Psycho-Babble Medication Thread 344050

Shown: posts 1 to 16 of 16. This is the beginning of the thread.

 

Resistant Depression

Posted by wraith on May 6, 2004, at 16:01:56

I hope this finds you all well. I have been diagnosed with Resistant Depression having not responded to SSRI's, Tricyclics and MOAI's. The latter two were taken together when it became clear the Tricyclics weren't working.

I am now on a tricylic augmented with Lithium and can now feel my mood begining to brighten. My question is has anyone else tried the above and if so with what degree of success?

I would be grateful for any comments on the above.

Many thanks

Wraith

 

Re: Resistant Depression

Posted by linkadge on May 6, 2004, at 16:32:03

In reply to Resistant Depression, posted by wraith on May 6, 2004, at 16:01:56

I think that lithium augmentation of trycicilics is one of the better researched augmentation techniques. Lithium is one of the drugs that the longer you take it the better you feel.

Especcialy in resistant depression where the pleasure centers of the brain are shrunken, lithium has a remarkable cell volumizing effect, as well as documented neurotrophic effects.


Linkadge

 

Re: Resistant Depression

Posted by griswald on May 6, 2004, at 19:12:29

In reply to Resistant Depression, posted by wraith on May 6, 2004, at 16:01:56

Have you tried Lamictal?

 

Re: Resistant Depression » wraith

Posted by harryp on May 6, 2004, at 19:56:52

In reply to Resistant Depression, posted by wraith on May 6, 2004, at 16:01:56

I agree with linkage. Lithium is also a very good augmentor for MAOIs. I'm glad you're getting results.

Out of curiousity, what TCA are you taking with it? People tend to lump them together, but some of them have very different neurochemical effects. Unfortunately, their use is becoming something of a lost art.

Could you also mention what MAOI you tried, and what dosage?

Thanks!

 

Re: Resistant Depression

Posted by zeugma on May 6, 2004, at 20:34:33

In reply to Re: Resistant Depression » wraith, posted by harryp on May 6, 2004, at 19:56:52

Out of curiousity, what TCA are you taking with it? People tend to lump them together, but some of them have very different neurochemical effects. Unfortunately, their use is becoming something of a lost art.

I agree with this statement, and would add that MAOI's have been a lost art even longer than the TCA's, and many have suffered as a result.

 

Re: Resistant Depression

Posted by jerrympls on May 6, 2004, at 23:15:58

In reply to Re: Resistant Depression, posted by zeugma on May 6, 2004, at 20:34:33

I have treatment resistant depression. Been on everything....and now I'm sinking. Effexor 375, Concerta, Seroquel, Ambien, Valium...I'm numb and just don't care. What scares me is that I'm gaining the courage needed to actually end my life.

 

Re: Resistant Depression

Posted by harryp on May 6, 2004, at 23:35:51

In reply to Re: Resistant Depression, posted by jerrympls on May 6, 2004, at 23:15:58

> I have treatment resistant depression. Been on everything....and now I'm sinking. Effexor 375, Concerta, Seroquel, Ambien, Valium...I'm numb and just don't care. What scares me is that I'm gaining the courage needed to actually end my life.

For starters, anyone would feel horrible on that cocktail! That's not your fault!

This is what I do: I give myself five years--if it doesn't get better, at least I know there's an endpoint.

So far, it's always gotten better--a lot sooner than I expected, usually.

You need better care. Whatever doctor put you on that combo needs to be replaced and quickly. Going to a decent hospital would probably be the best thing to do right now.

I promise you you will feel better once you get those drugs out of your system. If you haven't yet tried a MAOI, now is the time. If you have, do it again with a higher dose and lithium. In the meantime, I suggest trying ECT. It is the most effective treatment for depression known.

Just don't give up, okay? Depression is something you can fight, and as long as you keep getting up, sooner or later you'll beat it down.

