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Psycho-Babble Medication | about biological treatments | Framed
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Re: atypical depression: Annie

Posted by Elizabeth on November 10, 1999, at 15:45:14

In reply to Re: atypical depression: Annie, posted by Scott L. Schofield on November 9, 1999, at 10:21:55

> I'm not a big proponent of using drugs that don't work.

What a nice, noncontroversial statement. ("I support the good things in life. I oppose the bad things.")

> The old rule-of-thumb was to consider Parnate as a first choice for bipolar depression and Nardil for atypical unipolar depression, particularly if there also exists some social-phobia, panic-attacks, or obsessive-compulsive characteristics.

Really? I'd never heard this. What's the rationale? There is better evidence for Nardil when it comes to social phobia (I think MAOIs are falling out of favor for OCD), and Parnate may be better avoided in panic disorder (because of its stimulant-like properties), but why the unipolar vs. bipolar dichotomy?

Parnate seems to be better tolerated, from what I can tell -- Nardil tends to cause quite a bit of weight gain. Patients with diabetes mellitus should not take Nardil.

> One thing worth mentioning is that low-dose lithium in combination with an antidepressant has been used with some success at treating unipolar depressives. The range of dosages used was between 300 - 600 mg/day. 450 seemed to be the sweet-spot.

Really you need to check blood levels -- should be somewhere between 0.5 and 0.8 mmol/L. As an example, I'm a fairly small person with healthy kidneys taking 300 mg twice a day, and my most recent level was 0.7.

But yeah, lithium augmentation (of low-dose Parnate) did a really nice job for me when my mood had improved somewhat but my interest in life and ability to enjoy things were still absent.




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