Posted 05 February 2010 - 06:24 AM
You could add something that boosts noradrenaline and/or dopamine. Wellbutrin has been mentioned - the combo of Zoloft and Wellbutrin has gained some fame and has been dubbed 'Welloft'. There are also the TCA's to consider - adding desipramine, a strong NRI, might work, or nortriptyline, a milder one. There's also the possibility of adding selegiline, the MAO-B inhibitor, in a maximum dose of 10mg per day, but you would need medical supervision for the rare possibility of serotonin syndrome (selegiline does not require a MAO-diet at these low doses).
I've been reading on the web about SSRI experiences quite a lot, and my impression is that all SSRI's can cause apathy en lethargy, including the so called 'activating' SSRI's, Prozac and Zoloft. Many people report that 100mg of Zoloft eventually renders them listless and emotionally numb.
It's intriguing that apathy and emotional numbness haven't been linked to or reported with the use of clomipramine, the TCA that is about as strong an SRI as Zoloft. Clomipramine might be worth a try if you decide to go off the Zoloft altogether. I have also been on a combo of Luvox (fluvoxamine) and low dose clomipramine for a while (Luvox inhibits the breakdown of clomipramine), and the clomipramine countered the Luvox-induced apathy quite well. I think adding clomipramine to an SSRI can be very effective for OCD. One should be cautious about serotonin syndrome, but starting out with tiny doses should eliminate that risk.
Current meds: Zoloft (sertraline) 250mg, Neurontin (gabapentin) 2400mg or more, Concerta (methylphenidate XR) 18mg + methylphenidate 5mg as needed, 1 Deanxit (flupentixol 0,5mg + melitracene 10mg).
Have used before: alprazolam, oxazepam, clonazepam, diazepam, buprenorphine, amitriptyline, modafinil, fluoxetine (Prozac), imipramine, trimipramine, lorazepam (Ativan), flurazepam, amisulpride, piribedil, ziprasidone (Geodon), buspirone, tramadol, ondansetron, risperidone, tianeptine, amineptine, nortriptyline, codeine, paroxetine (Paxil/Seroxat).
-Some of the magic syrup was preserved.