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Start over with clomipramine or combination?

Posted by MuseMemento on April 26, 2014, at 20:19:01

I've just finished, unsuccessfully, a trial of methylphenidate 20 mg in addition to 300 mg bupropion xl, 20 mg escitalopram and 2 mg abilify. Tuesday is the next appointment with the pdoc and TCAs will be the next step. So, question, I know we'll be either discontinuing or tapering off the escitalopram to make way for clomipramine but should I also discontinue the bupropion, which had previously been my only successfuly AD, and abilify or change only the one agent at a time? I'm not sure the abiilify ever helped or that the bupropion is adding anything currently. I also know that there's an enzymatic interaction between clomipramine and bupropion which increases the plasma levels of clomipramine but I also smoke currently and it seems that may even the effect out. Treatment is for MDD, OCD, GAD, possibly PTSD. Thanks for any replies.


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poster:MuseMemento thread:1064818
URL: http://www.dr-bob.org/babble/20140419/msgs/1064818.html