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  • N&PD Moderators: Skorpio

Medication resistant depression

I do agree that it sounds like a spot-on description of Bipolar II, but many years ago I was diagnosed bipolar. I had similar symptoms, but found that the side effects of the medications I was put on just weren't worth any symptoms they blunted. I was on depakote, neurontin, and zyprexa, by the way. Since then I've encountered a plethora of these cases that fit comorbid diagnoses perfectly, and unfortunately there seems to be no good rule of thumb as to what works. I had to try various medications until I found something that sort of worked.
 
There are many families of Antidepressants:
-Tricyclics (Amitriptyline, Imipramine, Clomipramine...)
-MAOIs (Tranylcipromine, Moclobemide...)
-SSRIs (Fluoxetine, Paroxetine, Citalopram...)
-Other (Mianserin, Mirtazapine, Viloxazine, Tianeptine...)

All the Antidepressants you tried (Prozac, Effexor, Amitriptamine, Citralopram) are monoamines reuptake inhibitors, you should try another kind of antidepressant, such as Remeron (Mirtazapine).

Mirtazapine is a very good antidepressant, and it often works when other antidepressants fail...
And with it, it only takes one week or 10 days max to feel the effects..

----------------------------

But if the antidepressants you tried sent you "manic" as you said, maybe you're bipolar.
If you are, then Antidepressants are not what you need.

You need a mood stabilizer.

Here are some mood stabilizer that really work against bipolar disorders:

Anti-epileptics:
-Carbamazepine (or its derivative Oxcarbazepine)
-Lamotrigine
Antipsychotics:
-Olanzapine
-Amisulpride
 
I've been diagnosed as bipolar, but oonly in a mild way in that I only ever exhibit hypomania and have only once progressed to full mania (which was unpleasant); my depressive swings are nowhere near as common as the hypomanic ones, but make up for that in their intensity. Funnily enough, when hypomanic (I can generally recognize myself entering a hypomanic state) I find that amphetamines in lowish doses almost have a paradoxical calming effect. Only high doses of amphetamine push the hypomania into full blown mania
 
thesean001 said:
buprenorphine ;D
Click to expand...

Yep that's the only medication that really works against depression for me; and even after 2 years of use, it still kills my depression...

Even the antidepressants that really work (Remeron/Mirttazapine) work only during a few months and stop working after that... It's not the case of Bupe...
 
If it is a good mood stabilizer you're after I would recommend Epelim (Valporic acid)
 
almost- said:
Neuropsychopharmacology: The Fifth Generation of Progress: Current And Emerging Therapeutics For Depression:
http://www.acnp.org/Docs/G5/CH75_1081-1096.pdf
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That seems interesting:
A large open investigation (169) suggested, as did earlier studies, efficacy and very rapid onset of antidepressant effect of parenteral SAMe in humans.
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169. Fava M, Giannelli A, Rapisarda V, et al. Rapidity of onset of the antidepressant effect of parenteral S-adenosyl-L-methionine. Psychiatry Res 1995;56:295–297.

Abstract:
A possible method of reducing the delay in antidepressant response is to use S-adenosyl-L-methionine (SAMe), a naturally occurring compound that appears to have a rapid onset of effect in the treatment of depression. In this open, multicenter study, 195 patients were given 400 mg of SAMe, administered parenterally, for 15 days. Depressive symptoms remitted after both 7 and 15 days of treatment with SAMe, and no serious adverse events were reported. Further studies with a double-blind design are needed to confirm this preliminary indication that SAMe is a relatively safe and fast-acting antidepressant.
Click to expand...
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7568552&dopt=Abstract
 
I brought this one back...from the grave. I think it deserves more attention. To my knowledge, buprenorphine is supposed to be effective in extreme cases.
 
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