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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Flipsactown on February 22, 2004, at 2:43:10
I am in a quandary. I have been on ADs for over 12 years and have been very successful with it. However, the past 5 months have been very difficult for me in that I have been unable to shake the depression for a full 24 hrs. The depression seems to peak from 2PM to 7PM. I have only been on 900mg lithium, recently increased to 1200mg for a month and 5 months on 400mg lamictal. I am on 100mg prozac and 90mg remeron. My pdoc and I are aware that we are exceeding the recommended dosage for prozac and remeron. Bottomline: Should I give the lithium more time? Should I increase lamictal? I have been on most of the ssri's and wellbutrin. Should I just wipe the slate clean and start from scratch? H E L P !!!!!!!!
Flipsactown
Posted by Sad Panda on February 22, 2004, at 8:28:21
In reply to Start Over Meds? Lithium,lamictal,remeron,prozac, posted by Flipsactown on February 22, 2004, at 2:43:10
> I am in a quandary. I have been on ADs for over 12 years and have been very successful with it. However, the past 5 months have been very difficult for me in that I have been unable to shake the depression for a full 24 hrs. The depression seems to peak from 2PM to 7PM. I have only been on 900mg lithium, recently increased to 1200mg for a month and 5 months on 400mg lamictal. I am on 100mg prozac and 90mg remeron. My pdoc and I are aware that we are exceeding the recommended dosage for prozac and remeron. Bottomline: Should I give the lithium more time? Should I increase lamictal? I have been on most of the ssri's and wellbutrin. Should I just wipe the slate clean and start from scratch? H E L P !!!!!!!!
>
>
> FlipsactownI wonder if that much Remeron is a bad thing? I tend to think of Remeron as a nice little sleeping pill that is an antidote for SSRI side effects. Taking high doses is supposed to be activating but I have only found it irritating. I would 1st suggest lowering Remeron down as low as you can go. Have you tried Zoloft? I have heard that Zoloft+Nortriptyline or Desipramine is a good AD combo, maybe ditch Prozac+Remeron & switch to something like that?
I dunno about much about mood stabilizers except that Lithium+Lamictal is supposed to be a pretty good combo. I don't think I'd mess around too much with them.
Cheers,
Panda.
Posted by Mags on February 22, 2004, at 18:38:35
In reply to Re: Start Over Meds? Lithium,lamictal,remeron,prozac » Flipsactown, posted by Sad Panda on February 22, 2004, at 8:28:21
perhaps you need to ditch the prozac. I assume based on the Lithium and Lamictal that you are probably BP2? I can't be on and SSRI because they make my mood bounce all over the place, especially prozac. Remeron may be OK.....
Mags
Posted by polarbear206 on February 22, 2004, at 19:38:08
In reply to Start Over Meds? Lithium,lamictal,remeron,prozac, posted by Flipsactown on February 22, 2004, at 2:43:10
> I am in a quandary. I have been on ADs for over 12 years and have been very successful with it. However, the past 5 months have been very difficult for me in that I have been unable to shake the depression for a full 24 hrs. The depression seems to peak from 2PM to 7PM. I have only been on 900mg lithium, recently increased to 1200mg for a month and 5 months on 400mg lamictal. I am on 100mg prozac and 90mg remeron. My pdoc and I are aware that we are exceeding the recommended dosage for prozac and remeron. Bottomline: Should I give the lithium more time? Should I increase lamictal? I have been on most of the ssri's and wellbutrin. Should I just wipe the slate clean and start from scratch? H E L P !!!!!!!!
>
>
> Flipsactown
Wow! You are on high doses of both ADs. This can exacerbate your depression if your bipolar. This is preventing your mood stabilzers from working the right way for you. Good Luck.
Posted by Flipsactown on February 22, 2004, at 19:59:49
In reply to Re: Start Over Meds? Lithium,lamictal,remeron,prozac, posted by Mags on February 22, 2004, at 18:38:35
I have unipolar depression.
Flipsactown
> perhaps you need to ditch the prozac. I assume based on the Lithium and Lamictal that you are probably BP2? I can't be on and SSRI because they make my mood bounce all over the place, especially prozac. Remeron may be OK.....
> Mags
Posted by polarbear206 on February 23, 2004, at 7:46:50
In reply to Re: Start Over Meds? Lithium,lamictal,remeron,prozac » Mags, posted by Flipsactown on February 22, 2004, at 19:59:49
> I have unipolar depression.
>
> Flipsactown
>
>
>
>
> > perhaps you need to ditch the prozac. I assume based on the Lithium and Lamictal that you are probably BP2? I can't be on and SSRI because they make my mood bounce all over the place, especially prozac. Remeron may be OK.....
> > Mags
>
>If I were you I would get a second opinion on your diagnosis. You are probably bipolar. I think many of us bipolars on the board would agree.
Posted by Sad Panda on February 23, 2004, at 8:09:02
In reply to Re: Start Over Meds? Lithium,lamictal,remeron,prozac » Mags, posted by Flipsactown on February 22, 2004, at 19:59:49
Lithium,lamictal,remeron,prozac
> I have unipolar depression.
>
> Flipsactown
>That's way too many drugs then :)
You need a new doctor I suspect.
Cheers,
Panda.
