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The Absolute Max. Dose To Pull Me Through


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#1 Eden

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Posted 05 April 2012 - 07:28 AM

Hi folks, on 300mg Ven, due to move up to 375mg.

Currently my depression is not going well. and by not well, its pretty bad. Crying in the mornings, daytime during work (Toilets), and at night. Absolutley feel like whale shit at the bottom of the ocean. No specific trigger other then feeling like crap and the hopelessness of it all.

Anyhows, my question is:

For treatment resistant depression like mine, what is the absolute maximum dose you can take of this stuff?

Can these high doses also be used in conjunction with another pharmalogical treatment? What types have work for some people (I know everyones different but am curious as to what to speak about with the P'Doc).

I really dont feel that venlafaxine is doing much and ive been on 300mg for at least 3 weeks, and venlafaxine for 2/3 months.

Is there a drug out there which reduces strong harmful negative thoughts that comes with depression that can be used?

No space to breath, gasping for air. Any help is appreciated.
  • 0

"Describe the sunlight, so I can feel it's burn"

Tried - Fluoxetine, Citalopram, Escitalopram, Venlafaxine + XL, Mirtazipine, Buspirone, Seroquel (up to 150mg) Duloxetine 60mg p/d ~ All up to maximum dosages. Concerta 36mg, Ritalin 10mg
Currently on- Diazepam 2mg prn, Zopiclone 3.75mg prn, seroquel 400mg p/d

 




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#2 Blue Heron

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Posted 05 April 2012 - 09:46 AM

It'd be good if you were to list what you've tried already in your signature, so we can make educated recommendations.
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#3 Eden

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Posted 06 April 2012 - 02:17 AM

done. many thanks
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"Describe the sunlight, so I can feel it's burn"

Tried - Fluoxetine, Citalopram, Escitalopram, Venlafaxine + XL, Mirtazipine, Buspirone, Seroquel (up to 150mg) Duloxetine 60mg p/d ~ All up to maximum dosages. Concerta 36mg, Ritalin 10mg
Currently on- Diazepam 2mg prn, Zopiclone 3.75mg prn, seroquel 400mg p/d

 


#4 bengaltiger

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Posted 06 April 2012 - 12:46 PM

My opinion is, since you aren't really feeling much relief at 300mg, which is a pretty high dose, I wouldn't even bother moving up to 375mg. It might be better to cut your losses and move to a different med.

You've tried 3 ssri's which failed, and now an snri which is not helping. Did any of the ssri at least partially help?

Would you consider TCA's or MAOI's? IMHO, they are more effective.
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#5 Eden

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Posted 06 April 2012 - 03:27 PM

No, the other tablets did not help. but i suppose i am alive to write this post which is a bonus i suppose.

All i know is my medication doesnt cut mustard, but i dont really want to go on a medication which restricts my diet further propagation the isolation/no reward scenario.

Nothing has worked. down the rabbit hole i go.
  • 0

"Describe the sunlight, so I can feel it's burn"

Tried - Fluoxetine, Citalopram, Escitalopram, Venlafaxine + XL, Mirtazipine, Buspirone, Seroquel (up to 150mg) Duloxetine 60mg p/d ~ All up to maximum dosages. Concerta 36mg, Ritalin 10mg
Currently on- Diazepam 2mg prn, Zopiclone 3.75mg prn, seroquel 400mg p/d

 


#6 Mr_West

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Posted 06 April 2012 - 03:35 PM

My opinion is, since you aren't really feeling much relief at 300mg, which is a pretty high dose, I wouldn't even bother moving up to 375mg.


There is a benefit with moving Effexor up to 375mg in that you start getting an appreciable action on dopamine at that dose. That where it moves from being an SNRI (150-300mg) to an SNDRI.
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________________________________________________________________________________
Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

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#7 Eden

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Posted 07 April 2012 - 05:06 AM


My opinion is, since you aren't really feeling much relief at 300mg, which is a pretty high dose, I wouldn't even bother moving up to 375mg.


