Posted by SLS on June 11, 2015, at 19:33:16
In reply to Re: Memantine (Namenda) makes me feel worse. » SLS, posted by phidippus on June 11, 2015, at 14:09:32
> >I think Trileptal would be the agent I would prefer to try first.
>
> Not the strongest antimanic...Is that why Trileptal?Depakote and Zyprexa are practically guaranteed to put the fire out. However, Depakote leaves me more depressed and Zyprexa is not ideal because of metabolic side effects. I have recently become more impressed with Trileptal as an antimanic, at least for bipolar 2 disorder. I have seen it work very well for some people, and side effects were minimal. I tried taking Trileptal for bipolar depression, not mania. It didn't help, but it had no side effects for me. It wasn't sedating at all, and I did not gain any weight on it.
> > my manias are so severe and include psychotic states
>
> Do you have mixed states?My mania with Parnate have been somewhat dysphoric. Manias associated with Nardil were more euphoric.
> > I have tried backing off of every single psychotropic I currently take in order to reevaluate its utility and reestablish their lowest effective doses
> Have you tried going off all your meds?
Not in quite awhile. How might I profit from doing this? My untreated baseline depression leaves me virtually unable to live independently. I become severely anergic and vegetative. I become numb to my surroundings. My affect is flat and I have no motivation or interest in doing things. I spend much of my time staring into space, despite sitting in front of a TV or a movie. I am too vegetative to commit suicide.
> > I feel confident that my regime is close to being optimized.
> What is your regime?
Parnate 100 mg/day
nortriptyline 150 mg/day
Lamictal 300 mg/day
lithium 300 mg/day
Abilify 10 mg/day
prazosin 30 mg/day
> > I am still somewhat attracted to trying memantine once more> Memantine is tricky. You kind of have to go up slowly and find the sweet spot-and the sweet spot is barely noticeable, but its there.
> > I hope things are better for you.> Agh! I've lost my libido entirely-I'm on Luvox and I think its the culprit. I want to trade it in for mirtazapine.
Are there any other sigma-1 agonists besides Luvox that might help?
Did Zoloft (sigma-1 antagonist) make you feel worse?
> Also been getting depressed-Luvox works great for the OCD but seems to do nothing for depression. How can that be?
I think most people thought that the drug company's decision to request FDA approval of Luvox for OCD was a strategy to gain entry into the US market so that it may also be used off-label as an antidepressant. Unfortunately, Luvox usually sucks as an antidepressant.
Please take a look at this:
http://www.ncbi.nlm.nih.gov/pubmed/?term=sigma-1+mirtazapine
How did you respond to high-dose Prozac? I wonder if normal dosages of Prozac, or even Lexapro, can be combined with Luvox safely. If it were me, I would leave Luvox in place for OCD and build an antidepressant regime around it. For instance, you might explore taking Luvox, Effexor, and Remeron together. Serotonin syndrome is a concern, of course. You might want to have a thermometer and cyproheptadine on hand, just in case.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1079066
URL: http://www.dr-bob.org/babble/20150520/msgs/1079659.html