Antidepressants

[eimperati]

I am on Wellbutrin XL, Ablify and Zoloft. I am still not doing better. Do you think they would put me on another Antidepressant also?

[Hensley258]

I dissagree. From the sound of his post he has not tried that many different and safer meds, thus moving directly to an MAOI would be foolish. 99% of Psychiatrist will not even put a patient on MAOI until they have failed on at least 2 dozen medications and combinations.

As for EMSAM patch. A good idea that never did work as expected. I know plenty that have tried it and all have failed on it. Not to mention that at higher dosages it too has food restrictions just like MAOI drugs such as Parnate and Nardil.

MAOI should only be used as a last resort drug. Parnate is on my list, but it is way down on the bottom if I get to a point where nothing else works anymore.

[blackcompe]

The combination of wellbutrin and zoloft was actually a smart move by your clinician. That combination is like a two in one knockout punch, in that if you don't respond then, we know it's not a matter of which neurotransmitter system that needs to be enhanced, but rather a matter of how to enhance them. With that being said, perhaps you should try an MAOI. EMSAM is the popular MAOI on the market right now, and luckily, there are no food restrictions at the lowest dose. There's mixed opinions about the effectiveness of MAOI's, but generally they are effective when reuptake inhibitors aren't doing the job. If you don't notice a significant reduction in symptoms after an MAOI, maybe its time for an antagonist of some sort like: remeron, nefazodone, trazadone, or a tricyclic.

Abilify is approved for depression as an adjunct therapeutic. I don't see many depressed people on Abilify, but there's no telling whether it will be effective for you. Abilify is mainly used for schizophrenia and mania.

Before you do anything, it's best try the maximum dose of each medication, before switching to another class.

In my experience, I've found Effexor and Cymbalta (SNRI's) to be the most stimulating, next to he older tricyclic medications. Paxil was the most stimulating SSRI, over Prozac, Zoloft, Lexapro. But, after a few days, I felt nothing from Paxil. I felt nothing from the SSRI's as well. Effexor was consistent. This is probably so because Effexor is active in more than one way.

[Hensley258]

Sounds like you also found those meds to be useless.

1. Welbutrin is a joke and even as an add on medication does very little to help most people with real symptoms.
2. Abilify is all hype. The drug never did deliver what it claimed it could and everyday I see posts from people saying that it has not worked for them either.
3. Zoloft (Sertraline) not a bad SSRI at dosages above 100Mgs a day, but it lacks the power to squash Major depression when it is really bad.

I have been on all three drugs and none helped me either so try not to get frustrated.
You just found out what doesn't work for you and thats a good thing because now you can take steps toward more effective medication combinations.

If your doctor just wants to add more on to the three meds you have then I would get a second opinion from another Psychiatrist. It's probably all three meds that need changing and just adding more is not always the solution.