Posted by SLS on November 27, 2022, at 12:58:48
In reply to Re: Developing bad habits on Psycho-Babble?, posted by linkadge on November 25, 2022, at 16:07:55
Re: Developing bad habits on Psycho-Babble?
Hi, Linkadge.I find your essay regarding your personal experiences valuable. Remember, though, that as much as Linkadge is speaking for himself and others, so, too, is SLS. In your essay, I cant find anything that I dont already know or havent written about multiple times. So, Im going to avoid addressing that which you and I already know genetics, for example. Psychotherapy and reducing psychosocial stress being another.
Lets start out by talking about the protagonist in your essay you. You have written several things that I find important to recognize as issues, but without knowing all of the facts as they apply to the paramount thesis of this conversation the value that drugs have in treating Major Depressive Disorder and Bipolar Depressive Disorder.
1.Approximately how long ago did you post to the community the results of your 6-week trial of a standard antidepressant with or without augmentation agents?
2.Are you taking nortriptyline? You reported obtaining a 75% improvement while taking it.
3.If you are not currently taking the drug that gave you a 75% improvement, why the heck not? Why didnt you keep nortriptyline onboard indefinitely and save yourself years of work going back and repeating every single drug trial with the addition of nortriptyline a drug that gave you a 75% improvement? Nortriptyline is the mildest of tricyclics in regard to side-effects. I have yet to see you describe an intolerance to its side effects. As far as I know, nortriptyline has no contraindications when combining it with another psychiatric drug (marketed, off-label, experimental, non-tricyclic). There may be several that I am not aware of or forgot about.
4.If you havent tried a MAOI yet, then we really shouldnt use you as an example of someone who is completely refractory to old, standard antidepressant therapy.
5.What population are you using as a source of information to characterize drug reactions both good and bad?
6.Have you considered my suggestion to try Pristiq (desvenlafaxine) in place of Effexor (venlafaxine) in order to see if the side-effects you experience with Effexor might be absent with Pristiq?
7.Do you plan on adding nortriptyline to Wellbutrin and lithium?f
8.Will you switch from taking Effexor to Pristiq? The combination of either of these two drugs to Wellbutrin is often MUCH more effective globally than either agent alone.As far as everything else is concerned, have you forgotten the person whom you are addressing? Do you really think that I needed a lecture from you or anyone else - on the hardships and torture of going through one treatment failure after another for 40.5 years? I swallowed my first pill of an antidepressant (imipramine) in the Spring of 1982. I didnt achieve remission until recently. What does that prove to everyone here? It proves that SLS got well (found a new life) by building treatment strategies centered on standard antidepressants. My disease and treatment histories for the last 23 years are in the Psycho-Babble archives.
Is my robust treatment response to antidepressants an idiosyncratic anomaly when compared to the entire extant population of people with depression? What is the difference between you and me? Well, for one thing, you havent ever taken a MAOI. Of course, this necessarily means that you have not tried the treatment that brought me to remission. Like you, decades of treatment failures serves as the backdrop from which we draw our personal conclusions and judgments.
I never found an effective treatment for depression until I did.
In retrospect, and after careful study of my words and the usage of phrases like, For me and I experienced, I dont think anyone could fail to see the implications of my story. The only thing that separates me from you is that you never tried taking what Im taking. Everything else is moot.After answering the questions that I posed to you, do you see a pattern? Since I am not sure what your answers are at this juncture, they might be instructive for Psycho-Babble.
A competent physician would never let someone endure the unendurable for 6 weeks. Your example is a bit skewed.
I think it is worth continuing this conversation.
Linkadge: Please dont ever accuse me of not belonging to your club of treatment-resistant sufferers. As you so eloquently remind us, everyone is different, despite our similarities. I dont need lessons in this.
My guess is that both of us want the same thing to achieve remission for ourselves and help others achieve there is. Right now, I dont think you are helping. Of course, mine is but one opinion.
My main thesis here is:
Stay on lithium and nortriptyline as your core treatment around which to build. Thats pretty much a no-brainer. Why havent you done that. Any competent psychologist would have handled your case this way.
-Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.The only thing necessary for the triumph of evil is that good men do nothing.
poster:SLS
thread:1121118
URL: http://www.dr-bob.org/babble/20220917/msgs/1121135.html