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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by dab on April 13, 2001, at 12:09:35
I have never posted on one of these, so please bear with me if I do something wrong. I have been severly depressed for about 2 years (suicide attempts, etc.) I have tried just about every drug and combination of drugs with no real success.Paxil, Celexa, Trazodone,Effexor,Serzone & Neurontin,Wellbutrin SR,Wellbutrin with Neurontin,Zoloft with Neurontin,& Wllbutrin SR & probably some I cant remember. Currently I am on 150 of Lamictal along with Zoloft I have always had either Klonipin or xanax prn.as well as 30-60 mgs.Dalmane for sleep. I talked to my doc about topamax and he said it might be a good drug for me. I really don't think anything is going to help totally, although I now have some good days. I still fight the suicidal impulses when I have particularly bad days. Any help on the Topamax for severe depression alone would be helpful. I am also very interested in the weight loss results, if any, as the stuff I am taking now is making me gain weight.
Posted by SalArmy4me on April 13, 2001, at 12:24:46
In reply to Tried everything else. Topamax for depression?, posted by dab on April 13, 2001, at 12:09:35
Topamax is an option...not one I would pick, but I'm not a doctor. {I was on Topamax for about 2 weeks until I couldn't tolerate it anymore}. Here's some stuff you may not have thought of:
Carbamazepine XR - less side effects than Lithium or divalproex sodium
Desipramine - the least side-effects of all the Tricyclics; one of the SNRIs
High-dose Venlafaxine - at higher doses Venlafaxine affects more chemicals than SSRIs.
Buspirone - an effective antidepressant and anxiolytic at high doses.
Dopamine Agonists - Pramipexole has two studies on it (I take it).
"Power Combinations" - Remeron+Effexor; Wellbutrin+Remeron, RemeronProzac
Augmentation of anything you have tried before with Lithium, Pindolol, or Buspar (i took pindolol
Foreign medications to the US: the RIMA Moclobemide; Reboxetine; Amisulpride, etc
Atypical Neuroleptics/Antipsychotics with antidepressant properties: Risperidone, Olanzapine, Seroquel, Geodon
Provigil - a stimulant that is possibly effective
Irreversable MAOIs - Phenelzine, Tranylcypromine. Extremely Effective.
MAOI-B - Selegiline, an antidepressant almost comparable to Phenelzine.
I wonder specifically if you have tried the MAOI's....
Posted by JohnL on April 13, 2001, at 18:06:31
In reply to Tried everything else. Topamax for depression?, posted by dab on April 13, 2001, at 12:09:35
> I have never posted on one of these, so please bear with me if I do something wrong. I have been severly depressed for about 2 years (suicide attempts, etc.) I have tried just about every drug and combination of drugs with no real success.Paxil, Celexa, Trazodone,Effexor,Serzone & Neurontin,Wellbutrin SR,Wellbutrin with Neurontin,Zoloft with Neurontin,& Wllbutrin SR & probably some I cant remember. Currently I am on 150 of Lamictal along with Zoloft I have always had either Klonipin or xanax prn.as well as 30-60 mgs.Dalmane for sleep. I talked to my doc about topamax and he said it might be a good drug for me. I really don't think anything is going to help totally, although I now have some good days. I still fight the suicidal impulses when I have particularly bad days. Any help on the Topamax for severe depression alone would be helpful. I am also very interested in the weight loss results, if any, as the stuff I am taking now is making me gain weight.
Hey, wouldn't it be nice if we could go to Las Vegas and somehow stack the odds in our favor? Well, in the world of drugs, wouldn't it be nice if there was one that would stack the odds in our favor?
Well, there is. Actually several. What is a category of drugs that seems to work especially well in patients who have not had adequate results with a variety of antidepressants? Answer is antipsychotics. Specifically Zyprexa, Risperdal or Amisulpride.
Certainly this won't work for everyone. However, it is a way to stack the odds in your favor. The antipsychotics are very often excellent antidepressants. Especially when combined with antidepressants. Much better than either alone. In your shoes, with the benefit of hindsight, I would choose my favorite of the antidepressants and add Zyprexa to it. Give it two weeks. Then if I wanted to, I would try Risperdal and then Amisupride just to see which I like the best. Then I would go with my favorite for a long trial. Most people would probably disagree with this approach. But I have to tell you I have seen it work over and over again. While other drugs work somewhat some of the time, these antipsychotics seem to work very well a lot of the time. No guarantees. But I like stacking the odds in my favor. Hope something here is helpful.
John
Posted by Shar on April 14, 2001, at 10:24:32
In reply to Re: Tried everything else. Topamax for depression?, posted by JohnL on April 13, 2001, at 18:06:31
I agree with John. My new pdoc added Risperdal to my cocktail, after years of trying different meds with limited success (sort of like you've been through), and the Risperdal made a big difference.
I am dx dysthymia (depressed for life with occasional severe episodes) and had almost given up hope. My current cocktail is Effexor xr 300 mg., Wellbutrin sr 300 mg., Risperdal .75 mg., and Klonopin 1 mg. for sleep.
The interesting thing to me was that Risperdal worked pretty quickly, I think I noticed something within about a week. I was started on .5 mg, btw, and doc raised it because I was having "bottom falling out" problems. I'd be ok then crash.
Good luck. Don't give up until you've tried some of the augmenters John talked about!
Shar
What is a category of drugs that seems to work especially well in patients who have not had adequate results with a variety of antidepressants? Answer is antipsychotics. Specifically Zyprexa, Risperdal or Amisulpride.
>
This is the end of the thread.
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