Posted by sfy on October 14, 2004, at 14:34:59
In reply to Parnate, Morphine, and Trusting Joe Paramedic =), posted by utopizen on October 13, 2004, at 21:54:54
> While ECTs may produce some memory loss, MAOIs kill. I think memory loss is less of a risk than dying. I think memory is a little over-rated when we're preferring it to death. =)
>
> (ECTs can lead to fatalities, but this is currently like 1 in 10,000 or 1 in 1,000, can't remember which, and it's mainly due to anesthesia, which is similiar to having to undergo any operation where you go under).But what are the corresponding statistics regarding deaths occurring due to the use of MAOI's? That's the only way you can make a true comparison of their relative risks.
> I encourage your success with Parnate or Nardil if they help you. I didn't know you had prior experience with it. More power to you! I just wrongly assumed you heard things solely from this board about it, but if a doc you're seeing is experienced in managing it, he'll prescribe you that med that you can take for emergency hypertensive crisis and help guide you on the proper use of it.
I'm quite familiar with the use of nifedipine having been prescribed it when I was on Nardil. But for over two years, I never even thought about reaching for those pills.
> That said, let's not demonize drug companies. If a drug company gives a misleading statement in their NDA, that could lead to the FDA rejecting their application entirely, resulting in billion dollar loses.
>
> I don't think Eli Lilly misleadingly claimed in the clinical trial they submitted to the FDA that a substantial number of patients reported signifigant relief within 1-2 weeks of the 60mg dose. They made it clear in this statement that full benefit from the drug came after 4-6 weeks at 60mg.It wasn't my intent to demonize Lilly or any other drug company. I don't necessarily doubt their data on the efficacy of Cymbalta. My main point about these findings (which may have gotten lost) is that I assume that they only measure the effectiveness of Cymbalta for Major Depressive Disorder. There are no data on its use for the treatment of Dysthymia/Anhedonia/Atypical Depression which is where I currently find myself.
Just because a med is successful at treating MDD is no evidence that it will successfully treat other forms of depression. Prozac worked wonders for me in treating my earlier MDD but did nothing more.
> I want nothing more than for you to find relief. If Parnate or Nardil does that for you, more power to you. My only concern was that it would burden you with a dietary restriction, since I'm a nice guy and don't want to see others burdened with such things. If you're brave enough to deal with that, I admire that a lot.
Having been through this before, the diet is more a minor annoyance than a burden. But I'd rather be minorly annoyed than chronically depressed.
> It means you can never take a stimulant, unless your doc is super brave and you're super experimental and frankly I can't advise that, because you just can't predict what extent of hypertensive crisis that will cause no matter what doc you see. And the drug interactions-- you mentioned several mental illnesses- what if you wanted to take something to increase your drive, like Strattera? It's unlikely you'd be given the option.
I've already been down the stimulant route to no effect so that's not an issue. And Parnate provides its own stimulating effects.
> So yeah, if everything else failed, and I was left between Parnate and ECT, I'd say memory take a hike-- my life is more important than a few years of remembering when I felt hopeless and meaningless in this world.Well, I'm not exactly feeling hopelessness and meaninglessness right now - MDD is not an issue for me. And I'm still not convinced (though open to any evidence) that ECT has been shown to be effective in treating Dysthymia.
I appreciate your concerns and your generosity in offering another side to this discussion
poster:sfy
thread:402677
URL: http://www.dr-bob.org/babble/20041012/msgs/403022.html