There is a benefit with moving Effexor up to 375mg in that you start getting an appreciable action on dopamine at that dose. That where it moves from being an SNRI (150-300mg) to an SNDRI.


thanks mr west. is it known to take both a high dose of effexor at 375mg /day with another antidepressant? i mean i understand that the dose is high according to previous posts, but wondered if anyone has taken tcas/maoi/ssri/sndri in addition to a maximum dose of one tablet. either one action serotonin or multiple action ones (like effexor) serotonin, nor-adrenaline and dopamine.
  • 0

"Describe the sunlight, so I can feel it's burn"

Tried - Fluoxetine, Citalopram, Escitalopram, Venlafaxine + XL, Mirtazipine, Buspirone, Seroquel (up to 150mg) Duloxetine 60mg p/d ~ All up to maximum dosages. Concerta 36mg, Ritalin 10mg
Currently on- Diazepam 2mg prn, Zopiclone 3.75mg prn, seroquel 400mg p/d

 


#8 Mr_West

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Posted 07 April 2012 - 06:19 AM



My opinion is, since you aren't really feeling much relief at 300mg, which is a pretty high dose, I wouldn't even bother moving up to 375mg.


There is a benefit with moving Effexor up to 375mg in that you start getting an appreciable action on dopamine at that dose. That where it moves from being an SNRI (150-300mg) to an SNDRI.


thanks mr west. is it known to take both a high dose of effexor at 375mg /day with another antidepressant? i mean i understand that the dose is high according to previous posts, but wondered if anyone has taken tcas/maoi/ssri/sndri in addition to a maximum dose of one tablet. either one action serotonin or multiple action ones (like effexor) serotonin, nor-adrenaline and dopamine.


The big reason to push Effexor up to that dose is to avoid having to use a second drug in the same class. At that dose the only drug people have heard of with a similar SNDRI action is cocaine, but the kinetics keep people from normally having the ability to get high off of Effexor. The only other similar drugs are obscure test compounds that will probably never seek drug approval, though they might end up in shady bath salts. Oh, it also hits opiod receptors kind of like tramadol does to a lesser degree.

At the point you move up to 375mg Effexor will seem like a different drug. Some where between 75mg and 150mg you maxed out SSRI type action from Effexor, and at 300 you are close to maxing out NRI action. The next step if you would need to add a drug would probably be something like lamotrigine or abilify. Maybe lithium, but lamotrigine or abilify would probably be easier to tolerate.

Don't get the idea in your head that you will inevitably need to add a new drug to effexor till you've given this new dose a chance.
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________________________________________________________________________________
Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

CYP 2D6 *10, *39

#9 Eden

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Posted 07 April 2012 - 09:39 AM

''Don't get the idea in your head that you will inevitably need to add a new drug to effexor till you've given this new dose a chance.''

I understand, its just very frustrating that 5 months in, and ive been through alot of mental pain, coped just about with the deepest darkest depression, been to the edge of the abyss as it were. and there still isnt a drug thats helped other then diazepam. which messed up my memory and i think took me away from the bad thoughts, a good thing on one hand but i was only 'covering' them up, eventually id have to feel them again, as im doing now.

its like theres no end. its a continuous pain that never stops, forever relenting, and nothing i take, no amount of positive thinking, actions, prayer, medications is doing anything. it just seems. is this it. is this what my life will be like. is it worth it.
  • 0

"Describe the sunlight, so I can feel it's burn"

Tried - Fluoxetine, Citalopram, Escitalopram, Venlafaxine + XL, Mirtazipine, Buspirone, Seroquel (up to 150mg) Duloxetine 60mg p/d ~ All up to maximum dosages. Concerta 36mg, Ritalin 10mg
Currently on- Diazepam 2mg prn, Zopiclone 3.75mg prn, seroquel 400mg p/d

 


#10 Mr_West

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Posted 07 April 2012 - 10:38 AM

I understand, its just very frustrating that 5 months in, and ive been through alot of mental pain, coped just about with the deepest darkest depression, been to the edge of the abyss as it were. and there still isnt a drug thats helped other then diazepam. which messed up my memory and i think took me away from the bad thoughts, a good thing on one hand but i was only 'covering' them up, eventually id have to feel them again, as im doing now.

its like theres no end. its a continuous pain that never stops, forever relenting, and nothing i take, no amount of positive thinking, actions, prayer, medications is doing anything. it just seems. is this it. is this what my life will be like. is it worth it.


If diazepam helped, another anticonvulsant like lamotrigine may help. Lamotrigine also helps with certain kinds of depression. Being in a different class of medication you won't have to discontinue Effexor to start it.

What's helped me whe I get that suicidal ideation is to mark the calendar a year in the future. On that day I look back at how my sports teams did, what movies came out, whether there was anything good on TV, and even what I might have accomplished. Granted I follow the St Louis Cardinals and Mizzou sports so that might give me an edge in this exercise. The thing is if I ended it I would never know these things. A little intense joy can make up for a lot of shit. Sometimes you have to emphasize a future over the now.

