Posted by Ritch on February 23, 2003, at 9:39:37
In reply to New Thoughts, posted by Peter on February 23, 2003, at 0:36:45
> Yeah, it's a toss up between Nardil and straterra. On the one hand, the thought of straterra stresses me out a lot less, since it doesn't have such bizarre interactions with food and other meds. I've also seen some positive posts here on peoples' experiences with straterra-that it has good effects on the mood-depression and anxiety as well as ADD. There's also the possibility that I'm not experiencing the lamictal benefits because the adderall might be exacerbating my mood swings; perhaps, in this respect, straterra would be a much 'cleaner' alternative that could give me a clearer picture of whether the lamictal is in fact helping me.
> On the other hand, if I'm going to take yet another med, I would like it to be something that has more of a concrete potential to help my symptoms in the long run. In other words, I absolutely do not want to continue going around in circles; I'm sure you can all relate.
> Even though the SSRI's helped me for a few months at a time, they are certainly not long term solutions; it's fair to say I've had enough trials of SSRI's to make that conclusion.
> The straterra, while it has it's 'clean' benefits, might just be another med that, like so many others, would help me for a short period and then require me to 'wash-out' and start from scratch again.
> Now we get to the Nardil. I've heard it's like some wonder drug or something. But I'm still having trouble coming to grips with the dangers associated with it. I've already been going through a decent amount of stress regarding the possibility of the fatal lamictal rash. Now it will be the lamictal rash PLUS the "woops-I might have just eaten some tyramine by mistake-time to go to the ER." I've seen some posts that mention people having to go to the hospital even after taking that anti-hypertensive antidote med.
> I'm sure my pdoc will keep me on lamictal if I start Nardil, so I'd end up with 2 meds that I'd classify as pretty 'serious' when it comes to possible fatal reactions. Not to mention that my pdoc seems pretty sure about certain things that seemingly contradict Nardil's safety profile (according to its monograph). For instance, he said it's fine to take a stimulant like adderall with Nardil, but he said cocaine and Nardil can be a lethal combo. The monograph, as Mitch pointed out to me, says both amphetamines and cocaine are listed under the contraindictions. Those little discrepencies between what my pdoc says and what the medical documents say further add to my stress about taking Nardil, though I do have an accompanying curiosity that it might very well be the one med that, if it doesn't kill me, might actually work where all the other meds failed! It's a double-edged sword, no doubt.
> That's when I start trying to consider if I really need to start another med at all. Yes, I've been feeling especially sucky lately, but there are times when, if faced with an unexpected social occasion, I don't freak out and I seem fine. it has always been much easier for me to reach for a pill instead of considering possible psychological factors that lead me into these awful mood states. Trust me, I'm not talking as an anti-med, 'suck it up and deal with it' person-I've taken my fair share of meds, and if anything, I'm a big-time med advocate!
> But I have to consider-am I 'ill' enough to take Nardil, or am I just never satisfied with my life because of other reasons that relate more to psychological and spiritual health than to a stubborn biological imbalance? I guess this is a big topic for many.
> As you can see, I'm still in the dark about this, but I thank you all for your feedback. Any further opinions? My doc said if I'm not out of this funk by Monday or Tuesday, I should consider the MAOI or straterra-so the choice seems like it's up to me and I'm still torn between either or neither.
> Thanks,
> Peter
I'd go for the Straterra for now because you can continue to take Adderall while you are on it. That way you are just adding on something else-and you won't be going through a possible withdrawal (Adderall), at the same time you start the Nardil. There will be less confusion as to what is causing what (adverse effects from the Nardil or Adderall discontinuation syndrome?). I would be just as concerned about taking an MAOI with an amphetamine as you are. Give the Straterra 2-3 weeks and see if it helps any. If not-then drop it and hash-out a way to start the Nardil with your pdoc that doesn't leave you uptight and wondering about his judgement.
poster:Ritch
thread:202089
URL: http://www.dr-bob.org/babble/20030219/msgs/203035.html