Posted by dewdropinn on July 23, 2007, at 12:06:12
In reply to Re: May i be blunt, posted by steel on July 22, 2007, at 23:44:44
I completely agree with you concerning the accessibily of drugs overseas -- if it weren't for the fact that I purchased liquid deprenyl on my own and enjoyed some success with the drug, there's absolutely no way that I would ever have been given the opportunity to take EMSAM. I think the marketing is somewhat sketchy, but for people like us -- people who have tried and failed just about every FDA approved treatment -- it's important to have options and alternative sources of information.
Too bad about your response to lamictal -- just goes to show, there isn't a one-size-fits all treatment. It's also unfortunate that most of the available mood stabilizer option have gnarly side effects -- lithium and depakote were pretty vicious; I couldn't function on Seroquel and Geodon; Abilify had all the side effects of a classic stimulant without any of the benefits; the list goes on and on. Personally, I think the best of the bunch is Tegretol -- the new time-release formulations eliminate most of the annoying side effects, the drug has all of the benefits of depakote w/o the brutal side effects, and it definitely helps with insomnia -- sadly, it can't be taken with MAOIs, so it's probably not an option in your case.
As far as the remaining options go -- I have nothing but positive things to say about EMSAM -- the 6mg dose wasn't effective, but the 9mg patch was a whole different story -- improvements across the board w/o any side effects. I find that it's important to remove the patch at night so as to avoid insomnia, and you've gotta watch out for drug-drug interactions, but otherwise it's incredibly user friendly and effective. So that would be a definite option. EMSAM and klonopin worked nicely -- my insomnia resolved after going up to 9mg, so I was able to ditch klonopin, but if sleep and anxiety are a problem, this could be an effective combo; EMSAM and low dose seroquel appear to be effective for some, but I simply couldn't deal with the sedation and cognitive side effects -- so it was bad for me, but apparently good for others. So these may be options for you.
There's one other super unorthodox, but super effective combo you may want to explore. After on pharmacological catastrophe after the next, I managed to hook up with a doctor who was more research oriented. He came up with a cocktail that included low dose Lexapro (10mg) and low dose selegiline (5mg) -- apparently, there have been studies involving the combo, and it is occasionally prescribed for Parkinsons patients suffering from depression. Theoretically, this should be a very dangerous combination, but I guess so long as the selegiline remains well below the threshhold for inducing MAO-A inhibition, you can avoid triggering a hypertensive reaction or serotonin syndrome(it's MAO-B selective until you get to around 10mg -- so it only impacts dopamine and norepinephrine.) Even though 10mg is supposed to be MAO-B selective, it's poses risks -- one time I inadvertently took 10mg, and came very close to calling 911. The other thing to remeber is that you can only take low dose selegiline with Celexa and Lexapro -- all other SSRIs have some impact on dopamine or norepinephrine, so they aren't an option. In any event, Lexapro/Celexa and selegiline is a combo well worth exploring.
Last but not least -- I'm sure that you've seen a number of posts about the European anti-psychotic Amisulpride. If taken at a low dose, it agonizes select dopamine receptors (actually it's a post-synaptic dopamine blocker, which channels more of the neurotransmitter to the presynaptic receptors -- at high doses, it blocks both the post and pre-synaptic dopamine receptors and becomes a classic anti-psychotic with all the classic anti-psychotic side effects.) Amisulpride was like a depression cure for me -- within an hour of taking 25mg, the anxiety and depression disappeared -- simply an amazing drug that deserves more attention and research. Unfortunately, it also raises prolactin levels -- which rendered me totally impotent -- which is why I stopped taking it on a regular basis. This side effect doesn't occur with many who take the drug at low doses -- so you may get lucky. It's a great drug to have in your back pocket -- now that I'm on an effective combo (400mg Lamictal & 9mg EMSAM), I can tuck my stash of Amisulpride back in the medicine chest -- but before then, I would occasionally take it when I needed to be "at my best" (e.g. client meetings, projects with imminent deadlines, etc.) You've already ventured into the world of foreign pharmaceuticals, so you should be able to track down amisulpride fairly easily. My source stoppped shipping to the US years ago, and I've been out of the foreign drug loop for a while -- so I can't provide any recommendations, but it's not a difficult drug to obtain.
Hopefully this helps -- I can't tell you how much I empathize with your struggle. I took over 20 medications and every imaginable combination over the course of a decade -- some combos proved effective, but presented side effects that forced me to stop -- others just produced side effects. Ultimately, I decided that I would never achieve total remission -- I started evaluating medications based on net improvement (benefits minus side effects = net improvement), and if I acheived some nominal degree of improvement, I was thankful, where before, I would have been frustrated because, in spite of the medication, I was still living a compromised life. So, self-acceptance, adopting realistic expectations, and accepting the realities of treatment resistant depression were all a big part of my recovery. Ironically enough, about a year after I adopted this attitude, I found a combination that produced near complete remission. So, there are many available options, and so long as you've got options, you've got cause for hope.
Drew
> Sorry i missed this,i think your reasoning to not adding deprenyl makes a lot of sense,i agree its portrayed by sellers too easly.
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> But in that respect,lo what isint right?Luckly we have places like these to hear the REAL DEAL sometimes.
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> Im not dead set aganist Lamictal because of the drug itself,i have seen it used a lot with success,I am dead set aganist it because i have given it too many trials,and appts costing what they do,the time frame,the urgency of my need for help and so on,i simply dont want to re try drugs which i have had several attempts at already.
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> Lamictal is just not for me,same as neurontion does nothing for so many but helps me a lot.
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> FYI i did get what i asked for,KEPPRA,and although i cant say for sure as it would be unfair,it does seem the possability that its high profile of mental side effects deems true,as i experianced them all it seems on day two, i had anger i never felt before.
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> I have since stopped,and im back to where i begain,should i give the drug a fair chance?or go with my gut and not let myself fall victim to that rage again,ah drugs these are the times that make them so fun huh (sorry frustrated sarcasim there)
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> Thank you again for the response.
poster:dewdropinn
thread:769601
URL: http://www.dr-bob.org/babble/20070719/msgs/771356.html