You are a long way from trying everything. When you are absolutely lost in the wilderness of MI make a target of two years. If you pursue treatment, two or more years might be how long it takes you to get stable. For me the most crippling thing is I lose my ability to construct a future for myself. Stupid little exercises like the one above help me through.
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Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

CYP 2D6 *10, *39

#11 Blue Heron

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Posted 07 April 2012 - 10:43 AM

Taking it a day (or an hour) at a time might help, too.
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#12 metatrix

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Posted 07 April 2012 - 01:46 PM




My opinion is, since you aren't really feeling much relief at 300mg, which is a pretty high dose, I wouldn't even bother moving up to 375mg.


There is a benefit with moving Effexor up to 375mg in that you start getting an appreciable action on dopamine at that dose. That where it moves from being an SNRI (150-300mg) to an SNDRI.


thanks mr west. is it known to take both a high dose of effexor at 375mg /day with another antidepressant? i mean i understand that the dose is high according to previous posts, but wondered if anyone has taken tcas/maoi/ssri/sndri in addition to a maximum dose of one tablet. either one action serotonin or multiple action ones (like effexor) serotonin, nor-adrenaline and dopamine.


The big reason to push Effexor up to that dose is to avoid having to use a second drug in the same class. At that dose the only drug people have heard of with a similar SNDRI action is cocaine, but the kinetics keep people from normally having the ability to get high off of Effexor. The only other similar drugs are obscure test compounds that will probably never seek drug approval, though they might end up in shady bath salts. Oh, it also hits opiod receptors kind of like tramadol does to a lesser degree.

At the point you move up to 375mg Effexor will seem like a different drug. Some where between 75mg and 150mg you maxed out SSRI type action from Effexor, and at 300 you are close to maxing out NRI action. The next step if you would need to add a drug would probably be something like lamotrigine or abilify. Maybe lithium, but lamotrigine or abilify would probably be easier to tolerate.

Don't get the idea in your head that you will inevitably need to add a new drug to effexor till you've given this new dose a chance.


Out of curiosity, how does Effexor at 375mg compare to Cymbalta at 60mg? Thanks.

Also, is there no role for adding an amphetamine to Effexor? To hit the dopamine really hard?
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#13 Mr_West

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Posted 07 April 2012 - 06:27 PM

Out of curiosity, how does Effexor at 375mg compare to Cymbalta at 60mg? Thanks.

Also, is there no role for adding an amphetamine to Effexor? To hit the dopamine really hard?


I'm not sure about the Cymbalta and dopamine.

Adding the amphetamine might be possible. There could be a role. There are a lot of potential next steps here.
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________________________________________________________________________________
Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

CYP 2D6 *10, *39

#14 Eden

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Posted 08 April 2012 - 12:54 AM

out of curiosity, but arnt amphetamines restricted drugs?
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"Describe the sunlight, so I can feel it's burn"

Tried - Fluoxetine, Citalopram, Escitalopram, Venlafaxine + XL, Mirtazipine, Buspirone, Seroquel (up to 150mg) Duloxetine 60mg p/d ~ All up to maximum dosages. Concerta 36mg, Ritalin 10mg
Currently on- Diazepam 2mg prn, Zopiclone 3.75mg prn, seroquel 400mg p/d

 


#15 Mr_West

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Posted 08 April 2012 - 01:00 AM

out of curiosity, but arnt amphetamines restricted drugs?


Certain ones are available by prescription, like adderall. They tend to be a pain in the ass to get filled though. For severe treatment resistant ADHD even methamphetamine is available under the brand name Desoxyn.
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________________________________________________________________________________
Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

CYP 2D6 *10, *39

#16 bengaltiger

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Posted 08 April 2012 - 01:28 PM


My opinion is, since you aren't really feeling much relief at 300mg, which is a pretty high dose, I wouldn't even bother moving up to 375mg.


There is a benefit with moving Effexor up to 375mg in that you start getting an appreciable action on dopamine at that dose. That where it moves from being an SNRI (150-300mg) to an SNDRI.


Sure, you could jack up the effexor to 375mg... and maximize your side effects. But the ratio of SRI to NRI to DRI is fixed... inflexible. That is the inherant flaw of Effexor and Cymbalta.

You would be far better off taking three meds so you could specifically manipulate your desired effect for each neurotransmitter.

