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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by john-paul on October 9, 2002, at 19:53:06
I'v switched from trazodone to zoloft to effexor xr back to trazodone, it seems like each one becomes ineffective after a while, I am bipolar and also on depakote,and ambien. Is this common? should I just give up on the antidepressants. I'm tricating up from 100 mg of trazodone, yet the drug already seems usless. Any ideas on this, I am at my ropes end. My eyes constantly feel like I've been watching a sad movie. I feel like an emotional zombie, sad and numb.
Posted by BrittPark on October 10, 2002, at 19:57:18
In reply to antidepressant resistance, posted by john-paul on October 9, 2002, at 19:53:06
First let me ask some questions; how long were you on and how much did you take of each antidepressant; if trazodone didn't work one time what makes your doctor think it will work now?
Here are some suggestions: try a new class of AD, a TCA or an MAOI or Remeron. Find the AD that gives you the best response even if not very satisfactory and either add another antidepressant (from a different class, preferably) or augment. Some reasonable augmentation strategies might be an atypical anti-psychotic like Risperdal, Zyprexa, or Seroquel (sp?), or another AE like Topamax or Lamictal. (If lamictal, be very careful in titrating it up as it interacts strongly with depakote, or consider swithching to it instead of depakote. Lamictal seems to be more antidepressant than any other mood stabilizer). Substitute Xanax for Ambien. Xanax has a certain amount of antidepressant effect on its own for some people.
This is just a set of beginning ideas. There are dozens and dozens of possible drug combinations. One of them will almost certainly work for you. Oh, and if your medication is being handled by a GP, find yourself a psychiatrist, preferably an expert in psychopharmacoloy.
Don't get discouraged, with a good doctor you'll be able to find the right medication regime fairly quickly, some number of months. That may seem like a long time, but be patient, you will get better. When I was 19 and was first diagnosed with Major Depression the only drugs available were TCAs, MAOIs and benzos. But even then my psychiatrist and I found a combination, imipramine 200mg and serax prn, that worked well enough for me to start and finish college.
I'm currently going through a truly refractory depressive episode myself right now and have been working on it for months. It's frustrating but I'm sure my psychiatrist and I will find a way through. You will too.
Feel better,
Britt
Posted by john-paul on October 12, 2002, at 9:35:11
In reply to Re: antidepressant resistance » john-paul, posted by BrittPark on October 10, 2002, at 19:57:18
Thanks Brit. I was on 150mg trazodone, then 300mg zoloft, 375mh effexorxr, currently on 100mg trazodone. 1,000mg twice a day of depakote, 10mg of ambien at bedtime, and 375mg of anaprox twice daily for back pain. I see a GP and a counsler, My GP works with a Pdoc on consulting basis, HMO guidelines, ie: I've been diagnosed etc. The reason to switch back to trazodone is cost, older drugs are available in generic form. So my monthly cost went from about $40 for the effexor to $3.75 for trazodone. I'm not giving up as in exiting life, just think that maybe feeling bummed is 'normal'. This has been a long battle, I realize that part of it was my fault, I only went to the doc for depression, I loved the manic highs, until it almost cost me my job and family.
During a mianic episode someone at work said I threatened a coworker, that I do not remember. I do remember being totally pissed and saying I wish some one would pop him a good one. Looking back I can see that it was mania that had me drop out of the university, twice. I am printing your reply and taking it to the doc for my next visit,
I need him to refer me back to the Pdoc, or consult with her. Funny you should mention Zyprexa, as that is to be 'on the table' for next visit. I also usually feel like I am on the edge of a manic episode. Thanks again, See-ya JP
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