Posted by JadeKelly on December 18, 2008, at 18:04:23
In reply to Re: Treatment Resistant (Refractory) Depression, posted by CaptainAmerica1967 on December 17, 2008, at 21:11:43
Hi Jeff,
This is too long but IM DESPERATE!! I developed a tr/mdd about 3 years ago after a cluster of family tragedies struck in a very short time. It developed into apathy/numbness/not leaving my room/bed. I can't tolerate most a/d's, especially ssri's. I've been on Parnate for ten weeks and have been at 60mg for 3 days, wieght 125lbs. How high should I go? I got a week long reprieve/high following initial dose of 30mg, then 2-3 days of this when I increase dose. I honestly can't tell how well the A/d effect is because I am SO lethargic. It should be working by now, right? Whats the longest Parnate should take to work? I do think my mood is better. If I wasnt lethargic, I think the rest would fall into place. Was this your experience at all?
Our depresions sound similar, except I have never suffered from anxiety but am starting to as I lose hope with this catch 22 I seem to be in. I, too, get pretty intense high when I do a difficult workout. Don't know if thats everyone, or just some. Haven't done it for a while due to fatigue and fear of BP irregularities. I forgot to mention, BP always on the low side, but even when I can get it up to 120/80, I'm still lethargic. I need ritalin for a while as I'm very familiar with it and I can switch or add nortriptyline when fatigue/lethargy wears off.
Right now the only drug I take is 3mg klonopin, been taking it for years for a nerve injury in my neck. REALLY want to stop taking it and see if I still need it. Have no psychological dependence on it but don't want w/d's to interfere with Parnate benefit. Do you think I should taper off now? Or wait?
It makes sense to me, due to my ignorance in this subject, to copy your regimen (one that I was headed towards! I wanted ritalin or nortriptyline) and that advised to you by one of the leading tr/dep PDoc's, Dr. Gordon I think it is, in New york. I took Ritalin for 12 years for ADD, as diagnosed by only PDoc, and I responded to it beautifully. I don't have an addictive personality at all so I was able to go from original dose of 5mg 3x day to 5mg 5xday during those 12 years. (I often wonder if it wasn't working as a mild A/D also) Pdoc made me d/c with MAOI, will not talk about augment to get me up and moving. But no risk to bedridden 24/7??
My current problem, I have lost faith in my PDoc, he is not at all creative with despensing of meds, and I realize that he doesn't seem to care much that I've became deeply depressed, then onto apathetic and numb, in front of his very eyes. The only reason I'm on an MAOI is that I was following a poster (before I joined), RobertDavid, who was trying the patch. I took that and had the same immediate reaction (great). When I had to go up to 9mg patch it made sense to switch to Parnate.
So, I need Doc to prescribe first choice, low dose Ritalin (5mg 3-5x day), to get me up and moving, then maybe 2nd choice, nortriptyline or amitriptyline, and I noticed a 3rd you take Li??, would you recommend? It sounds like you are not in full remission, in what way: depression, fatigue, apathy, etc?
Finally, and most importantly, how does one go about getting much needed medication from a PDoc who is experienced enough to not be overly conservative, like the one you consulted with ? This is getting to be an emergency for me as I have to go back to work (not to mention the time of year) Do Docs scribe with phone consult? I've only had the one. ANY help appreciated.
poster:JadeKelly
thread:868231
URL: http://www.dr-bob.org/babble/20081214/msgs/869494.html