Posted by Louisiana Sportsman on April 27, 2014, at 20:30:27
In reply to Re: Start over with clomipramine or combination? » LouisianaSportsman, posted by MuseMemento on April 27, 2014, at 14:04:41
>I'm now curious about adding modafinil, possibly up to 400 mg daily.
>I'm currently on Nuvigil #60 150mg. (300mg.) which is equal ~ to 600mg. of modafinil.
>Perhaps latuda or saphris would be a better addition, though?
>My "favorite" AAPs are Abilify, Latuda and Saphris because they seem effective without excessive H1 antagonism (sedation). Asenapine isn't one of the AAPs indicated for depression (like olanzapine, quetiapine, and aforementioned aripiprazole and lurasidone), but I tend to suggest it over Seroquel and especially Zyprexa unless there is a sleep problem at hand.
> Is the latuda treating you better than the abilify did?
>Physiologically, yes. Lurasidone is more metabolically sound and I am losing weight that I gained with the aripiprazole. In terms of symptom relief, I'd say that it is about equal, perhaps. One of the reasons I was reluctant to switch from Abilify was because I thought maybe due to partial agonism, it wouldn't attenuate my stimulants as much as some AAPs, but I actually noticed more out of my stimulants once I switched to Latuda, a full D2 antagonist.
> How are the effects of the brintellix compared to other SSRIs that you've tried?
>Here's a post where I answer this exact question:
http://www.dr-bob.org/babble/20140419/msgs/1064505.html
>I've been curious to try brintellix or vilazodone in combination with desipramine, amongst others, simply because it seems to offer something unique.
>Great idea for a combo! I made a post about the merits of a vortioxetine augmentation combo here:
http://www.dr-bob.org/babble/20140328/msgs/1064234.html
> I'd also like to try lamictal but I don't want to make too many changes too quickly lest I have no sense of what's working.
>Not really sure what lamotrigine does for me to be quite honest, but of course my PDOC says it would be ill-advised to take me off of my long-term mood stabilizer in regards to Lamictal due to its unique titration requirements. It's a good medicine for a lot of people and I think it's a good idea for you.
My pick? eslicarbazepine acetate, a prodrug which is activated into eslicarbazepine which an active metabolite of oxcarbamazepine which is a structural derivative of carbamazepine. (Tegretol -> Trileptal -> and now, Aptiom) Aptiom, from the manufacturer of Latuda, actually, came out earlier this month, in fact. The suggested maintenance dosage is one 800mg. tablet QD.
> Any other thoughts on the merits of your current combo?
>YES! Have you considered gabapentin or pregabalin? Hands down the best anxiolytic (better than alprazolam) for me that also acts a mood stabilizer and and antidepressant. My favorite medicament.
I urge you to check into it.
I find that modafinils + stimulants = happy campers.
poster:Louisiana Sportsman
thread:1064818
URL: http://www.dr-bob.org/babble/20140419/msgs/1064865.html