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Re: Near the end: What meds can I try? Quick pls!

Posted by david maclean on February 17, 2003, at 9:27:21

In reply to Re: Near the end: What meds can I try? Quick pls! » david maclean, posted by likelife on February 16, 2003, at 23:08:07

> David,
>
> I've also experienced longstanding dysthymia, overlaid with recurrent major
> depressive disorder. I've experimented with a number of meds and found that
> desipramine taken with a small dose of ritalin (30 mg) has worked wonders.
> Since starting the ritalin, almost 6 months ago, I've had periods of what
> seem like full remission, from both disorders. I'm not constantly
> symptom-free, but feel better than I have in 5+ years.
>
> The Ritalin was also very quick acting--I noticed results immediately.
>
> Take care,
> Natalie


Natalie, that is a very encouraging piece of information. Like you, I too have had the odd infrequent major depressive period on top of my dysthymia. My mild personality disorder (OCPD) does not much help solve the mood difficulties.

I have two sets of questions to ask about what you have said. Apologies that I have a lot to say but I would appreciate it if you could take a moment to read it through.

FIRSTLY

We do not have desipramine avialable here in the UK. Are there any other members of that class of antidepressant which I could check to see if we can get it here?

SECONDLY

The Ritalin sounds interesting. I know almost nothing about it. Does it wear off ("poop out") after a few months and therefore the dose needs increasing?

Do you get problematic side effects?

If I am not able to get Ritalin from my doc then would other mild stimulants work like Dexedrine (dexamphetamine suphate) or Provigil (modafinil)? I think Ritalin is the med of choice for childhood hyperactivity and so I guess it may in some way actually be qualitatively different to the other two I mentioned. Right?

Importantly, does the improved mood and improved alertness you get from Ritalin come at the expense of a "trough" feeling at some later point. Do you see what I mean? For example if you take 10 strong coffees then you will feel alert but when the alertness wears off then you feel very lethargic. Does anything like this happen with Ritalin?

Finally, can I take a mildy stimulant med like Ritalin with my MAOI moclobemide (UK: Manerix). Moclobemide is a "Reversible MAOI" and not the same as the old generation of MAOIs like phenelzine (Nardil), isocarboxazid (Marplan) or tranylcypromine (US: Parnate, UK: Parstelin) but it is still an MAOI.

Sorry to ask so many questions. Hope someone can advise.

David


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poster:david maclean thread:200976
URL: http://www.dr-bob.org/babble/20030214/msgs/201101.html