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Re: med change » sadone

Posted by yznhymer on September 21, 2007, at 2:36:24

In reply to med change, posted by sadone on September 21, 2007, at 1:08:23

> I am curious to find out from others what their experiences were when they withdrew from an SSRI - in my case 350mg Effexor (not working after 3 years) to an MOAI Parnate? I dont mind skipping the foods on the do not eat list assoc. with these older anti-depressants - but I DO mind the possibility of weight gain issues. I have heard the carbo cravings are particulary bad with Parnate - which in turn would make my depression worse - as I also have many years of eating disorder issues. I am so unsure of what road to take...Do I stay with effexor and coast along in my isolated antisocial suicidal thinking world or try something that may make it worse - or better? any advice would be helpful !
> Sad-One

I'm sorry you're feeling so bad. I've been in the same place for lengthy periods of time (years!) myself but somehow held on to the belief - with no real evidence I may add, just on faith - that things would get better eventually. So I kept trying new strategies... a step forward, a step back, spinning in place. I learned to live with depression while working to beat it. I think what kept me going was developing an attitude toward my depression that separates it from myself. There is me, and there is my depression. Lots of people learn to adapt to a disability and I figured I would make adaptations to my life to make mine as bearable as possible. I may be on the verge of kicking its *ss.

I can't speak to Parnate but I gained 20 lbs the first month or so that I was on Nardil, another old MAOI. The antidepressant effect was outstanding, however, especially in terms of social issues and mood. Is there a particular reason you're leaning toward an MAOI at this point? Have you considered the EMSAM patch? Its also an MAOI. I've been on it for a while and have had no weight gain issues whatsoever... no sexual side effects either, which was an issue with Nardil and just about every other AD I've tried. There have been a few other side effects that have passed - none of which were deal breakers.

I'm getting a pretty good antidepressant effect from EMSAM. Not as robust as Nardil, but I'm still on the lowest dose. I should add that I am more talkative, outgoing, and gregarious on EMSAM. My energy and motivation seem to be fluctuating and are still problematic but the higher dose I am anticipating may help.

Anyway, enough about me. I would say, don't settle for your current state - there are many options to try. Shoot for complete remission but accept any partial improvements. Definitely be patient and gentle with yourself. If weight gain is an issue, you're correct to check out Parnate before jumping in. On the other hand, if you get a good antidepressant response and are prepared for possible weight gain, you might be able to mitigate the damage proactively by exercising religiously and shifting your diet away from refined carbs as much as possible. Forewarned is forearmed, as they say.

Also, and I know this is hard to implement when you're starting from a depressed state, but my experience has been that hitting depression from as many angles as possible can yield a much better response. Medication, diet, exercise, therapy, relaxation techniques, supplements, etc. etc. can incrementally improve your mood in combination where alone they don't do the trick. If you can't get going on any of this alone, perhaps the best first move is finding a good supportive cognitive behavioral therapist. They can help you to take the other steps that may appear too difficult to initiate yourself. If finding the right therapist is too big a task (it took me forever - I loathed the process), ask a friend or relative to help.

Best of luck to you.

Y


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