Posted by SLS on September 7, 2004, at 16:53:35
In reply to Re: Milnacipran » SLS, posted by nmk on September 7, 2004, at 15:38:32
Hi Nicole.
> Lupron scares the life out of me.
It should. I once looked into it for a friend as a treatment for endometriosis. It has a reputation for doing some pretty scary things. I would have thought Yasmin to be the better choice for PMDD. I have never heard of your doctor's strategy. Maybe he has had success with it personally? I don't know. I hate to disuade people from trying something that their doctor feels strongly would work.
> I really don't know what to do next.
> Do you think I should play it safe and try a tca or move on to something like Parnate.If you have never tried a TCA, I guess that is the logical choice. I am not a big fan of clomipramine, even though it probably gets more people well than any of the others. It carries a pretty big burden of side effects, many of which are anticholinergic, and many of which are similar to the SSRIs. I would probably be more apt to try nortriptyline first. However, your doctor might have very good reasons for choosing clomipramine first, and I wouldn't want to second guess him.
MAOIs are always worth trying. I think Nardil makes more sense given your symptoms of anxiety and agitation. Why is your doctor leaning towards Parnate? I don't know why, but it seems to me that women do better on Nardil. That is ONLY a personal opinion based on some intuitive notions and observations. Make believe I never said it. Actually, there is some evidence that women respond less often to TCA than do men.
I think you should post a question on the Alternative board regarding the connection to your menstrual cycle. There are some things I'm sure Larry Hoover can suggest. I could list a few, but I feel more comfortable deferring to the people there who certainly know more than me.
Now that I have thoroughly confused you...
If you can afford the time to try a TCA before going with the MAOI, it would seem to make sense. You would avoid the diet restrictions and drug interactions or the MAOIs. It is pure guess work as to what you will eventually respond to, of course. You could at the same time begin to look into the alternative treatments geared towards the menstrual cycle.
Maybe:
1. TCA
2. concurrent alternative stuff (Evening Primrose Oil, vitamin B6, etc.)
3. MAOI
4. add hormone stuff
Wait for some other opinions. I need to think about this for awhile.
- Scott
poster:SLS
thread:380308
URL: http://www.dr-bob.org/babble/20040904/msgs/387732.html