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Re: Nardil and agitation » Jon W

Posted by denise528 on August 3, 2002, at 7:10:29

In reply to Re: Nardil and agitation » denise528, posted by JonW on August 2, 2002, at 16:30:17

> Denise,
>
> The Nardil did make me agitated but I'm bipolar and sensitive to anti-depressants. Have you been evaluated for bipolar spectrum disorder? Have you ever been on any "mood stabilizers"? You might want to consider Lamictal as it has anti-depressant qualities to it. I believe the latest thinking is that it's not so good for the highs of bipolar disorder but is very effective for bipolar depression. Have you ever been on any atypical anti-psychotics? Something like zyprexa or Geodon that address both agitation and depression might be worth asking your pdoc about.
>
> The truth is that if your illness is intractable it may require more than one med. However, I certainly understand not wanting to take a med just to have to take another med unless it is absolutely necessary. The thing about Nardil is that it sucks if it doesn't work. The side-effects are worse than other drugs (although it's my understanding that things get better with time) and you generally have to wait 2 weeks before starting another anti-depressant. So if it doesn't work, you've put yourself through side-effects and are out 2 weeks with no AD (a stimulant could be prescribed to get you through, though). On the flip side, this drug has performed miracles for many people. If you decide to take it and can tolerate the side-effects don't give up on it too soon. You might want to try Parnate instead. It's my understanding that it is more suited for endogenous depressions and has fewer side-effects. Another option is moclobemide, however, it is one of the least potent ADs. This doesn't mean it wouldn't be effective, but there are no food restrictions, no withdrawal, and no 2 week wait to try the next AD. I've been on this drug and it didn't make me agitated. In fact, I'm probably going to try it again but this time I'm going to give it a full 12 weeks.
>
> One question, are you sure you're with the best pdoc for you? He doesn't sound so great telling you your illness isn't bad enough to try Nardil. I've heard several pdocs say that a failure of 2 ADs justifies a trial of an MAOI. You might want to take a look at this questionare prepared by Ivan Goldberg to see what you think of your pdoc:
>
> http://www.psycom.net/depression.central.expert.html
>
> Anyway, just a thought... good luck with everything!
>
> Jon

Hi Jon,

Thanks so much for getting back. To answer you question I have tried Lamictal (50mg) and it doestn't really do anything, I don't get any side effects from it but neither does it make me feel any better. Effexor just makes me feel drowsy, antisocial and completely unmotivated, the only good thing about it is that it relaxes me.

I'm fairly certain my depression is endogoneous so maybe Parnate would help.

The only thing that gets me out of the pit is Zyprexa 10mg but it worries me that I'm taking an antipsychotic as I'm not psychotic. I'm also worried about the long term effects and that maybe I'll end up not only depressed but also with Tardive dyskinia.

I'd like to try ECT but everyone looks aghast when I mention it, they think that I just want to try the most drastic thing out. I, I really don't care anymore if I do die, I'm more scared of this depression than I am about dying and I don't care about losing my memory as there is nothing about this past year that I want to remember.

I do sort of like my psychiatrist, he is very enthusiastic about what he does but he won't accept that I'm not getting better after a year, I think this is because it's not a very good reflection on him. He keeps saying well at least your working and your not in the state you were in the first time I saw you. I did see two other Psychiatrists on the National Health and they were both crap, one was totally disinterested and the other one, although nicer was a bit like Manuel out of Fawlty Towers, I had no confidence in him.

I don't know if you are from the UK but the standard of Mental Health care is awful, we are way behind the states, you don't get to hear about any studies.

At the moment I am messing around with my drugs, sometimes taking Effexor to calm me and other times taking Sertraline to wake me up. Sometimes I feel better the day after I have taken them, so I go through a crappy day on them just to have a few good days afterwards.

Anyway, thanks for your advice. I really don't know what I'm going to do next, just keep plodding on I guess.

And thanks for the link, I'll check it out.

Denise


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