I think you're right on the money with your idea of adding a stimulant to effexor. You wouldn't necessarily need to increase the fexx. I felt much worse at 300mg than 225mg.

Edited by bengaltiger, 08 April 2012 - 01:49 PM.

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#17 Mr_West

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Posted 08 April 2012 - 05:38 PM



My opinion is, since you aren't really feeling much relief at 300mg, which is a pretty high dose, I wouldn't even bother moving up to 375mg.


There is a benefit with moving Effexor up to 375mg in that you start getting an appreciable action on dopamine at that dose. That where it moves from being an SNRI (150-300mg) to an SNDRI.


Sure, you could jack up the effexor to 375mg... and maximize your side effects. But the ratio of SRI to NRI to DRI is fixed... inflexible. That is the inherant flaw of Effexor and Cymbalta.


It is fixed with Cymbalta for the most part, but it is dose dependent with Effexor. Cymbalta has rather close dissociation constants determining its affinity for SERT and NET, which makes it a pretty balanced SNRI at most doses. Effexor's got a strong affinity for the serotonin though with a moderate affinity for the norepinephrine transporter. Effexor only really begins to touch the dopamine transporter at very high doses. The dissociation constants are fixed for both drugs. The difference is that Cymbalta's are close while Effexor's are farther apart by quite a degree.

This post http://thelastpsychi...he_most_im.html explains how the rum fountain effect hits Effexor at the 75mg to 150mg transition. Part one of the series http://thelastpsychi...article_on.html gives more background on the principle with respect to Seroquel.

Most of the side effects for Effexor kick in between the 75mg-150mg dosage range, but some can sneak in as you move up in dose like you experienced. If someone is tolerating it well though, there isn't a reason to not try moving up before adding a second drug. Even if a second drug was to be added, it probably wouldn't be a stimulant. The four most likely drugs to add on top of it (in alphabetical rather than a meaningful order) are probably going to be one of Abilify, Lamotrigine, Lithium, or Seroquel. If I had to pick two drugs and dosages it would be either Abilify at 5-10mg or Lamictal at 25-100mg.
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Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

CYP 2D6 *10, *39

#18 Eden

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Posted 09 April 2012 - 01:37 AM

ok, I may think about suggestion of tritating upwards to 375mg effexor and adding additional combo like amblifiy. ive read up on wikipedia re Lamotrigine and there seems to be alot of risk for nasty side effects :/.

Not sure if lithium is the way to go to somehow stablise my mood ( i seem to be cycling from borderline suicidal to not suicidal within a few days). Im on seroquel 125mg p/night as it stands.Helps me sleep somewhat but not really sure what its meant to be doing for my depression. The p'doc thinks i should continue taking it. ??
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"Describe the sunlight, so I can feel it's burn"

Tried - Fluoxetine, Citalopram, Escitalopram, Venlafaxine + XL, Mirtazipine, Buspirone, Seroquel (up to 150mg) Duloxetine 60mg p/d ~ All up to maximum dosages. Concerta 36mg, Ritalin 10mg
Currently on- Diazepam 2mg prn, Zopiclone 3.75mg prn, seroquel 400mg p/d

 


#19 Blue Heron

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Posted 09 April 2012 - 06:24 AM

Edenz, Lamictal's really nasty side effects are exceedingly rare. It actually causes fewer side effects than other meds. Titrating up on it can be a real pain in the ass, though, since it tends to be activating at first. Titrating up slowly reduces one's chances of getting "the rash."

Hope you find a med cocktail that works.
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#20 Nurse Ratched

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Posted 09 April 2012 - 06:48 AM

Have you tried Wellbutrin? Might be easier than doing Lamictal titration, and it isn't anything like the SSRIs or Effexor.
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#21 notfred

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Posted 09 April 2012 - 07:24 AM

Lamotrigine and there seems to be alot of risk for nasty side effects :/.


That is NOT true. It is for most people free of side effects or very manageable with side effects. The SJS rash is exceedingly rare and blown out of proportion on the Internet.
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I am in full remission (296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Abilify 15 mg, (Aripiprazole), Eszopiclone 6 mg (Lunesta), Vyvance 70 mg, (dextroamphetamine) Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal), Ondansetron 8 mg (Zofran)

Supps: Multi-vitamin/mineral, Vitamin D-3 2,000 IU, Omega-3-acid ethyl esters 4 g (Lovaza), Fish oil 1-4 g.

