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Re: Trying a different tack » mtdewcmu

Posted by SLS on December 31, 2009, at 2:20:37

In reply to Re: Trying a different tack, posted by mtdewcmu on December 30, 2009, at 22:31:09

> > > I am suspicious that Prozac is doing more harm than good, so I am going to try simplifying my regimen to Wellbutrin (300mg, XL) and Remeron (45mg). Wish me luck.

> > Good luck!!!
> >
> > :-)
> >
> > If you decide to return to an SRI, I would recommend using either Effexor or Lexapro to go along with the other drugs you are taking. You could perhaps add Geodon if your response to these treatments is incomplete.

> Unfortunately, I am paying out of pocket for my meds, and Lexapro and Effexor are both very expensive. The instant release form of Effexor is not, but I don't want to take it 2-3 times a day.
>
> Geodon is also expensive. Do you think there is a point in trying Geodon if Abilify has not helped?

I wish I could say for sure. I haven't kept track of anyone who has taken both drugs in this order to be able to come to any conclusions. I would say that the drugs are different enough to entertain the idea.

> I also had unpleasant side effects from Abilify, like heart palpitations (which I attribute to the adrenergic blocking effect)...

I'm drawing a blank. What adrenergic blocking effect are you referring to?

> ...and orthostatic hypotension. Is Geodon any better in this respect?

I know that I am not being a lot of help here, but I would again have to say that I don't know, primarily because I haven't heard of hypotension being a problem with Abilify. Geodon would probably be worse as it is a more potent antagonist at NE alpha1 receptors. However, I had no such problem with Geodon at a dosage of 80mg.

> I am thinking of moving on from the SSRIs (and Effexor is very similar to an SSRI) and trying nortriptyline if necessary. I liked the way amitriptyline felt. The only problem with amitriptyline was the tachycardia, but nortriptyline is supposed to be better.

Nortriptyline is better because it has a much reduced potency as an anticholinergic. I think it is a reasonable choice. You can always augment it if it does not produce adequate results as monotherapy.


- Scott

 

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URL: http://www.dr-bob.org/babble/20091227/msgs/931733.html