Posted by Janet P on July 13, 2009, at 15:45:17
In reply to Re: Parnate vs. ENSAM vs. Lamictal » Karen44, posted by Donna Louise on July 4, 2006, at 5:59:17
Hi Karen,
I too have Major Recurent Depressive Disorder and I'm med resistant as you seem to be. I also have an anxiety disorder and sleep apnea. I have tried literally every anti-depressant, mood stabilizer, and meds for diagnosis other than depression to see if they'd help. At one time I was, on a doctor's prescription, taking 12 different medications and or supplements at one time. While I do NOT subscribe to "stacking" that many medications, taking 2-3 medications might be the answer for which you are looking. I too am taking Parnate. It was a sort-of last resort since I'd tried everything else but it is covering 80-90% of my depression. My doctor is now suggesting that I take Lamictal on top of the Parnate to handle the balance of my imbalance. I am very seriously considering it. If it affects my cognitive ability, I will stop it as quickly as medically able. I also take a minimum of 500mg of Omega 3 daily, a multiple B vitamin and Juice Plus. Omega 3 has been proven to help with depression and it has other excellent health benefits. The B is for the anxiety that seems to come with most depression. Juice Plus just powdered fruit and vegetables and it has helped immeasurably. I believe it gives my body the nutrition it needs to help me stay much more level and much healthier. Without it I think I would already be taking Lamictal and probably would have been back in the hospital. A place I prefer to avoid if possible.
Since you've been diagnosed with Major Depression, it might not be a good idea to stop all medications. Without them it is very easy to get so depressed so quickly you won't be able to make a decision to go back on meds and the alternative it not good.
Is it possible to transfer to a doctor closer to you? My previous psychiatrist talked about moving his office and it took him over a year to actually get it done. It isn't easy for a doctor to just pick up and move. Try asking him if you can see him once every 2 or 3 weeks with a phone consult in the middle if you feel you really need to speak with him. I've never had to see my psych that often but every person is different.Please know that I did not begin taking any medications for depression until I was 28 yrs old. I am now almost 50 so I know what you are going thru. Keep in mind too, that physical problems, and I've had my share, can make you very depressed. If you are currently "becoming very emotional and crying at the drop of a pin", you need to stay on meds. When I find myself unable to make a decision, I let my doctor make them for me. I wouldn't be seeing him if I didn't trust him to make proper choices on my behalf.
I hope this post finds you well in all aspects of your life.
Take good care
Janet P
> > > > Thanks for the responses. I have been diagnosed with Major Depressive Disorder, Recurrent, Severe. I think Parnate helped me get past severe depression and then has not helped further. I believe the original thought was to add Lamictal to the Parnate. But apparently my psychiatrist thinks that Lamictal alone might also work for me. I have had terrible adverse and/or allergic reactions to all antidepressants I have tried other than Parnate. I have heard positive and negative things about Ensam, and I am not sure I want to take two things at once. I would really like to try no medications, but I am becoming very emotional, crying at the drop of a pin. I am really tired of it all and certainly can't risk cognitive problems as have been reported by some with Lamictal.
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> > > > Karen
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> > > I have the same diagnosis, along with GAD (generalized anxiety disorder) as you do, it is doubtful with that dx lamictal alone would do the whole job. I need several meds to be anywhere near effective, otherwise I only have one nostril above water. But you never know without trying, it just may work for you. I have not had cognitive difficulties with lamictal, but I have never taken more than 200mg, more than that is not helpful (according to the literature) for what we have anyway. And it seems doses higher than 200mg is when the cognitive troubles start. So that may never be an issue for you. And as for EMSAM, same thing. Could be the best thing that ever happened for you and if not, you just quit it. You never know until you try. What is for sure, if your life is becoming unmanagable as I don't see how it wouldn't be with the dx we have, no meds is probably not an option. Believe me, I have tried to go that route many times and have just been crushingly disappointed. But you may have to try that too, like I did, just so you know what exactly your options are. Just don't let it go so far that you can't think straight enough to get yourself some help.
> > > I wish you the best of luck with this rocky road we are all on.
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> > > donna
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> > Donna
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> > I am hoping I will be okay without any antidepressant medication. I went for 10 years without any antidepressant medication and was Okay,not great, but okay until I started developing all sorts of physical problems including COPD, need for cervical spine surgery (I was in excrutiating pain from what was going on with me then). I had five hosptializations in 2005 including three surgeries and one for what I thought was a heart attack (the first one). Turned out to be pulmonary problems plus GERD. Learned last year as well that I have sleep apnea, etc. etc. etc. So, I got on medication for depression. The original recommendation was ECT, and I refused due to my work. Can't afford to lose memory. Now that the physical problems are better with a slight relapse coughing up blood daily (no it's not cancer), I am doing better physically and wonder if I might be able to manage without antidepressant medication. My psychiatrist said last Friday that I looked tense. Didn't think I was feeling tense, but I have been moving my office from one building to another to see if I can escape the bleeding from lungs. It's not there when I go on vacation or when I have a long weekend. Anyway, I want to know what I might consider, if anything regarding medication, and Ensam and Lamictal have been mentioned by my psychiatrist. I see him again this Friday and am really tired of this weekly trek of two hours there and two hours back for a 45 minute appointment. Getting sick and tired of it all. Then I hear how some folks can't even get in to see a psychiatrist, and I think what am I complaining about. I have been doing this weekly thing (meds and therapy) for over a year now and hate it. I think I want to tell him I don't want to come weekly anymore--maybe bi-weekly. He said he is looking to open an office closer to where I live, one hour away, but I don't believe him because he has been saying this since last fall, and it hasn't happened. I just don't know what to do anymore.
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> > Karen
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> Wow karen, you have been through the mill. Whatever that means...all ground up, I guess. What a tough and scary year. Depression would just naturally go along with all that. Maybe as you recover physically you will feel better mentally too. I sure hope so. One thing to consider with all that has been going on is if anything you are taking for your other conditions would be contraindicated with and MAOI. Probably not unless you have to take some kind of pseudoephedrine for your lungs. And your choice of pain killer not be darvocet or demerol.
> One choice you could make for now is to not make a choice and see how you feel as you get better. You can always start something later and if you don't like whatever you start, you can stop it. I hate the pressure of feeling like I have to make a decision, it is enough to make me anxious and depressed.
> I wonder if with that long drive your pdoc would consider a phone consult instead of some of those trips.
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> donna
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poster:Janet P
thread:661936
URL: http://www.dr-bob.org/babble/20090709/msgs/906562.html