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Re: should Nardil / Parnate really be a last resort?? g_g_g_unit

Posted by SLS on November 19, 2008, at 9:11:33

In reply to should Nardil / Parnate really be a last resort??, posted by g_g_g_unit on November 19, 2008, at 4:37:53

> just curious cos my psych offered Nardil to me during my last appointment which really surprised me, as i've always been too hesitant to bring it up. i can be quite the completist and so some nagging part of me still feels i should try effexor and/or paxil beforehand, but i am really tired of SSRIs.

I think your answer lies in how determined you are to stay away from MAOIs. I am very happy to hear that your doctor is enlightened enough to choose to use them in certain cases. "Last resort". You might want to reserve that term for things like VNS or psychosurgery.

When I was first treated for depression in 1982, Parnate was the FIRST antidepressant that was chosen for me by the research team at Columbia-Presbyterian (now New York Presbyterian Hospital). This was the era before SSRIs. However, MAOIs were still considered a last resort of sorts by many in that it was routine to try a bunch of TCAs first. Because of their aggressive use of MAOIs, Columbia-Presbyterian gained notoriety for a high-rate of success. They even discovered the utility of using Nardil for social phobia. I ended up asking for a TCA first because I was concerned about the special MAOI diet. So Parnate was the second antidepressant tried on me. I ended up with brief, partial responses to each drug. However, when the two drugs were combined, I attained full remission. What happened subsequently is a long story and involves the doctor taking the two drugs away from me because I began to get manic. He should simply have added a mood stabilizer and allow me to continue the antidepressants. Hindsight is 20/20. I never responded to that same combination of drugs again.

- Scott




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