Dx: Depression, Insomnia, ADHD-PI, Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#22 Nurse Ratched

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Posted 09 April 2012 - 07:29 AM

I had beginnings of bad rash. Went away quickly after stopping treatment. I loved effects of lamictal so much that I rechallanged a year later and I'm so glad I did. Slower titration and going to stick at a lower dose.
  • 0

Current Meds: Topamax 200 mgs, Seroquel XR 300 mgs, Wellbutrin 300 mgs, Vistaril 50 mgs x4, Klonopin .5 mgs, Ambien CR 12.5 mgs

Former meds: Paxil, Zoloft, Effexor, Remeron, Elavil, Abilify, Lamictal, Geodon, Zyprexa, BuSpar, Xanax, Depakote, Trazodone, Ambien, Lithium, Risperdal, Doxepin,  Cogentin, Haldol, Saphris, Latuda, Neurontin, Lexapro.


#23 Mr_West

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Posted 09 April 2012 - 08:11 AM

( i seem to be cycling from borderline suicidal to not suicidal within a few days).


Depending on the context the word cycling could change everything.

Edenz, Lamictal's really nasty side effects are exceedingly rare. It actually causes fewer side effects than other meds. Titrating up on it can be a real pain in the ass, though, since it tends to be activating at first. Titrating up slowly reduces one's chances of getting "the rash."

Hope you find a med cocktail that works.


Do this.


Lamotrigine and there seems to be alot of risk for nasty side effects :/.


That is NOT true. It is for most people free of side effects or very manageable with side effects. The SJS rash is exceedingly rare and blown out of proportion on the Internet.


And you get to realize this.

If it gets along with your skin Lamictal/lamotrigine can be very gentle. The minute you mentioned cycling, even if it is from depressed to more depressed, lamotrigine became a still better option. Talk to your doctor about the movements you take within your depression.

Lithium is still the best prophylaxis for suicide, but lamotrigine can be the kind hand that lifts you to normal.
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________________________________________________________________________________
Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

CYP 2D6 *10, *39

#24 bengaltiger

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Posted 09 April 2012 - 08:21 AM

Most of the side effects for Effexor kick in between the 75mg-150mg dosage range, but some can sneak in as you move up in dose like you experienced. If someone is tolerating it well though, there isn't a reason to not try moving up before adding a second drug. Even if a second drug was to be added, it probably wouldn't be a stimulant. The four most likely drugs to add on top of it (in alphabetical rather than a meaningful order) are probably going to be one of Abilify, Lamotrigine, Lithium, or Seroquel. If I had to pick two drugs and dosages it would be either Abilify at 5-10mg or Lamictal at 25-100mg.


Thanks, West. I appreciate your knowledge. I have read those articles re: Quel and Fexx. Great stuff. I agree on the abilify and lamictal.

By what process would you choose between lamictal or abilify? Would racing thoughts or OCD favor abilify?

I would like to know how abilify acts at, say 2mg compared with 5mg and 10mg. I've just added 1.25mg abilify to effexor... and the agitation, anxiety has truly jolted me.

Will this dissipate, and what can I expect from 5 or 10mg? Even worse agitation? I hope the opposite.

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#25 Mr_West

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Posted 09 April 2012 - 08:53 AM


Most of the side effects for Effexor kick in between the 75mg-150mg dosage range, but some can sneak in as you move up in dose like you experienced. If someone is tolerating it well though, there isn't a reason to not try moving up before adding a second drug. Even if a second drug was to be added, it probably wouldn't be a stimulant. The four most likely drugs to add on top of it (in alphabetical rather than a meaningful order) are probably going to be one of Abilify, Lamotrigine, Lithium, or Seroquel. If I had to pick two drugs and dosages it would be either Abilify at 5-10mg or Lamictal at 25-100mg.


Thanks, West. I appreciate your knowledge. I have read those articles re: Quel and Fexx. Great stuff. I agree on the abilify and lamictal.

By what process would you choose between lamictal or abilify? Would racing thoughts or OCD favor abilify?

I would like to know how abilify acts at, say 2mg compared with 5mg and 10mg. I've just added 1.25mg abilify to effexor... and the agitation, anxiety has truly jolted me.

Will this dissipate, and what can I expect from 5 or 10mg? Even worse agitation? I hope the opposite.


Up to 5mg Abilify would be largely stimulant. After that it becomes a powerful antipsychotic. 5mg tends to be the peak of abilify's stimulating abilities while 10mg where it tends to introduce calming effects. Once more calming effects settle in you may feel more compulsion towards movement, but the overal effect should be less agitating than a lower dose of abilify.

