be and give it more time. ??? I know, hard.
Realistically and logically my gut instinct says switch to a SNRI + NRI combination, or SSRI + NRI combination. Effexor+Nortriptyline, Zoloft+Nortriptyline, Effexor+Savella, Savella+Nortriptyline, Effexor+Savella+Nortriptyline. You get the picture. I didn't mention Cymbalta because at other forums it just seems to be a loser so often, but I must admit there are enough huge success stories to warrant considering it. In every one of those cases though, it was combined with something else such as Wellbutrin, Savella, or Nortriptyline.
And get rid of the underperformers. But don't do it in a hurry. Wean off in slow tiny steps. If you don't need them, you don't need them, simple as that. If they aren't doing a ton of good, they are excess malignant baggage weighing you down, weighing your liver down, weighing everything down. Metabolizing meds is hard enough on the human body, we don't need to worsen ourselves by allowing underperformers to pollute our inner landscape. I know Seroquel is prescribed like candy and is sometimes useful in depression. Let's get some reality mixed into that. Here it is. Give an antipsychotic, any antipsychotic, the most sedating ones in particular, to anyone, for an extended period of time, and just witness what it does to them. Usually not a desirable outcome. Depression the same or worse, flatness apathy, empty, couch potato, diabetes risk, weight gain. I like antipyschotics at the right time for the right reason at the right dose. But for sleep? I'm sorry, I totally disagree with that common strategy.
poster:bleauberry
thread:930558
URL: http://www.dr-bob.org/babble/20091217/msgs/930579.html