Posted by Christ_empowered on October 20, 2014, at 7:25:43
In reply to Re: need just a bit more » cadett, posted by SLS on October 20, 2014, at 3:26:36
Have you heard of "california rocket fuel" ? Its Effoxer XR+Remeron, I think usually both at full doses. Surprise, surprise; there's a new-ish remake using Cymbalta instead of Effexor.
The only abstract I could find on the combo said it helps, but can cause "changes in mental state," which apparently includes (hypo)mania.
I just skimmed over the little abstract. I've heard that 30mgs/day Remeron causes less dense sedation and weight gain than the lower doses (I wanna say you can go up to 60mgs/day).
Remeron is generic, so acquisition costs are minimal. The combo could cause serotonin syndrome. The Effexor xr+ Remeron combo compared favorably to Parnate (similar results, more tolerable, no dietary restrictions) in some big study, probably one of the end stages of STAR D. If I recall correctly, the sample size was really small, so...the data isn't great. And that's Effexor xr+remeron, not cymbalta+Remeron, so...
...just a thought :-) I'd be kinda sorta concerned about night time Remeron plus xanax, just because...well...over-sedation is probably not what you're aiming for. Also, if (hypo)manic activation occurs, you've got nothing in the combo to help you simmer down.
Other thoughts....very low dose zyprexa, buspar, abilify (thank you, SLS), seroquel (maybe xr, if you have good insurance) at low-ish dose....lamictal...
...I have no idea what your remaining problems are, of course. Since you're getting reasonably good, but obviously sub-optimal results, now might be a good time to make a list of what you want/need out of treatment.Some symptoms are very treatable with Rx drugs. Others might be better dealt with through therapy, exercise, better sleep hygiene, maybe even supplements/complementary medicine, if you're into that sort of thing.
Hope this helps.
poster:Christ_empowered
thread:1072534
URL: http://www.dr-bob.org/babble/20141017/msgs/1072539.html