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Re: Going Off Parnate, next drug - your insight? » sophia04

Posted by Jedi on June 19, 2007, at 21:50:45

In reply to Re: Going Off Parnate, next drug - your insight?, posted by sophia04 on June 17, 2007, at 20:59:39

Hi Sophia,
Is your depression atypical? If so a combination of the nortriptyline, which worked for a while for you, and phenelzine(Nardil) might be a working combination. They are officially contraindicated but sometimes used in TRD. I know you had a lot of problems with Parnate, but Nardil is a completely different medication and works very well with atypical depression and social anxiety. It is not without side effects but I haven't found an AD that is. Just a thought.
Take care,
Jedi

References:
A 3-year follow-up of a group of treatment-resistant depressed patients with a MAOI/tricyclic combination.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=7560546&ordinalpos=38&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Treatment response of depressed outpatients unresponsive to both a tricyclic and a monoamine oxidase inhibitor antidepressant.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8071301&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Combined MAO-inhibitor and tri- (tetra) cyclic antidepressant treatment in therapy resistant depression.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=3406429&ordinalpos=16&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


> Thank you all for your feedback. The SSRIs were prescribed first and not under a psychiatrists supervision, but I do believe I stayed on them long enough to decipher their (lack of) effectiveness. However, it's hard to say - imipramine was the first drug to really *blow* a 5-year treatment-resistent depression away, but this was at a dose of 275mg (which I understand is relatively high). When Nortriptyline (175 mg) started to loose its effectiveness (after about 1 year) i briefly went back to imipramine, but found that I did not respond to it in the same way, and so went back to Nortriptyline. After a short stint back on Nor.. I decided to give Parnate a try, and have found it the most difficult drug to tolerate thus far. I will discuss other TCA options with my doc tomorrow. Thanks so much! You are all so helpful.
>
> Sophia
>


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poster:Jedi thread:763671
URL: http://www.dr-bob.org/babble/20070613/msgs/764299.html