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Re: Antidepressants don't work except for when the » Chairman_MAO

Posted by SLS on March 4, 2006, at 8:13:29

In reply to Re: Antidepressants don't work except for when the » SLS, posted by Chairman_MAO on March 3, 2006, at 15:53:57

> I also need d-amphetamine to focus enough to get anything done in the workforce--at least until I can find a job that I dont need to take it to do.

Have you thought about adding desipramine instead? It might help increase activity in the left DLPFC like Strattera. It has been one of the tools used to treat ADD in the past. The only two side effects that were troublesome for me when using this combination were postural hypotension and delayed micturition. Of course there are remedies for these things, fludrocortisone and bethanechol respectively, but these effects can resolve with time on their own. My advice is to titrate the desipramine very slowly so as not to trigger these side effects so severely in the first place. Also, if the antidepressant effect of Nardil is somehow incomplete, an effective augmentor might improve libido.

I avoided mentioning nortriptyline because I think it might be too serotonergic. Atomoxetine might resolve your condition, but I know of no examples of people combining it with an MAOI to want to go so far as to recommend it.

Regarding the UMDNJ psychiatric department, I have worked with only one of their doctors. I found him competent, but didn't spend enough time with him to be able to get a good "feel" for him. He wrote up an interesting report on the use of Keppra (levetiracetam) for treating rapid-cycling bipolar disorder and some stuff on epilepsy. I wish I could have gone back to him with another Keppra success story. It does help a bit, but not enough to consider my reaction to it as being an antidepressant response.


- Scott

 

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