Posted by shelliR on May 16, 2001, at 22:28:02
In reply to Ultram, selegiline » shelliR, posted by Elizabeth on May 16, 2001, at 14:01:54
> I think that Dr. Bodkin has been willing to consult with psychiatrists in other parts of the country on this subject. (Considering how busy he always is, this is really sweet of him if it's correct.) Your best chance is to find a pdoc in your area who has ties to McLean (e.g., who worked there or did a residency there). Those guys all seem to know each other, and someone who knows Bodkin personally would be more receptive to his research, I think. Failing that, the next best option is to find someone in your area who has a research background or orientation, or who is interested specifically in creative approaches to TRD.
That is really difficult. Creative approaches to TRD here means adding stimulents with MAOIs and combining lots of meds, but nothing like Dr. Bodkin. He didn't really have a good referral down here either. My last trials were all with nardil with atypical antipsychotics--all of which made me feel strange. To tell you the truth, I don't believe that they have been out long enough for anyone to say that they are truely safe for long term use. My pdoc has had one case of TD with an atypical and one case with an SSRI, both resolved within four months. My doctor in the hospital has also had one case with an atypical and he doesn't have a very large patient population. So I'm sort of relieved that they did nothing for me. I actually feel safer taking hydrocodone. Really!
I picked my present pdoc because he's been around for years and years and I had the feeling he wouldn't be freaked out by my low dose of hydrocodone. I was right, but he's not of much help either. My last pdoc is best known for trd, but she was really critical about any opiate use (threatened to terminate with me) and also didn't understand my refusal to take lamictal because of a quick large weight gain. I was tired of defending myself. We worked together off and on (mostly on) for about ten years. Also I had to pay out of pocket and I pay too much for insurance to do that unless I felt I was getting something I couldn't get anywhere else.
> > I also have an old friend living in Somerset.
> Somerset...? (Where's that?)
Woops--Somerville. (although there is a town called somerset in MA)
> Going off MAOIs is hard, yup -- on top of the worst withdrawal syndrome of all the classic ADs, there's that damned "washout period."
I had no withdrawal symptoms going of of Nardil. (I've done it twice, in less than a week). Maybe it's because my dose has never been higher than 45 mg a day.
> I think the idea of selegiline in very high doses is an excellent one, and I often wonder if it wouldn't be worth it for me to give it another shot. (I didn't use benzos or anything to deal with the panic symptoms that I got when I was on it, so I never got past 40mg.) Selegiline seems to cause very little orthostatic hypotension and does not cause weight gain.
I am crazy busy (too busy) with my business now to do any drug trials. Drug trials have always been really hard for me and sometimes have landed me in the hospital. So far I'm still so low on the hydrocodone that I'm not worried. (After three years I really haven't increased). But because it is so short term I am able to observe how really really depressed I am without it (unlike when the nardil was working well). So I go through these brief periods of real fear about my depression.
If I do try selegiline, I will have to plan a few weeks off from responsibility. I hate responsibility, but I also know that meeting deadlines and having people come over a lot (I work from home) gets me out of bed during hard times. I don't want to disappoint anyone and I don't want to fail at something I'm really good at.
I just ordered codeiene with paracetamol--(Is that the same thing as tylenal?). I'm not particularly worried about combinations, since I still have never taken more than 7.5 mg a day, and usually less.
If you try selegiline again, I'd be really interested in hearing how it goes. I might be willing to take a few weeks off in August to try it. It's actually easier to go into the hospital for me to do drug trials because when you run a home business, your phone rings day and night and even though I turn the ringer off on my business line, some customers will call on my personal line, and I won't know and I'll answer. And it's is hard to say I'm out of town and then answer the phone!