Posted by Bob on January 8, 2001, at 12:21:14
In reply to Re: response to meds in general, posted by SLS on January 8, 2001, at 8:54:14
> > Inevitably, the side effects eventually outweigh the diminishing benefits, and I start to taper off the drug. This is where something interesting begins to happen. When I get down to levels of med where each reduction corresponds to significant reductions in blood level, it seems that briefly, while the level is actually falling in my blood, I feel great. Almost as if my norepinephrine receptors become sensitive during this time, until suddenly the levels become depleted or "stabilized" again, at which point I feel worse than ever. This phenomenon has occurred with almost all drugs I've dabbled in which I've reached therapeutic plateaus with, including: Anafranil, Effexor, Depakote, Celexa, Zoloft, etc... Of course, once blood levels actually reach zero, I experience very nasty withdrawl. Again, though, what I am wondering is whether anyone on this list ever experiences this brief period (usually a day or two) of doing well) while tapering down on meds)?
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> Dear Bob,
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> This is a well documented phenomenon. It is known as a "withdrawal positive rebound". My history has been marked by this phenomenon, particularly with tricyclics and MAO inhibitors. So much so can this positive rebound occur, that it sometimes launches someone into a mania. I have read of this happening even among people diagnosed as unipolar depressives.
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> I believe that all observed effects, good and bad, associated with drug treatment are significant and may offer clues as to what drugs might work. Personally, I don't know exactly what to make of this phenomenon except to suggest that MAO inhibitors, Nardil in particular, might be worth a try if you were to associate this phenomenon with a common neurophysiological substrate that we both may share. If you haven't already tried an MAOI, I would suggest it as something for you to consider. If you were to experience a partial response to one, you could then begin adding adjunctive medication such as lithium, Ritalin, or even desipramine or nortriptyline. The latter two drugs are often used in such combinations in treatment-resistant cases, and are safe to add if prudently cautious titration schedules are followed. I am currently taking Parnate + desipramine + Lamictal + Risperdal. It is helping.
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> - ScottThanks... that was informative and helpful! I was under the impression that MAOIs had a nastier side effect profile than even the tricyclics. Do you find this to be true?
Bob
poster:Bob
thread:51109
URL: http://www.dr-bob.org/babble/20001231/msgs/51168.html