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Re: help!!!!!!!--other options

Posted by jd on February 23, 2000, at 2:53:42

In reply to help!!!!!!!, posted by kayla on February 22, 2000, at 11:40:44

Kayla,

As some other people on this board have remarked recently, running out of antidepressants to try doesn't mean you're running out of medication options. In fact, all it may mean is that your depression and social anxiety (if they indeed have a chemical basis) would best be treated by an entirely different kind of medicine.

While a partial response to Parnate might lead you and your doctor to consider a trial of Nardil (the other well-known MAOI, a very different drug often better for social anxiety than Parnate), there are all kinds of other things you don't mention having tried or considered. The main category is probably mood stabilizers, which can often help in otherwise refractory depression. Lithium, valproate, and gabapentin are three popular mood stabilizers (the latter two actually anti-convulsants) that are often very effective, either alone or added atop an antidepressant. Gabapentin is perhaps especially worth consideration since it's been showing some effectiveness recently in social phobia and anxiety disorders, as well as with mood problems. But there are lots of other things to consider as well--what is the best thing to try first depends largely on the details of your particular situation. If your current pdoc isn't up-to-date on these treatment options (and a lot of them frankly aren't--the field has changed extremely quickly), you may want to consider getting a referral to a doctor who specializes in refractory mood & anxiety disorders. There are a lot of possibilities still out there! (Of course, there's also "talk therapy" too, but no one likes to be reminded of this if the problem feels largely chemical!) :-)

best to you,
jd
> I have been suffering from social anxiety for the past 6 years, and the last 2 years I have succumbed to a horrible depression that only keeps getting worse. I have tried many different meds, and I am at a loss as to what to try next. I have taken most of the ssri's, wellbutrin, effexor, sm. dose of pamelor, desipramine(made the anxiety sooooo much worse), and I finally responded to Parnate. Didn't last long though. Tried augmenting with cytomel,no good. When I stopped taking the Parnate, that's when my depression really became horrible. I really need something to give me some pep, and I have a tendency to sleep too much. I would love to hear from some you folks if you have any suggestions as to what I should try next. I know that it is all trial and error, but my pdoc and I are at loose ends. he is thinking along the lines of serzone, but I am afraid that is not going to give me the boost i so desperately need. Any advice would be appreciated more than you know.


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poster:jd thread:23086
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