Posted by Flipsactown on February 27, 2004, at 22:02:33
In reply to Re: Start Over Meds? Lithium,lamictal,remeron,prozac » Flipsactown, posted by Sad Panda on February 23, 2004, at 8:09:02
In my desperate attempt to get depression relief, at least in the waking hours, I decided on my on to take 2 extra 20mg prozac capsules and in a couple of hours, although I had a slight headache, I noticed that my depression was gone. This was not the first time I have taken high dose prozac. In fact I was up to 160mg and decided to drop back down to 140mg hoping to get the same relief which I did. Problem solved, right? Not!! My pdoc refused to rx 140mg and would only go up to 100mg of prozac and add all these other meds as follows:
100mg prozac, 400mg lamictal, 1500mg lithium and 90mg remeron. I have a pdoc appointment on 3/16 and will again request a high dose prozac of 140mg since this appears to be the AD that I respond to. My concern is with all the other AD's which I want to slowly taper off of. Also prozac has already pooped out on me at 80mg before and am I going to have the same problem at the higher dose, if my pdoc rxs it?. Any comments or ideas? Thanks.Flipsactown
> Lithium,lamictal,remeron,prozac
>
> > I have unipolar depression.
> >
> > Flipsactown
> >
>
> That's way too many drugs then :)
>
> You need a new doctor I suspect.
>
> Cheers,
> Panda.
>
>
Posted by Sad Panda on February 27, 2004, at 23:38:37
In reply to Re: Start Over Meds? Lithium,lamictal,remeron,prozac, posted by Flipsactown on February 27, 2004, at 22:02:33
> In my desperate attempt to get depression relief, at least in the waking hours, I decided on my on to take 2 extra 20mg prozac capsules and in a couple of hours, although I had a slight headache, I noticed that my depression was gone. This was not the first time I have taken high dose prozac. In fact I was up to 160mg and decided to drop back down to 140mg hoping to get the same relief which I did. Problem solved, right? Not!! My pdoc refused to rx 140mg and would only go up to 100mg of prozac and add all these other meds as follows:
> 100mg prozac, 400mg lamictal, 1500mg lithium and 90mg remeron. I have a pdoc appointment on 3/16 and will again request a high dose prozac of 140mg since this appears to be the AD that I respond to. My concern is with all the other AD's which I want to slowly taper off of. Also prozac has already pooped out on me at 80mg before and am I going to have the same problem at the higher dose, if my pdoc rxs it?. Any comments or ideas? Thanks.
>
> Flipsactown
>
>
> > Lithium,lamictal,remeron,prozac
> >
> > > I have unipolar depression.
> > >
> > > Flipsactown
> > >
> >
> > That's way too many drugs then :)
> >
> > You need a new doctor I suspect.
> >
> > Cheers,
> > Panda.
> >
> >
>
>
If Prozac works so well for you surely one of the other SSRI's would work too. How about Zoloft or Celexa?Cheers,
Panda.
Posted by Flipsactown on February 28, 2004, at 0:16:26
In reply to Re: Start Over Meds? Lithium,lamictal,remeron,prozac » Flipsactown, posted by Sad Panda on February 27, 2004, at 23:38:37
I used zolof for a couple of years until it pooped out and I have tried celexa. I may not have given celexa the time needed to be effective as I discontinued it and went back to old reliable prozac. I wonder if zoloft and prozac have been scripted together before? What about the poop out factor? Do all ADs poop out?
Flipsactown
> > In my desperate attempt to get depression relief, at least in the waking hours, I decided on my on to take 2 extra 20mg prozac capsules and in a couple of hours, although I had a slight headache, I noticed that my depression was gone. This was not the first time I have taken high dose prozac. In fact I was up to 160mg and decided to drop back down to 140mg hoping to get the same relief which I did. Problem solved, right? Not!! My pdoc refused to rx 140mg and would only go up to 100mg of prozac and add all these other meds as follows:
> > 100mg prozac, 400mg lamictal, 1500mg lithium and 90mg remeron. I have a pdoc appointment on 3/16 and will again request a high dose prozac of 140mg since this appears to be the AD that I respond to. My concern is with all the other AD's which I want to slowly taper off of. Also prozac has already pooped out on me at 80mg before and am I going to have the same problem at the higher dose, if my pdoc rxs it?. Any comments or ideas? Thanks.
> >
> > Flipsactown
> >
> >
> > > Lithium,lamictal,remeron,prozac
> > >
> > > > I have unipolar depression.
> > > >
> > > > Flipsactown
> > > >
> > >
> > > That's way too many drugs then :)
> > >
> > > You need a new doctor I suspect.
> > >
> > > Cheers,
> > > Panda.
> > >
> > >
> >
> >
>
>
> If Prozac works so well for you surely one of the other SSRI's would work too. How about Zoloft or Celexa?
>
> Cheers,
> Panda.
>
>
>
Posted by Sad Panda on February 28, 2004, at 1:54:29
In reply to Re: Start Over Meds? Lithium,lamictal,remeron,prozac » Sad Panda, posted by Flipsactown on February 28, 2004, at 0:16:26
> I used zolof for a couple of years until it pooped out and I have tried celexa. I may not have given celexa the time needed to be effective as I discontinued it and went back to old reliable prozac. I wonder if zoloft and prozac have been scripted together before? What about the poop out factor? Do all ADs poop out?
>
> Flipsactown
>
>
>I think 'poop out' is just tolerance. Maybe Zoloft works at the normal dosage again?
In Doctor Bob's tips a pdoc talks about a patient using Prozac to boost the level of Effexor because she couldn't afford to pay for extra Effexor.
Cheers,
Panda.
This is the end of the thread.
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