 

Re: Resistant Depression--see above (nm) » jerrympls

Posted by harryp on May 6, 2004, at 23:37:10

In reply to Re: Resistant Depression, posted by jerrympls on May 6, 2004, at 23:15:58

 

Re: Resistant Depression » harryp

Posted by jerrympls on May 6, 2004, at 23:48:33

In reply to Re: Resistant Depression, posted by harryp on May 6, 2004, at 23:35:51

> > I have treatment resistant depression. Been on everything....and now I'm sinking. Effexor 375, Concerta, Seroquel, Ambien, Valium...I'm numb and just don't care. What scares me is that I'm gaining the courage needed to actually end my life.
>
> For starters, anyone would feel horrible on that cocktail! That's not your fault!
>
> This is what I do: I give myself five years--if it doesn't get better, at least I know there's an endpoint.
>
> So far, it's always gotten better--a lot sooner than I expected, usually.
>
> You need better care. Whatever doctor put you on that combo needs to be replaced and quickly. Going to a decent hospital would probably be the best thing to do right now.
>
> I promise you you will feel better once you get those drugs out of your system. If you haven't yet tried a MAOI, now is the time. If you have, do it again with a higher dose and lithium. In the meantime, I suggest trying ECT. It is the most effective treatment for depression known.
>
> Just don't give up, okay? Depression is something you can fight, and as long as you keep getting up, sooner or later you'll beat it down.

Hi Harry-
I've been fighting depression for about 12 years now. I am 32. My 20's were lost...are lost. I've been on everything - MAOI's, TC, Combos, cocktails, opiates, stimulants, ECT, I was even a research participant in the Vegal Nerve Stimulator tests (I had it removed Aug. 2003). I've been on novel meds, anti-psychotics - you name it. I've been in therapy, hospitals - everything. My friends stopped calling/emailing last year. Parents don't want to hear about it. I have nothing to look forward to - nor do I have the desire to. I'm working so hard each day just to get up...this is not life...it's hell. It's about time I get a break and get to retire in heaven. NO worries.....I'm not gonna kill myself now.

Help me Obi Won Kenobi....you're my only hope......


 

Re: Resistant Depression » jerrympls

Posted by harryp on May 7, 2004, at 0:30:52

In reply to Re: Resistant Depression » harryp, posted by jerrympls on May 6, 2004, at 23:48:33

God, that's so horrible. 11 years (at least) here, with some decent remissions--had three decent years in my 20's despite being pretty debilitated--29 now. Finally got results from Parnate--if it quits working I'm toast.

I admire your determination. I don't know if you care for philosophy, but Immanuel Kant would say your persistance in living despite your misery gives you and your act (in living) genuine goodness and moral worth, whereas the act of living because one enjoys life is morally neutral (though certainly good in the sense that happiness is a good.)

I wish I had some advice, but I can't think of anything except that I would go the MAOI route again, with a higher dose and lithium augmentation. Make sure you try both Nardil and Parnate and titrate up to the maximum dosages (~100 mg Parnate), not sure about Nardil.

Bernstein's *Drug Therapy in Psychiatry* has the following additional suggestions.

If no response to Lithium, add 25 micrograms triiodothyronine.

No reponse--add 1-2mg bid Trifluoperazine

No response--add a TCA or HCA (probably amitriptyline--titrated slowly)

No response--I'd start over with the untried MAOI.

I'm concerned that the Seroquel, Ambien, and Valium could be worsening your depression. I'd try to get rid of those and use Trazodone as a sleep aid. Maybe by simplifying things it will turn out that the Effexor is doing some good after all.

It's especially cruel that our culture makes young people feel guilty for not being happy. The twenties were a write-off for a lot of the people I know who weren't even mentally ill--blown off with drugs, alcohol, parties and random sex you can't even remember having, job hopping, video games, etc. You have time.

 

Re: Resistant Depression » jerrympls

Posted by harryp on May 7, 2004, at 0:33:05

In reply to Re: Resistant Depression » harryp, posted by jerrympls on May 6, 2004, at 23:48:33

Hmm. Remeron and a MAOI has sent ace back into his normal ecstatic state. Might be worth a try.

