Posted by med_empowered on May 28, 2005, at 19:27:19
In reply to hmm... » med_empowered, posted by iforgotmypassword on May 28, 2005, at 18:59:44
hey! Sorry about your situation. I didn't realize Abilify and Geodon weren't around in canada. What *might* work better than doing an antypical antipsychotic long-term would be using one short-term and placing in a mood-stabilizer; even if you're not bipolar, mood-stabilizers can help treat resistant depression and help you control anger/aggression without the same level of sedation you'd get from an antipsychotic. Personally, I'm a trileptal and lamictal fan, but depakote is good too, especially when you need some *soothing* effects. Another option might be Symbyax (the prozac-zyprexa combo), although I think you might be better off picking your own antidepressant and dose, and then adding zyprexa. In terms of side effects, zyprexa tends to be kinda sedating and can cause weight gain/diabetes, but doesn't have the same kind of EPS and prolactin crap that's associated with risperdal. If you wanted to get really creative, there's amoxapine (sold as Asendin in the US). Its an old tricyclic antidepressant that's chemically related to loxapine, an antipsychotic. It works on psychotic depression, treatment resistant depression, and may be effective in psychosis. In the begining, its secating, but over the long term it seems to do really well at treating hardcore depression with a pretty good side-effect profile (minimal EPS). Loxapine itself (sold as Loxitane in the US, I think) is an option as an add-on antipsychotic; although its an old drug, it seems to have an "atypical" profile in terms of mechanism of action and side-effects. My only concern with using an antipsychotic in your situation would be that if the dosing isn't done right you could end up with all the side-effects of an anti-psychotic without the benefits..the ideal is to use the antipsychotic in such a way that levels of serotonin, neurepinephrine, and dopamine are actually increased where desired (frontal lobes in particular) while keeping side effects from the anti-depressant and antipsychotic at a minimum (no point in treating the depression if you gain too much weight, sleep all the time, or develop diabetes). Personally, adding BuSpar to my own anti-psychotic/anti-depressant mix helped a lot with the symptoms AND the side-effects. Anyway, sorry this was soooo long, and GOOD LUCK!
poster:med_empowered
thread:504281
URL: http://www.dr-bob.org/babble/20050527/msgs/504396.html