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methylphenidate augmentation of venlafaxine

Posted by europerep on August 27, 2010, at 14:19:56

hello there...

I have started adding methylphenidate to my 600mg/d venlafaxine regimen, as the next step against treatment-resistant depression... I started with 5mg instant release in the morning, then went to 10mg IR, and now since a couple of days I switched to 20mg extended release in the morning..
at first it gave me some headaches, but now, if it has an impact on my mood, it is actually negative. I can't say whether it's due to methylphenidate or whether it's just "conjunctional", but somehow I feel even more empty, and instead of decreased libido I now have basically none.. like I really couldn't care less.
my question would be up to which dose I should try it out before considering it failed? I personally do not believe that increasing dopamine, or any other of the "notorious three" neurotransmitters will actually help me.. I mean, 600mg of venlafaxine is certainly a lot, and it does help, but only marginally, and I do not think that there is still much too come by inhibiting even more reuptake of anything. in the one placebo-controlled trial of methylphenidate as an augmentation in TRD (which failed to show efficacy beyond placebo btw) they went to 54mg XR, should I go to 60mg XR then? I really want to give it a thorough trial to be able to say definitely whether it worked or not, but I just wanted to hear what some people on here would recommend as a target dose, be it from experience, knowledge, intuition, whatever ;-)..

thanks in advance!
eR

 

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poster:europerep thread:960153
URL: http://www.dr-bob.org/babble/20100821/msgs/960153.html