Psycho-Babble Medication | about biological treatments | Framed
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Re: Follow-up

Posted by Toby on October 26, 1998, at 16:11:28

In reply to Follow-up for Toby, posted by carter on October 23, 1998, at 21:35:03

I am indeed a doctor, board certified in psychiatry and neurology.

You've had this depression pretty consistently over the last 10 years? Have you been treated all along, or only recently? Has nothing really given much benefit or too many side effects to really tell?

Have you been tried on an MAOI, specifically tranylcypromine? MAOI's are superior to TCA's in treating atypical depression (overeating, increased appetite and weight gain, sweet craving, hypersomnia--too much time in bed, "rejection-sensitivity," profound loss of energy or "leaden paralysis," feeling better in the morning and worse as the day proceeds, phobic-anxiety, panic attacks, worries about physical health without reason). Any of those apply to you? You did list a few in your post. MAOI's successfully treat 55-70% of depressions that fail to respond to other antidepressants. I recommended tranylcypromine because it has much less risk of sexual side effects and better track record for improving energy.

Side effects: mild hypotension, dizziness, palpitations, dry mouth, sedation when first starting out and typically resolve pretty quickly.

Regarding the jitteriness from the Wellbutrin -- that usually goes away within 4-6 weeks of starting it, so if you took it that long without any change in symptoms, taking it longer probably won't show any benefit.

Amantadine for tremors from Wellbutrin I have not tried or heard of. I'm not sure that it would do much because amantadine increases dopamine, as does Wellbutrin so it may even increase the tremors as a side effect. Amantadine shouldn't have adverse sexual side effects. It works as an antiviral for Influenza A, and I guess might work for the Borna virus (I haven't read that, so don't know specifically). Amantadine has caused depression in some clinical trials. I wonder if Dr. Bob knows about antidepressant properties.




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