Posted by Jedi on November 25, 2007, at 2:44:41
In reply to Re: Some would rank Nardil No. 1 for SAD » medweirdo, posted by Nardilstarted2007 on November 24, 2007, at 21:15:59
Hi,
I've been taking Nardil at 90mg for most of eleven years. I have come off four times to try newer combinations of meds. Mainly this is because of the weight gain, delayed orgasm, insomnia, and daytime sleepiness. I have tried more than forty different combinations of antidepressants and augmentors. Nothing works like Nardil for my symptoms. Each time I've been off Nardil my major depression has returned.I currently use 90mg of Nardil, 2mg of clonazepam and 25mg of Seroquel. My diagnosis is treatment resistant atypical depression with social anxiety disorder and dysthymia(double depression). IMHO I believe that Nardil is the best med for atypical depression and the combination of Nardil and clonazepam is the best for Social Anxiety Disorder. I believe that Nardil should be a 2nd tier trial if the SSRIs fail for atypical depression. Many psychiatrists use it as a last resort, even after ECT. Some won't use it at all. The med really isn't as dangerous as some of the old research implies. When was the last time you heard of someone dying from a MAOI.
I use the very low dose of Seroquel for the Nardil induced insomnia. So far it has worked better than any other med for this.
Take care,
JediReference:
Ann Pharmacother. 2006 Mar;40(3):567-70. Epub 2006 Feb 14. Quetiapine for insomnia associated with refractory depression exacerbated by phenelzine. Sokolski KN, Brown BJ.
Mood Disorders Clinic, Veterans Affairs Long Beach Healthcare System, Long Beach, CA 90822, USA. kenneth.sokolski@med.va.govOBJECTIVE: To report the successful treatment of phenelzine-associated insomnia with low-dose quetiapine in a patient with refractory depression. CASE SUMMARY: A 42-year-old white man with severe major depression unresponsive to selective serotonin-reuptake inhibitors, bupropion, and tricyclic antidepressants improved following treatment with the monoamine oxidase inhibitor (MAOI) phenelzine. Insomnia, present to a moderate degree prior to antidepressant therapy, worsened markedly following phenelzine treatment and failed to respond to diphenhydramine, temazepam, triazolam, clonazepam, zolpidem, or trazodone given at high therapeutic doses. Sleep disturbance resolved with low-dose (50 mg) adjunctive quetiapine, with no adverse effects. DISCUSSION: Major depression refractory to standard therapy is a common and serious condition. Some cases respond to MAOIs; however, orthostatic hypotension and insomnia frequently occur. Potentially serious MAOI interactions with psychotropic drugs have raised concerns about combining these agents. In this case, a failure of a number of other medications known to treat MAOI-associated insomnia safely prompted a trial of quetiapine. Despite the possibility that enhanced serotonergic activity might have resulted in serotonin syndrome, no adverse interactions between phenelzine and quetiapine were noted. The use of low-dose, once-daily quetiapine, along with its unique binding properties, may account for its increased safety in combination with phenelzine. CONCLUSIONS: This case illustrates that low-dose quetiapine may be an alternative treatment for phenelzine-associated insomnia. Further case reports are needed to establish the safety and effectiveness of combining these agents.
PMID: 16478812 [PubMed - indexed for MEDLINE]
poster:Jedi
thread:795876
URL: http://www.dr-bob.org/babble/20071115/msgs/796921.html