As to the question

By what process would you choose between lamictal or abilify? Would racing thoughts or OCD favor abilify?


Medicine is only something I practice on an amateur basis over the internet. The question you are offering between Abilify and Lamitcal is really dirty right now, but studies should ofer more insight within the next two years. Right now the process to choose one or the other is empiricism. Abilify has a tremendous marketing budget and really works well in some areas, but lamictal kind of owns the BP II niche even if it mostly popped up after the patent died.
  • 0
________________________________________________________________________________
Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

CYP 2D6 *10, *39

#26 notfred

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Posted 09 April 2012 - 08:57 AM

Up to 5mg Abilify would be largely stimulant. After that it becomes a powerful antipsychotic. 5mg tends to be the peak of abilify's stimulating abilities while 10mg where it tends to introduce calming effects. Once more calming effects settle in you may feel more compulsion towards movement, but the overal effect should be less agitating than a lower dose of abilify.



I disagree.The PI says doses up to and including 15 mg are allowed for antidepressant augmentation. I started at 2 mg and have been on 15 mgs for almost a year and do not find any AP activity. My pdoc is adamant that I can't go above 15 mgs as i would then experience AP activity.
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I am in full remission (296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Abilify 15 mg, (Aripiprazole), Eszopiclone 6 mg (Lunesta), Vyvance 70 mg, (dextroamphetamine) Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal), Ondansetron 8 mg (Zofran)

Supps: Multi-vitamin/mineral, Vitamin D-3 2,000 IU, Omega-3-acid ethyl esters 4 g (Lovaza), Fish oil 1-4 g.

Dx: Depression, Insomnia, ADHD-PI, Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#27 bengaltiger

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Posted 09 April 2012 - 09:22 AM

I disagree.The PI says doses up to and including 15 mg are allowed for antidepressant augmentation. I started at 2 mg and have been on 15 mgs for almost a year and do not find any AP activity. My pdoc is adamant that I can't go above 15 mgs as i would then experience AP activity.


Thanks NF. Yep, this makes sense... otherwise your vyvanse would be useless.

Can you describe the action of abilify 2mg when you began... on up to 15mg? I assume you didn't just jump from 2 to 15mg. Did you find it overly stimulating at lower doses? Calming at 15mg?

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#28 notfred

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Posted 09 April 2012 - 09:31 AM


I disagree.The PI says doses up to and including 15 mg are allowed for antidepressant augmentation. I started at 2 mg and have been on 15 mgs for almost a year and do not find any AP activity. My pdoc is adamant that I can't go above 15 mgs as i would then experience AP activity.


Thanks NF. Yep, this makes sense... otherwise your vyvanse would be useless.

Can you describe the action of abilify 2mg when you began... on up to 15mg? I assume you didn't just jump from 2 to 15mg. Did you find it overly stimulating at lower doses? Calming at 15mg?


I titrated very slowly not raising until I reached steady state. Like a month between dose changes. I did not feel anything until 7-10 mgs and then the AD effect kicked in quite robustly. It has kinda pooped some over the years so I went to 15 with some improvement. Abilify is neither activating or calming to me, even at 15 mgs. For augmentation some find small doses, 2-9 mgs, to be effective.
  • 0

I am in full remission (296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Abilify 15 mg, (Aripiprazole), Eszopiclone 6 mg (Lunesta), Vyvance 70 mg, (dextroamphetamine) Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal), Ondansetron 8 mg (Zofran)

Supps: Multi-vitamin/mineral, Vitamin D-3 2,000 IU, Omega-3-acid ethyl esters 4 g (Lovaza), Fish oil 1-4 g.

Dx: Depression, Insomnia, ADHD-PI, Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#29 Eden

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Posted 16 April 2012 - 07:41 AM

Thanks for all the responses guys, definately food for thought.

375mg seems to have stablised me slightly. If but only just. Still get the odd panic thought, feelings of doom but not half as strong as they were previously.
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"Describe the sunlight, so I can feel it's burn"

Tried - Fluoxetine, Citalopram, Escitalopram, Venlafaxine + XL, Mirtazipine, Buspirone, Seroquel (up to 150mg) Duloxetine 60mg p/d ~ All up to maximum dosages. Concerta 36mg, Ritalin 10mg
Currently on- Diazepam 2mg prn, Zopiclone 3.75mg prn, seroquel 400mg p/d

 



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