![[dr. bob]](/dr-bob-sm.gif)
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 Roslynn on January 17, 2019, at 14:21:54
Hi everyone,
Anyone here with unipolar treat their depression using only other classes of meds and no antidepressant on board?
Such as, taking an antipsychotic, mood stabilizer, augmentation meds, or anticonvulsants etc. but no AD?
The ADS have not worked for me and yet i'm afraid to not have one in my system. I've been on one or another AD for YEARS.
Kind of afraid to go with another class of meds as monotherapy, but this is being suggested to me.
Does anyone (with unipolar) have such a treatment regimen?
Thank you for any help!
Roslynn
Posted by linkadge on January 17, 2019, at 16:38:04
In reply to treating depression w/o an antidepressant on board, posted by Roslynn on January 17, 2019, at 14:21:54
Hi,
I have had decent success with lithium for depression. My mother is bipolar and responded to lithium. While I don't believe I am bipolar, I do find that lithium helps quite a bit with unipolar issues, especially sleep, anxiety, and surprisingly, anhedonia.
There is some evidence backing quetiapine for unipolar depression. Abilify has some evidence as an AD adjunct. Some of the other mood stabilizers don't really have much evidence of effect in pure unipolar disorders, but can be helpful for some unipolar symptoms like anxiety or insomnia.
For me, sleep is a bit component to my mood. If I can get good sleep every night, I can usually stay out of any major issues.
If you do go the mood stabilizer route. I would suggest trying lithium first. I only take 300mg and side effects are minimal. Lithium can also augment other antidepressants. If an antidepressant was sort of working, you could try adding lithium.
Also, I do use marijuanna medically and it helps with unipolar quite a bit.
Linkadge
Posted by rjlockhart37 on January 17, 2019, at 18:51:35
In reply to treating depression w/o an antidepressant on board, posted by Roslynn on January 17, 2019, at 14:21:54
lamotragine - can treat unipolar, noticed im not so much in a deep slump, even though i have been depressed while on it, it reduced the intensity of depression. 200 a good dose for depression
Posted by Christ_empowered on January 17, 2019, at 20:27:20
In reply to treating depression w/o an antidepressant on board, posted by Roslynn on January 17, 2019, at 14:21:54
id avoid the neuroleptics --if-- possible. not to scare you (I take one, btw), but the TD risk is looking closer and closer to the rate seen w/ the 1st generation drugs...
and the mood disordered are more likely to develop TD and -severe- TD than those with schizophrenia. :-( i take antioxidants, it seems to help prevent tics and such.
lamictal? xanax xr? modafanil or a traditional stimulant?
i hope things get better in your world. :-)
Posted by Roslynn on January 18, 2019, at 15:08:50
In reply to treating depression w/o an antidepressant on board, posted by Roslynn on January 17, 2019, at 14:21:54
Thank you for your suggestions :)
I've actually been on lithium and seroquel at low doses for quite a while now. I can't increase either due to side effects but they are part of my med regimen.
I've taken lamictal but experienced that horrible brain fog.
Christ_empowered, I'm not really a big fan of the antipsychotics either...I would maybe try one of the new ones but my insurance doesn't cover those.
I guess I could start a random antidepressant and then add something to it that I haven't tried before. Otherwise I feel like I have no "base" to my meds group.
Thanks for your replies,
Roslynn
Posted by linkadge on January 18, 2019, at 18:27:21
In reply to Re: treating depression w/o an antidepressant on board, posted by Roslynn on January 18, 2019, at 15:08:50
I assume you've tried some of the atypical antidepressants like trazodone, mirtazapine, or older TCAs like nortriptyline?
I found that lithium and nortriptyline worked fairly well.
Linkadge
Posted by Christ_empowered on January 18, 2019, at 23:51:15
In reply to Re: treating depression w/o an antidepressant on board » Roslynn, posted by linkadge on January 18, 2019, at 18:27:21
goof ball? I think when uppers+downers are prescribed together for depression, valium is supposed to be the downer of choice (i could be wrong...) ?
addictive? yes. but the Mother's Little Helpers and many stimulants are now generic, even the xr uppers....
and that combinations works -fast-. when i was on upper+downer+abilify, i got good coverage, etc., and...yeah. yeah. looking back, i really should have been on something -not- a neuroleptic to balance out the upper+downer...trileptal, maybe? I dunno...
i would say tramadol, but now the dea has declared open season on pain kilers for most people, so...probably not an option right now. :-(
i am sorry. im actually trying to lower my neuroleptic intake, very slowly. i dont think its being prescribed simply because of my labels...
I think there's a control element, plus my IQ estimate is somehow up, so I'm an intelligent 'mental patient...' in modern America. good luck with that, LOL.
hope this helps.
Posted by Roslynn on January 19, 2019, at 14:31:48
In reply to Re: treating depression w/o an antidepressant on board » Roslynn, posted by linkadge on January 18, 2019, at 18:27:21
> I assume you've tried some of the atypical antidepressants like trazodone, mirtazapine, or older TCAs like nortriptyline?
>
> I found that lithium and nortriptyline worked fairly well.
>
> LinkadgeI've tried mirtazapine (with and without Effexor) and some of the TCAs, but not all. Nortriptyline made me dizzy/fatigued. But I have heard it helps a lot of people. I thought trazedone was for sleep?
I believe my former pdoc was not a big fan of the TCAs, or did not like their side effect profile or mechanism of action for me. (Not sure about my current pdoc.)
However I did not understand this because it seems to me there is some variety within this class of meds. They do seem to have some differences.
I did look at my insurance formulary and some of the tricyclics are listed as prior authorization needed. Weird! Thought since they're older/cheaper, insurance would not have a problem paying for them.
Thank you for your suggestions,
Roslynn
Posted by Roslynn on January 19, 2019, at 14:37:03
In reply to Re: treating depression w/o an antidepressant on board, posted by Christ_empowered on January 18, 2019, at 23:51:15
Thank you for the suggestions and for thinking "out of the box" :)
It's cool a bunch of stuff is now generic but I heard there is a shortage of buspar and some others...it will affect my decision for sure.
Thanks,
Roslynn
Posted by beckett2 on January 19, 2019, at 22:24:51
In reply to treating depression w/o an antidepressant on board, posted by Roslynn on January 17, 2019, at 14:21:54
Saphris may be superior to Seroquel as an anti-depressant. Of course, response varies. And most likely your insurance doesn't carry it-- but maybe. There's odd little eddies within insurance policies.
(In addition, Saphris didn't leave me as out of it.)
Good luck :-)
> Hi everyone,
>
> Anyone here with unipolar treat their depression using only other classes of meds and no antidepressant on board?
>
> Such as, taking an antipsychotic, mood stabilizer, augmentation meds, or anticonvulsants etc. but no AD?
>
> The ADS have not worked for me and yet i'm afraid to not have one in my system. I've been on one or another AD for YEARS.
>
> Kind of afraid to go with another class of meds as monotherapy, but this is being suggested to me.
>
> Does anyone (with unipolar) have such a treatment regimen?
>
> Thank you for any help!
>
> Roslynn
Posted by Roslynn on January 20, 2019, at 13:59:18
In reply to Re: treating depression w/o an antidepressant on board » Roslynn, posted by beckett2 on January 19, 2019, at 22:24:51
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.