 

Re: Resistant Depression » harryp

Posted by jerrympls on May 7, 2004, at 1:40:46

In reply to Re: Resistant Depression » jerrympls, posted by harryp on May 7, 2004, at 0:33:05

Problem - 100 lbs weight gain from SSRIs and MAOI's. Trazadone has been tried many times - hangover is too much. I'm on Synthroid. Been on Lithium, Neurontin, Tegretol, Topomax, Lamictal, Imiprimine, Nortriptyline, Ascendin, Serzone, Wellbutrin, Remeron, Nardil, all SSRIs - multiple times, Dexedrine, Adderall, Ritalin/Concerta, Clonidine,most benzos, Nembutal, Sonata, Ambien, Halcion, Restoril, Dalmane, Atarax, Testosterone Gel, Effexor, Parnate, Fish Oils, ECT, VNS, CBT, hydrocodone, oxycodone, Fentenyl transdermal patch, Depakote....

All with adequeate trials at therapeutic dosages alone and in various combinations. My current doc suggested psycho-surgery - HA! = lobotomy - and more ECT (had it over 7 years ago - still have memory problems).

I've seen endocrinologists, reseach psychiatrists & psychopharmacologists, therapists....you name it.

My doctors say they haven't given up - but I know they have. And when they give up - what do ya do?

No friends
No family support
No money
No dreams

Poor me - right? I guess...I'm just numb.

I've thought about walking in front of an oncoming bus - usually everytime I cross the street. Thought about what music I'd like to have played at my funeral.

But..for some unknown reason I keep going...existing in a horrific state. Wouldn't you call that self-abuse?

The turth is that for 10-20% of those with depression have terminal depression. I've come to realize I have terminal depression.

No one's ever fought for me...tired I've become of fighting for my life every day. Strong I am...but not that strong.....

...to be continued......

 

Re: Resistant Depression - Jerry

Posted by Anna P. on May 7, 2004, at 2:13:18

In reply to Re: Resistant Depression » harryp, posted by jerrympls on May 7, 2004, at 1:40:46

Hello Jerry,

I've noticed that you mentioned the opiates as the one possibility you have tried. Can you tell me any hospital, any doctor, any state where I can get prescribed opiates for my treatment-resistant depression?

I've already tried Ultram and Buprenorphine in the past without success.

Anna P.

 

Re: Resistant Depression - Jerry

Posted by tamdon on May 7, 2004, at 2:55:45

In reply to Re: Resistant Depression - Jerry, posted by Anna P. on May 7, 2004, at 2:13:18

Wow, I thought I was the only one that lost my twenties to depression and experimentation with different anti-depressant combos. I am 32. I can hardly believe it because the years blew by and I am in a bad way still because an MAOI recently started to work then stopped when I tried to diet. I gained weight due to the drugs, too. Hang in there. Know there are people who are in practically the same boat. Yeah, ECT, too.

 

Re: Resistant Depression » jerrympls

Posted by finelinebob on May 7, 2004, at 4:26:06

In reply to Re: Resistant Depression » harryp, posted by jerrympls on May 7, 2004, at 1:40:46

"Western" medicine isn't the only kind out there. Maybe posting on PB-Alternative can give you some other things to try.

Speaking from personal experience -- my PTSD after 9/11 got so bad I couldn't get 10 feet out of my apartment before I ran back inside. Acupuncture worked wonders for me, and in combination with the meds I was already taking for my other disorders gave me a tremendous boost of clear headedness and energy. That enabled the most productive period I've ever had in talk therapy as well. I wish my circumstances were such that I could have all three in combination right now.

hth -- flb

 

Re: Resistant Depression

Posted by wraith on May 7, 2004, at 13:48:07

In reply to Re: Resistant Depression » wraith, posted by harryp on May 6, 2004, at 19:56:52

> I agree with linkage. Lithium is also a very good augmentor for MAOIs. I'm glad you're getting results.
>
> Out of curiousity, what TCA are you taking with it? People tend to lump them together, but some of them have very different neurochemical effects. Unfortunately, their use is becoming something of a lost art.
>
> Could you also mention what MAOI you tried, and what dosage?
>
> Thanks!

Harry P,

Currently I am taking Amitriptyline with Lithium augmentation. Prior to that my Psychiatrist had me on Nardil (50mg) together with Surmontil (100mg) and Tegretol - It had some effect but I was left with Confusion and underlying depression. This suprised my Pysch as he believed this combination was as effective as ect.

Thanks for your response.

Cheers

Wraith


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