Posted by christophrejmc on February 18, 2002, at 22:06:52
In reply to Hey Chris........ » christophrejmc, posted by spike4848 on February 18, 2002, at 9:51:15
> Chris,
>
> I have been using nardil for a few years for anxiety and depression with great sucess, but alot of side effects. Have you found any other med/med combo effective? I am trying zoloft/klonopin/provigil without much luck.
>
> Thanks,
>
> SpikeSpike:
I've not been too impressed with any other meds... I'm not sure what your history is, but if you were on Nardil, you are probably atleast somewhat treatment refractory. I'll try to list some of the meds that have caught my attention recently (I'm sure you're aware of all these, but if I'm not discussing psychopharmacotherapy, I feel less alive y'know?).
I hear of high-dose Effexor being efficacious for MAOI responders, but I'm not convinced that it's really anything special.
Trimipramine is an interesting drug -- a tricyclic without a known action (it may be an antagonist at D1 (also D2?) receptors), but a good response rate. It *increases* REM sleep (opposed to most (all?) other ADs that supress REM), which is kind of neat (heh). It's possible that this would be helpful for TRD.
Stephen Stahl (the Dr. Seuss of psychopharmacology) is working on the dopamine partial agonist aripiprazole from a new class of antipsychotics called "dopamine system stabilizers" that might be useful for depression (the CRF antagonists/Substance P inhibitors coming out don't look too impressive, unfortunately).
You might also want to try Marplan. It's similar to Nardil, but some people experience fewer (or, different) side-effects. (You have tried Parnate, right?)
I'm sure I could come up with more ideas, but they probably wouldn't be anything you haven't thought of.I think I remember you mentioning that one of your main problems with Nardil was sexual dysfunction; I've been reading a decent article (http://www.vh.org/Providers/Conferences/CPS/19.html) about MAOI side-effects and it suggests using cyproheptadine or bethanacol before *ahem* activity (I know you said you've tried the usual antidotes, but I thought I'd make sure).
I'm thinking of adding something (Mirapex, amantadine, Aricept, Cylert, or T3) to help with residual symptoms; if I find something that works well, I'll let you know.
-Chris
poster:christophrejmc
thread:94406
URL: http://www.dr-bob.org/babble/20020215/msgs/94562.html