Posted by SLS on September 17, 2011, at 9:11:37
In reply to Re: 40% down to 25% » SLS, posted by Dinah on September 16, 2011, at 21:16:07
Hi Dinah.
> There was a two week difference between your post saying you were at 40% and your post saying you'd gone down to 25%. Is it possible to segregate permanent change from the natural ups and downs of any illness?
I think I understand what you are saying. Were I to keep a daily mood chart, it is possible that any differences between your two scenarios would be revealed. That I still experience a depression that is considered to be severe (although less severe than in the past) is unacceptable when alternate treatments exist.
> If you've felt well for a while on this medication, is it possible that this is a dip rather than a decline?
It really doesn't matter to me which of the two it is. I rate myself now as being only slightly better than a year ago. Of course, this is better than nothing. If Nardil had not been a MAOI, I could simply add other drugs to it, and have a reduced risk of relapsing. Unfortunately, this is not the case, as the two medications I am to try are serotonin reuptake inhibitors, which if they were to be mixed with Nardil would most certainly provoke serotonin syndrome.
> I'm also wondering if you have felt good on a medication for an extended length of time,
Yes. 100% for 6 months in 1987 on a treatment regime of Parnate and desipramine.
> ...or if you only felt like it was really working for the first little while you were on it?
Yeah, I got that more robust improvement during the first few weeks of Nardil treatment.
> Is it possible that it's the shock of a change in brain chemistry that makes you feel good for a while?
I guess there must be some degree of disruption of homeostasis forced by the drug being used in order to provoke an antidepressant response.
> I think on any medication there's a drift back to setpoint. I definitely find this with Provigil. Now I have to take my morning Provigil to avoid sleeping all day. It doesn't feel like it initially did.
That stinks. Have you already been through the stimulants? I suppose there is a chance that Nuvigil could effectively replace Provigil. Knowing that Risperdal functions as a 5-HT2a receptor antagonist leads me to wonder if using nortriptyline might provide you with similar benefit and with less daytime sedation or sleepiness. Perhaps you don't need any dopamine receptor antagonists at all. Just a thought or two...
Have you ever tried Geodon? It is the most antidepressant-like of the APs. It can be stimulating. Unfortunately, it is a very unpredictable drug that is hard to categorize. You need to start at 40mg per day as a minimum dosage to avoid the emergence of anxiety. If it produces somnolence, profound brain-fog, and cognitive blunting early in treatment, it probably will not be of any use, and you could discontinue it immediately should these things appear and persist for a few days.
I don't see any reason why you would have to discontinue Riserdal to perform any of these trials.
Getting back to me, I can remember where I was and what I was doing when I experienced robust improvements in my depressive condition. This includes periods of time lasting but for a few hours; so profound is the difference in experience. I guess it's like someone who is blind from birth suddenly gaining sight for a few minutes. The experience is unmistakeable as a change in his perception of the universe, and will never be forgotten.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.
poster:SLS
thread:994620
URL: http://www.dr-bob.org/babble/20110914/msgs/996993.html