Posted by SLS on October 3, 2012, at 15:14:27
In reply to Re: PS. what should i do? » phidippus, posted by b2chica on October 3, 2012, at 14:07:28
Have you discontinued Lamictal?
Why are you still taking Pristiq if it is not preventing depression?
Did Pristiq work when you first started taking it? Does it continue to give you a partial response?
Did it make a difference to raise the dosage of Pristiq from 50 mg to 100 mg?
When you tried Wellbutrin, were you also taking Pristiq?
When you tried Wellbutrin, were you also taking Zyprexa?
Have you ever taken Effexor 300 mg/day?
I bet there are lots of things you haven't tried yet. You actually seem quite treatable. Just keep taking your Trileptal 600 mg/day. If you can induce mania, it should be easily controlled by using a mood stabilizer or an antimanic antipsychotic.
I think you are going to need an anticovulsant mood stabilizer (Trileptal 600 - 900 mg/day), an antimanic antipsychotic (Zyprexa 15 - 20 mg/day) and, if necessary, one or two antidepressants (Effexor 300 mg/day or Pristiq 200 mg/day; Wellbutrin 300 mg/day).
One can make the argument that treating you with only a combination of Trileptal and lithium makes sense. I guess it depends on where along the bipolar spectrum you are, and how much depression persists despite continued treament.
Try to keep things simple and have patience. This is not an easy thing to do. To tell you the truth, to avoid suicidaity and remain employable, it might make sense to continue with Zyprexa or switch to Abilify while continuing with Trileptal. As you can see, there are plenty of alternative treatments available. You have reason to be optimistic, despite the difficult time you are enduring right now.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1027311
URL: http://www.dr-bob.org/babble/20121001/msgs/1027466.html