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Kramer: Help with atypical depression (resistant).

Posted by Sparkboy on April 2, 2002, at 16:09:22

I finally got a correct diagnosis in 1987. Tests showed (and continue to show) I am otherwise physically healthy. Parnate worked perfectly, but stopped working after 3 months. Retrials proved pointless. Re-uptake inhibitors are useless. Dexedrine augmenting Zoloft was counterproductive (no lift, irritability). Lithium, Tegretol no good. A trial of serotonin re-uptake enhancer tianeptine (Stablon) brought oversleeping in the summer and irritability.

What helps me now: moclobemide 75-150 mg/day, Neurontin 600 mg/day, Ambien 1-2 times a week. Have had oversleeping and leaden fatigue controlled for several years, but recently, intensified anxiety late in the year caused me to need Ativan 1.5-2 mg/day. I think the oversleeping of winter used to shut down some of the anxiety. Deliberate sleep deprivation one time (for a few days) brought on a severe anxiety attack, lasting 2 months (this was years ago).

What is disabling is the inability to be around people and form relationships for any length of time. Anxiety and sensitivity to criticism very problematic. Also flatness of warm feelings (restored when Parnate worked).

My questions:

Parnate was unique in being able to provide a true AD response, even among the MAOIs. Does the nature of Parnate suggest to you any improvements in my drug strategy?

Gepirone is scheduled for release in the second half of this year. Do you have any more precise info on a release date?

Would a trial of Lamictal be worth considering?

Thanks for any input.




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