Posted by mtdewcmu on April 14, 2011, at 8:42:32
In reply to Re: Nortriptyline vs reboxetine » Bob, posted by SLS on April 14, 2011, at 4:59:40
> I must have hit a bump in the road this past week that was simply a worsening associated with the natural course of my illness rather than a lithium-induced worsening. I rechallenged myself with lithium 300mg and have recaptured the antidepressant effect. I like this drug (today). Interestingly, Harvard / Mass General determined that low dosages of lithium (300-600mg) act as an augmenter of antidepressants in MDD. Most patients whom responded did so at a dosage of 450mg. The antidepressant used in the study was fluoxetine. There is substantial indication in the medical literature that lithium added to a tricyclic can produce a rapid and robust improvement. It is nice to know that lithium can also augment a SSRI. Unfortunately, there are no studies I know of that compares the rate of response to an SRI versus a tricyclic when lithium is added.
>So it probably would have made more sense if Symbyax had been formulated as fluoxetine + lithium, huh? But there's no money in selling lithium.
Does lithium hold enough benefits to justify its toxic effects in MDD? You have to get blood tests, and it causes the shakes, and it dysregulates your kidneys, and it probably has other subtle metabolic effects. But if it works well, I'm interested.
poster:mtdewcmu
thread:981366
URL: http://www.dr-bob.org/babble/20110406/msgs/982781.html