Jump to content
CrazyBoards.org

What to ask the doc for next?


Recommended Posts

I've just come out of the hospital and am in a partial hospital program. I'm still feeling some moderate depression and some pretty strong anxiety. Problem is I've tried most of the new ADs except for paxil which is making it hard for my pdoc to prescribe something. I was wondering if anyone had any ideas. My signature has meds tried. Not sure if he prescribes old ADs but I could ask. Thanks in advance.

Link to comment
Share on other sites

older ADs are definitely worth asking about, and given what you've already tried, i think it's the logical next step. i see you've tried clomipramine, would you be willing to try another TCA? sometimes they do the trick where SSRIs won't.

i'm sorry you're having such a rough time. i hope you get some relief soon.

Link to comment
Share on other sites

long shot here but Cytomel? it is a thyroid med that is used off label for bipolar depression. Its pretty off the beaten path, but i just thought of it cuz my pdoc sometimes Rx's it (he did to me) for cases like yours where all of the usual suspects have been tried 

my other idea would be Caplyta - its only approved for schizophrenia now, but they are seeking approval for BP depression and supposedly the stats look good. It wouldnt be an add on though it would have to be a switch and i know that isnt ideal when things are somewhat stable. 

Oh Wait! I don't see Fetzima in your sig (if your not in the US sorry) it is a new SNRI that might be worth a shot, maybe a lower side effect profile than TCAs 

Link to comment
Share on other sites

You could also ask for some other tricyclics. I see you’ve tried doxepin, but what about amitripyline or nortriptyline? Then there are the MAOIs, of course. Also, it seems like there are still one or two newer ones that you haven’t tried yet. I can’t think of them (other than Fetzima, which Iceberg mentioned). Another idea is to try some of the ones you’ve already tried for a second time. If you discontinued any of them because of bad side effects, you may be able to tolerate them the second time through. Many of the meds I’ve tried for a second time have not had any (or hardly any) side effects at all. 

Link to comment
Share on other sites

1 hour ago, Iceberg said:

Did you ever try the california rocket fuel approach (remeron+effexor or another SNRI) ?

No I haven't. Remeron alone did nothing for me. I thought I had a good response to effexor but my regular pdoc read old notes and apparently I complained that it was too stimulating so she won't let me re-try it.

Right now I'm trying to get the program pdoc to prescribe me caplyta but his never prescribed it before and so is cautious but he said he'd think about it. Unfortunately, vraylar is giving me horrible akathisia so we're going to have to eventually transition to something else. The only new AAPs that I haven't tried are geodon, fanapt, and caplyta. Plus there is the issue of will my insurance cover caplyta *sigh* I feel so hopeless right now

Link to comment
Share on other sites

On 2/28/2021 at 1:42 PM, CeremonyNewOrder said:

I've just come out of the hospital and am in a partial hospital program. I'm still feeling some moderate depression and some pretty strong anxiety. Problem is I've tried most of the new ADs except for paxil which is making it hard for my pdoc to prescribe something. I was wondering if anyone had any ideas. My signature has meds tried. Not sure if he prescribes old ADs but I could ask. Thanks in advance.

Do you have any history of overdosing on your meds? If not, maybe one of the other tricyclics or MAOI's? 

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...