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Re: Dump everything? » bleauberry

Posted by SLS on May 20, 2012, at 7:12:32

In reply to Re: Dump everything?, posted by bleauberry on May 20, 2012, at 5:25:03

Bleauberry:

Dump everything? Dump Trileptal and lithium?

> If tramadol works then I would think take it.

What is this "if" stuff?

What if I were to tell you that we don't know that tramadol will work? We don't. It has not been established. So, then, your if statement is conditional upon the establishment of its efficacy.

How would you go about establishing that tramadol works in this case? Initial dosage? Titration schedule? Length of trial? You know - stuff like that. How long would you allow SC to suffer if it didn't work immediately?

Remember your admonishment to me regarding depression and suicide? What makes you think that tramadol has a better chance of working than Abilify in the treatment of bipolar depression? Would you say that there is a sense of urgency here?

You say that Abilify works best with a SSRI. Upon what do you base this statement? It has been helping me achieve remission, and I am not taking a SSRI for BIPOLAR DEPRESSION. However, I am taking it with a MAOI and lithium. It doesn't give me the slightest hint of cognitive dulling or affective flattening at 10 mg.

I agree that tramadol is not to be excluded from consideration for treating the depression.

I don't know how one would justify removing Trileptal when it extinguished the mania and allowed SC to pass through a zone of euthymia after starting it. I don't know if removing it was what you had in mind. After some experimentation with dosages, it seems that a dosage of 600 mg produces affective flattening for SC, but not a dosage of 300 mg. It has been established that Trileptal at 300 mg is effective in treating the mania in this case.

By the way, do you postulate that tramadol would be effective for depression because it is an SNRI like Effexor, in addition to being an opioid receptor agonist? Isn't there more of a chance that it would be maniagenic than Abilify? I don't know. Abilify can cause mania, but this is a rare event. Zyprexa can cause mania, too, as can Geodon. Only a handful of cases for each drug has been reported to Medline and other medical databases.

http://www.ncbi.nlm.nih.gov/pubmed/22122647

You might be right about everything you have to say. I am just curious what you took into consideration when you made your recommendations.


SeilaC:

I am sorry to talk about you in the third person.


- Scott


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