List of AD's that have failed me again

[lunksmoo]

Let's start with my antidepressant list since 1990:

Amitriptyline

Imipramine

Desimpramine

Prozac

Depakote

Zoloft

Remeron

Trazodone

Effexor

Cymbalta

Lexapro

Lamictal

I started out with excrutiating, disabling panic attacks in 1990, led to severe depression, sleep problems (can't fall asleep, when I do, sleep for 15 hours, can't wake up), social anxiety, morbid obesity to name a few problems. My God, when does it fucking end?

[realitytest]

I have a very long list too, lunksmoo. In fact, I earned that unenviable label of "treatment resistant depression" (atypical variety. That is: hypersomnia, overeating, sociall sensitivity ...)

Mentioning my crap since it sounds a bit like yours except that I never had panic attacks. I also have sleep disorders out the wazoo. I guess you tried the amityptilne, Remeron and Trazadone for that (the last two cause LOTS of weight gain - as I'm sure you know).

What I notice conspicuously absent are (first) Ambien Neurontin and Klonopin - which are my magic potion for sleep. Not tom brag, but my insomnia was world class. . Also Klonopin is like THE medicine against panic.

The other absentee appears anything that significantly hits dopamine. Not even a trial of Wellbutrin much less an MAO inhibitor (Nardil or Parnate) There's the new Selegiline patch now too.

I am very very sad that I had to discontinue Nardil for compelling (and unusual) medical reasons. It 's the only AD that ever worked for me.

The good news I get from your list is that long as it is, some of the best medications are absent. (ALL the ones that helped me, to be precise - and greatly). You have a lot of recourse yet. There is absolutely no cause for despair.

I'm on the cheering squad for the MAOs especially. They are all too little prescribed today owing to reliance on SSRI's, fear of lawuits anf the near absolute inexperience with them, of most younger psychiatrists. I say if a person isn't willing to do without pastrami (and the ither tems on the forbidden foods list - now known to be much less restrictive than previously thought), then the person isn't all that depressed!

They are THE treatment of choice for treatment resistant depression. Sounds like you too might be close to deserving that labell (maybe after a trial of Wellbutrin.)

Of course, you'll want to see how the Lamictal works for you first too. Too bad it takes so long to build up a proper dose to test it out. (I'm on it too and at 200 mg. but expecting to work up to 4-500mg before throwing in the towel).

As for Klonopin...well, it's a great medicine. Sounds like your psychiatrist is afraid of benzos for fear of addiction. Maybe s/he is a bit too conservative?

Good luck - and be of good cheer. You've got (as per me) the best meds yet untried.

rt

[username]

Have you tried adding an atypical AP like resperidone to an SSRI/MRI/TCA?

ADs do not work for me unless I am on resperidone at the same time.

Resperidone by itself does nothing, but with an AD it really helps.

[lunksmoo]

Thank you for your replies. I guess I need to call my pdoc and have my lamictal increased. I was feeling pretty good until last week when I went on a business trip and didn't get much sleep and was hurried all the time. I'm taking 20 mg of lexapro, and 100 mg of lamictal. I have depression, not bipolar, so the lamictal is being used to enhance the lexapro. I had gastric bypass surgery about 3 years ago, lost 170 lbs. (yeah), but the new stomach didn't absorb the zoloft I was taking at the time (and was working quite well), and I went into a pit of DEEP depression. Tried effexor and cymbalta, didn't work at all, now lexapro and lamictal have been working pretty good, but the lamictal may need to be changed.

I guess my earlier post was from a little bit of frustration. My bouts with depression over the last 3 years have put me on an emotional yo-yo. Happy I lost the weight, but feeling so terrible. I would still like to lose about 80 lbs., and the depression hasn't helped. It makes me tired all of the time, not wanting to exercise, and not watch what I am eating. Hopefully a little better mood will get me back in the swing of things.