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After a hellish treatment-resistant year+ of severe depression, trying paroxetine followed by venlafaxine, dothiepin (as it was then), mirtazapine and reboxetine (the worst - horrible anxiety) my psychiatrist tried lithium augmentation. I refused to stay on reboxetine and asked to go back on dothiepin as, ironically, I found the side-effects much more tolerable than those associated with the newer drugs.
Dosulepin (200mg) and lithium carbonate (400mg) worked really well for me. They quite possibly saved my life and almost certainly saved me from ECT. I took them for 6 years - yes, 6 years at 200mg, not exactly a 'maintenance dose'. During that time I had few side effects, felt great, took up running, went trekking in the Himalayas and passed my advanced driving test. Came off everything in 2005 and don't remember having any problems. Insomnia was once again a problem but always has been for me. Apart from that life was going really well for me and by the end of 2008 I was feeling really happy and optimistic about the future.
Don't know why the depression came back in February 2008, but it did. Could well have been associated with the subclinical hypothyroidism (6 years of lithium?? another story). So back to see a new psychiatrist, who persuaded my GP to put me on thyroid replacement at last, which has made me less weak and exhausted but not much effect on the mood.
Now I'm on 300mg a day (!) of dosulepin and 600mg lithium. It is all taking a long time to have much effect but despite the industrial-strength dose there seem to be few side effects. Also, the thyroxine dose needs to be titrated, so it's early days there. Just wondered if anyone else had had a good response with dosulepin, come off it and found it to be less effective second time around? Also scared about the prospect of being on it for a long time to come and its long-term effects.
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