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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Christina on October 22, 2001, at 11:28:42
Help. What are the best meds for the treatment of Dysthymia? Anyone having any success? I've tried Paxil, Zoloft, Prozac (daily), Wellbutrin, Effexor, Lithium, Celexa and now I am on Serzone.
Nothing seems to help.
Maybe a combo might help. Any suggestions? I'm near desperation.
Thanks
Posted by Elizabeth on October 22, 2001, at 12:12:40
In reply to Dysthymia Meds. What helps?, posted by Christina on October 22, 2001, at 11:28:42
> Help. What are the best meds for the treatment of Dysthymia? Anyone having any success? I've tried Paxil, Zoloft, Prozac (daily), Wellbutrin, Effexor, Lithium, Celexa and now I am on Serzone.
A few ideas:
Remeron
Lamictal
MAOIs (Nardil, Parnate, selegiline)
stimulants (Ritalin, Dexedrine, Cylert)It might be worthwhile to try a tricyclic AD, although I think they are generally less effective in dysthymia than are other ADs.
Anything you can say about your symptoms? "Dysthymia" covers a lot of territory.
-elizabeth
Posted by Christina on October 22, 2001, at 20:00:57
In reply to Re: Dysthymia Meds. What helps? » Christina, posted by Elizabeth on October 22, 2001, at 12:12:40
Elizabeth: thanks for your response. My main symptons are anhedonia and fatigue. I've also gained 40 lbs in the past few years since going on ADs. I was hoping to lose weight on Serzone, but no such luck.
I have tried Ritalin a few years ago, but it made me to irritable. I asked my new pdoc for Dexedrine, but he won't give it to me, even tho I think it will help. I may seek another opinion.> > Help. What are the best meds for the treatment of Dysthymia? Anyone having any success? I've tried Paxil, Zoloft, Prozac (daily), Wellbutrin, Effexor, Lithium, Celexa and now I am on Serzone.
>
> A few ideas:
>
> Remeron
> Lamictal
> MAOIs (Nardil, Parnate, selegiline)
> stimulants (Ritalin, Dexedrine, Cylert)
>
> It might be worthwhile to try a tricyclic AD, although I think they are generally less effective in dysthymia than are other ADs.
>
> Anything you can say about your symptoms? "Dysthymia" covers a lot of territory.
>
> -elizabeth
Posted by Christina on October 23, 2001, at 19:59:31
In reply to Re: Dysthymia Meds. What helps?, posted by Christina on October 22, 2001, at 20:00:57
I went back to doc today and he took me off Serzone and started me back on Prozac. Last time I took Prozac, it didn't work because pdoc started me with that and Depakote..which didn't work.
We'll see what happens.
I've read that Zyprexa is a good augmenter for Prozac, but I'm concerned it may too sedating.
Posted by phillybob on October 24, 2001, at 20:36:50
In reply to Med update, posted by Christina on October 23, 2001, at 19:59:31
Christine, if you can swing it, maybe go for a second opinion.
I have not found the ideal solution yet, but stimulants definitely help.
My pdoc finally agreed, after years of trials with AD's (except MAOIs) and the mood stabilizers, that I am classic ADD.
It's not fun that pdocs, in general, seem to have such a hesitancy to prescribe stimulants. The stimulants are a class of drugs that had been prescribed so often years ago, before mass pharmaceutical company marketing of more profitable newer meds became all the rage.
I have been alternating between 10 mg dexadrine 2X daily (20 mg total) and 20 mg adderall 2X daily(though 40 mg in one shot for the latter is supposed to be more preferred than divided doses).
I'm not sure yet if one works better than the other nor if their effects can be sustained, but I might be able to rotate the two and even three (ritalin) if need be to maintain efficacy.
Finally, I do take an AD (right now, Effexor XR, 75 mg/nite) which I think helps even out the side effects of stimulants (anxiety and/or the ups and downs of their effects "wearing off").
I've also had success with 45 mg/nite of Remeron in the past (but appetite and weight gain ensued).
I might move over to imipramine at a small dose at night instead of the effexor. Not quite sure, yet.
You might be fine with the Prozac and the stimulant.
(or, as John might pipe in with the "add Zyprexa" offer of advice ... which my pdoc has said also, but due to the weight gain, I've steered clear (though have tryed for brief periods).
This is the end of the thread.
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