Posted by SLS on September 7, 2004, at 8:32:03
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by pseudonym on September 6, 2004, at 13:20:36
Hi Pseudonym.
> As for your current situation, I believe Abilify + Cymbalta would not be a bad route to pursue.
I have been taking Abilify 10mg for about a year now. It helps a little, I guess. When I first began taking it, I noticed an improvement in motivation and sociability. I'm not sure it is doing that much anymore, but I continue to take it to help keep me from entering severely suicidal states. I didn't find any additional benefit from going to 20mg.
> It seems clear from your approach that you are targeting DA and NA neurotransmitters.
That's what I have had success with in the past, but I wouldn't discount the importance that modulating serotonergic neurotransmission might have. I do wish that nomifensine and amineptine were still around.
> Serotonergic drugs don't seem to help you much, correct?
SSRIs have not been much help.
> Given that you were most helped by Parnate and desipramine, it would seem likely that the selegiline patch, when released, by Watson in combination with Mylan pharmaceuticals, would be the best treatment on the surface. Why? It mediates the release of both NA and DA.
Hmm. I guess I should move it closer to the top of my list. I didn't have too much interest in it initially because I failed a course of oral selegiline. However, I only went up to 30mg. Thanks.
> I can't determine what Lamictal and Namenda are doing for you or what lead you to take them. I recollect your explanation for Lamictal had to with "interest" and "physical energy". I would think that Abilify would be enough to do that. Your thoughts?
I have tried to discontinue or lower the dosage of Lamictal several times over the last year without success. It does help enough to continue with it, but it only seems to help when I am taking TCAs at the same time. Since beginning Namenda, I have been able to reduce my dosage of Lamictal to 150mg; low enough so that it doesn't impair my memory and cognition as much as it did at 300mg. Both drugs inhibit glutamatergic neurotransmission: Lamictal through glutamate release inhibition and Namenda through glutamate receptor (NMDA subtype) blockade. Because these anti-glutamatergic drugs have had some positive effect, I have my eye on riluzole (Rilutek), another release inhibitor now being used to treat amyotrophic lateral sclerosis (ALS), sometimes referred to as Lou Gehrig's Disease. Riluzole was recently reported by the NIMH to demonstrate antidepressant effects in a clinical trial to treat bipolar depression.
> My two cents
A worthwhile investment to be sure!
Thanks again. I'll definitely place the patch higher on my list.
- Scott
poster:SLS
thread:380308
URL: http://www.dr-bob.org/babble/20040904/msgs/387553.html