Posted by harryp on May 6, 2004, at 22:38:17
In reply to just plain not getting any better, posted by linkadge on May 4, 2004, at 18:17:24
Based on what I have read, I think you need to try a different family of drugs. If you get no response to one SSRI, usually trying other SSRI's is not useful (if you get a partial response, or a side effect problem, then trying another SSRI could be worthwhile).
I strongly recommend trying some TCA's. They are totally different from Effexor, and actually quite a varied group in terms of SE's. You might not have any trouble with any of them, and if you do, quitting is a simple matter (unlike with Effexor!).
Since serotonergic drugs haven't worked well for you I would suggest trying Desipramine. It has the best SE profile of the TCA's and is a norepinephine reuptake inhibitor.
If it doesn't work, I'd try Imipramine (inhibits both serotonin and norepinephrine reuptake--but more SE's) or else go to a MAOI (true "industrial strength" AD's with surprisingly good SE profile--particularly Parnate--as long as you are careful with diet/drugs, etc.).
If a MAOI is not working well enough, add lithium.
Just be creative and aggressive, and don't give up. Unless you find an unusually good, determined, and empathic doctor, it's an unfortunate fact that people with our kinds of problems are pretty much on our own--drug wise.
poster:harryp
thread:343348
URL: http://www.dr-bob.org/babble/20040505/msgs/344184.html