Combinations for Treatment-Resistant Depression
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- Опубліковано 14 бер 2022
- Learn the essentials of psychopharmacology from Dr. Stephen Stahl! This clip from Stahl’s Essential Psychopharmacology, Video Edition covers potential treatment options for treatment-resistant depression. Learn more: nei.global/epvideos
Triple-action combo, such as SSRI/SNRI plus NDRI. Selective serotonin reuptake inhibitor (SSRI) plus a norepinephrine dopamine reuptake inhibitor (NDRI) leads to a single boost for serotonin (5HT), norepinephrine (NE), and dopamine (DA). Serotonin norepinephrine reuptake inhibitor (SNRI) plus a norepinephrine dopamine reuptake inhibitor (NDRI) leads to a single boost for serotonin (5HT), a double boost for norepinephrine (NE), and a single boost for dopamine (DA).
California rocket fuel: SNRI plus mirtazapine. Combining a serotonin norepinephrine reuptake inhibitor (SNRI) with mirtazapine is a combination that has a great degree of theoretical synergy: 5HT is quadruple-boosted (with reuptake blockade, alpha 2 antagonism, 5HT2A antagonism, and 5HT2C antagonism), NE is quadruple-boosted (with reuptake blockade, alpha 2 antagonism, 5HT2A antagonism, and 5HT2C antagonism), and there may even be a double boost of dopamine (with 5HT2A and 5HT2C antagonism).
About: In Stahl’s Essential Psychopharmacology: Video Edition, the newly published fifth edition of the landmark textbook comes to life as Dr. Stahl himself presents every chapter with fully animated illustrations. Learn more: nei.global/epvideos
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Maoi antidepressants are superior in the right hands
Hello I am taking 30mg mitazapine with 60mg cymbalta + 25mg pristiq. It's been working very well for me when other options like TMS and ketamine haven't. My only concern is the substantial weight gain from the mitazapine. I've gained about 20lbs. What can I do to help? I've tried a low calorie diet and that doesn't seem to help.
I like the creative perspective on pharmacology, but the data does not seem to bear out the 1+1+1 = 10, its pretty much a 1+1+1= 3 not even factoring in that the response rate to these meds is universally less that one. To simplify it is more like a 1/6th chance that 1+1+1=3, same goes with side effects, substance use combination liability, and the absolutley unknown longitudinal effects of such a combination. If it works it works, but if 1+1+1 consistently equalled 10, there would be far more patents on such combos - as seen with singular auvelity.
I'm on venlaf+ mirta + piracetam.
Sometimes piracetam is not enough and i think about methiphedidate or memantine
Good 👍
What about fluoxetine + bupropion + methylphenidate? Its what I take
With all due respect. You're the one taking it. You'd know better if it's working. This is theoretical what he's talking about.
I wish I had just started with something like moclobemide from the beginning to get all three pumped up a bit. Instead, I have been on all kinds of different combinations hoping to get depression, anxiety, ADHD, and chronic pain all under control without side-effects aggravating each other. Currently sertraline + methylphenidate + clonidine + pregabalin. Still pain, depression, insomnia and can't increase the SSRI dose. Adding or switching to SNRI makes me too reactive. Considering exploring the options doctors don't want to, like tramadol, DXM, ketamine, and, sigh. Just lots of sighing.
What is your diet and lifestyle like ? Are you eating inflammatory foods ? Gluten ? Grains ? Etc
moclobemide is a joke if you have treatment resistant depression. Nardil or Parnate is what you need.
@@ivankaralic6872 damn that sounds intense what’s that
I have been on Lithium + Duloxetine + Mirtazapine + Olanzapine + Propranolol etc. For years. Still can't get out of bed... Maybe I should try something different? After literally years of saying that that combo has done literally nothing but given me horrible side effects, the Duloxetine is now Desvenlafaxine. No improvement. I'm so tired.
MAOIs is the solution. look up Dr. Ken gillian
Have you tried paroxetine?
Ssri + Sari?
Is anyone taking DXM? I'm supposed to start Auvelity Monday. Interested in feedback.
Off topic. I’m starting Auvelity soon. Hope it’s working for you.
@@Awesomes007 it's not off topic. I'm glad you are finding this medication. If you can endure the side effects for a while it works better than anything I've ever tried (and I've been trying meds for 20 years).
@@Silly_Hobbit_Twix_Are_4_Squids I’m a couple weeks into Auvelity and I’ll say that the transition off of the two SNRIs I was on has been relatively easier than previous transitions. I feel a bit more hopeful and optimistic and am not despairing. I’m able to face difficult things a bit better. I am having some increased racing thoughts and worsening of a tic I have, but I’m pleased so far. Looking forward to how I feel in a couple weeks.
@@Awesomes007 hey! Any improvement is improvement. I have my first follow-up in 2 days and I'm a lot happier but I still get some irritability.
Cripes! Just remembered my afternoon dose and it's almost 9:30 pm here. 😬
I'm going to see what can be done for irritability (if anything). My motger told me today I'm doing a lot better. Things still get me down occasionally but I don't catastrophize or have a full on meltdown and I am fine after a while, a distraction or a nap.
Still having motivation issues with my art but it may come back with time. Meanwhile I've resumed interest in the Sims 4 and I have a boyfriend who is crazy about me and I feel the same about him. Never thought I'd find a real one after narcissistic discard. Things are really looking up! 🙌🏼
@@Silly_Hobbit_Twix_Are_4_Squids Yay! 😃
2:00
It is far from Rocket Fuel.
Haha. I've had that experience too. Totally...!
Read the book The Copper Revolution by Jason Hommel.
Mr corruption