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Dr. Bob is Robert Hsiung, MD,
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Posted by BGB on December 5, 2007, at 18:12:30
I have BP II, and my depression has been getting worse and worse over the past few months. I have no energy or drive, so my p-doc prescribed a combo of Wellbutrin SR and Remeron. They have been increased to 400mg of Wellbutrin and 60mg of Remeron. This helped with my energy and motivation, but I am still feeling terribly sad and having a lot of suicidal thoughts. I saw my p-doc again today and he has added 60mg of Cymbalta to the mix. Oh, I also take 1,000mg of Depakote ER and 200mg of Lamictal for mood stabilization. I've been on those two for over five years without any breakthrough mania.
Has anyone else out there taken these together? I'm just wondering how it worked for you and if you had any weird side effects. I'm really hoping that this does the trick; I've heard that Cymbalta and Remeron are supposed to be an excellent combo.
I had no side effects at all from the Remeron and Wellbutrin (no Remeron weight gain!), and have been enjoying having my sex life back! I hope the Cymbalta won't zap my libido.
Thanks to everyone for your advice and support. I really appreciate the kind and knowledgeable people here on Psycho-Babble!
Posted by star008 on December 5, 2007, at 21:42:49
In reply to Cymbalta, Remeron, and Wellbutrin, Oh My!, posted by BGB on December 5, 2007, at 18:12:30
Haven't tried that combo.. I have tried remeron and cymbalta.. Couldn't handle the remeron.. too tired and it gave me suicidal thoughts..Works well for some people though.
I tooK cymbalta and wellbutrin together.. Okay combo but the wellbutrin made my stomach hurt so I had to quit after awhile. I was still depressed but not as bad. No sexual side effects at least.
Cymbalta was very good for my suicial thoughts.. Before I started taking it I was thinking about death every single day.. That stopped within a couple of days of cymbalta. I am still depressed on Cymbalta with P{rovigil but not wanting to die every day.. some progress, huh??
Posted by Phillipa on December 6, 2007, at 0:00:06
In reply to Re: Cymbalta, Remeron, and Wellbutrin, Oh My!, posted by star008 on December 5, 2007, at 21:42:49
Took all three separately and none worked for me. Oh well what can I say????Phillipa
Posted by kingcolon on December 8, 2007, at 1:17:44
In reply to Cymbalta, Remeron, and Wellbutrin, Oh My!, posted by BGB on December 5, 2007, at 18:12:30
Here's an abstract that shows promise for Provigil for bipolar depression.
Modafinil Shows Promise for Bipolar Depression
A study involving 85 patients with bipolar disorder suggests that modafinil (Provigil), a drug indicated for sleep disorders, effectively controls the depressive symptoms associated with bipolar disorder.
"There are very few treatments for the depressive phase of bipolar disorder, and as a result there is an urgent need to evaluate potential new therapeutics," said Mark Frye, MD, director of the Mayo Clinic Mood Disorders Clinic and Research Program, Rochester, Minn.
After 6 weeks, 44% of the patients in the modafinil group reported symptom improvement, and 39% said that their symptoms were in remission, compared with 23% and 18%, respectively, for the placebo group.
Modafinil is often called the "wake-up pill," because it is indicated to treat patients who suffer from excessive sleepiness associated with narcolepsy, obstructive sleep apnea, and shift-work sleep disorder.
Source:
Belmaker RH. Modafinil add-on in the treatment of bipolar depression. Am J Psychiatry. 2007;164:1143-1145.
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