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Re: Gillmore (again) » gilmourr

Posted by SLS on January 18, 2013, at 6:30:45

In reply to Re: Gillmore (again), posted by gilmourr on January 18, 2013, at 4:35:56

I like Jono's plan.

Regarding Nardil, it is likely that you will experience some kind of brief response to it after having been off it for more than three months. The problem is, it will poop-out again rather quickly. I think you should look to augment it with something from the beginning or very soon after starting it. If you opt for going with a TCA, I recommend nortriptyline. It is the mildest with respect to anticholinergic/noradrenergic side effects. There is also lithium, Lamictal, Abilily, Latuda, and even Wellbutrin. Before abandoning the Zoloft, though, I would try adding nortriptyline or Wellbutrin or Abilify to it. In fact, you could begin treatment with Abilify and Lamictal before discontinuing the Zoloft.

One possible plan. There are things you can do first before going for ECT or TMS. If it is an emergency, ECT can be considered, but I might first try Zyprexa as an intervention.

Optimize your dosage of Zoloft to 100 - 200 mg/day

1. Add Wellbutrin.
2. Add Abilify.
3. Add Lamictal.
4. Discontinue Wellbutrin.
5. Add nortriptyline.
6. Discontinue Zoloft.
7. Add Nardil.
8. Add lithium.
9. Discontinue Abilify.
10. Add Latuda

You will modify this schedule depending on your reactions along the way.

Now is the wrong time to ask, of course, but what is your diagnosis?

What are your major symptoms?

Did you ever rapid cycle? (4 or more episodes per year)

Do you ever have racing thoughts?

Is there any history of mania or hypomania?

How old were you when you became ill?

What evidence is there in your family history of mental illness?


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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