![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by MuseMemento on April 6, 2014, at 22:43:40
Recently (3 days ago) added 20 mg sustained release methylphenidate to 300 mg bupropion xl, 20 mg escitalopram, and 2 mg abilify. Since then I've noticed increased appetite, which is not helpful, increased sedation and decreased focus. Do I give it another couple of days? I assume that it's a rapid response medication and any potential benefits will be demonstrated either by now or in the next couple of days. I don't want to give up on a med too soon, though. Thanks.
Posted by MuseMemento on April 6, 2014, at 23:10:13
In reply to Methylphenidate Sedation, Worsening Depression?, posted by MuseMemento on April 6, 2014, at 22:43:40
Also, any risk of serotonin syndrome with both methylphenidate and escitalopram on board? The pharmacist assured me no and pdoc had no concerns but the anxious mind...
Posted by vbs on April 7, 2014, at 6:30:32
In reply to Re: Methylphenidate Sedation, Worsening Depression?, posted by MuseMemento on April 6, 2014, at 23:10:13
> Also, any risk of serotonin syndrome with both methylphenidate and escitalopram on board? The pharmacist assured me no and pdoc had no concerns but the anxious mind...
I took methylphenidate and an SSRI for years without any problems. You'll be fine.
Posted by Christ_empowered on April 7, 2014, at 7:45:05
In reply to Methylphenidate Sedation, Worsening Depression?, posted by MuseMemento on April 6, 2014, at 22:43:40
do you think maybe its doing something with the abilify? random Q...I have no idea.
serotonin syndrome happens, but I think its rare. Even in off label use for depression, doses of ritalin/focalin can go much higher.
Posted by MuseMemento on April 7, 2014, at 10:46:03
In reply to Re: Methylphenidate Sedation, Worsening Depression?, posted by Christ_empowered on April 7, 2014, at 7:45:05
I'm not sure if I'm responding to the abilify but I don't think it's causing the sedation. I'd been on it a full month before the methylphenidate with no such problems.
Posted by Christ_empowered on April 7, 2014, at 11:32:53
In reply to Re: Methylphenidate Sedation, Worsening Depression? » Christ_empowered, posted by MuseMemento on April 7, 2014, at 10:46:03
maybe try some flavor amphetamine?
Posted by MuseMemento on April 7, 2014, at 11:42:02
In reply to Re: Methylphenidate Sedation, Worsening Depression?, posted by Christ_empowered on April 7, 2014, at 11:32:53
I was thinking that, as well but I think we'll probably be changing course to clomipramine as a base and work from there. Is four days a long enough trial of methylphenidate to know if it will offer anything?
Posted by phidippus on April 11, 2014, at 13:40:14
In reply to Re: Methylphenidate Sedation, Worsening Depression? » Christ_empowered, posted by MuseMemento on April 7, 2014, at 11:42:02
What are you using the methylphenidate for?
Eric
Posted by MuseMemento on April 11, 2014, at 14:30:15
In reply to Re: Methylphenidate Sedation, Worsening Depression? » MuseMemento, posted by phidippus on April 11, 2014, at 13:40:14
Intended to augment the ADs and alleviate cognitive impairment central to my depression. I dont seem to be receiving enough benefit from the other meds for it to serve, as an augment, though. I stopped after four days because it didn't seem to be helping and I was anxious about serotonin syndrme. I didn'thave a fever or hypertension but I was a little jerky.
Posted by phidippus on April 11, 2014, at 16:41:10
In reply to Re: Methylphenidate Sedation, Worsening Depression? » phidippus, posted by MuseMemento on April 11, 2014, at 14:30:15
I think dextroamphetamines tend to be more helpful with cognitive function.
Eric
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.