Posted by JohnL on April 16, 2001, at 6:04:45
In reply to Multi Med Changes w/ no wash outs. Consequences???, posted by PaulW on April 15, 2001, at 13:33:25
Paul,
I've tried dozens of drugs to arrive at my current very effective cocktail. Only once did I do a washout. I do not believe multiple med changes screw anything up. In contrast, I think multiple med changes are good because it is the only way to pinpoint which drug is a superior match for you. Excluding MAOIs, a one day washout is fine.In your shoes, with the benefit of hindsight, I would stay on Effexor but add Zyprexa to it. If you don't like Zyprexa after two weeks, then switch to Risperdal. I preach these drugs all the time, but for good reason. Clinical and anecdotal evidence is very encouraging, not to mention my own success after years of failure with other common and other exotic approaches.
There are actually doctors who specialize in rapid fire drug trials with patients. Drugs are tried for only 5 days to 2 weeks each. I've had two doctors that treated me this way. I was able to weed out a lot of dud drugs and stumble onto really good ones, in a relatively short amount of time. Without this approach, I would still be suffering and would still probably be stuck back in the SSRI arena, flooded with confusion and frustration of what to do next.
When a superior drug match is encountered, it is often obvious within days. Once superior matches have been identified, then longer trials can be committed to. This is not at all a common way to treat patients, and it is often controversial, but I can say from personal experience it works. You have already weeded out some dud inferior matches for you. Though it doesn't feel like, you have made progress by narrowing down the list. At this point, to stack the odds in your favor, I would consider adding Zyprexa and then Risperdal to your ongoing Effexor. And on the back burner I would keep Prozac in mind. It is a time tested proven workhorse and is still the most unique of all the SSRIs. It could not have stood the test of time without good reason. As a sidenote, clinical trials as well as anecdotal evidence show there is some kind of real special synergy between Prozac and Zyprexa when they are combined. Try it! And don't worry about the washout thing.(MAOIs excluded)
John
poster:JohnL
thread:59957
URL: http://www.dr-bob.org/babble/20010411/msgs/60040.html