Posted by bleauberry on October 24, 2009, at 17:59:12
In reply to Those who quit Parnate...what r u on now?, posted by delna on October 23, 2009, at 14:38:59
Well, I am going here completely on the experience of Dr Goldman. This is what he has seen in his practice:
When Parnate fails:
Nardil
Nortriptyline + Zoloft
Reboxetine + Zoloft
Amitriptyline
Clomipramine
Imipramine
Sometimes the addition of an antipsychoticMy own experience and gut says to take a look at where you've been in meds...and do something different than what has already been done.
For example, if someone has anxiety that has not done well with any anti-anxiety meds, then they should try a stimulant. Really! Just like the thread on this page about the person who did their first dose of Ritalin and saw their anxiety and depression vanish instantly. How can a stimulant improve anxiety? Who cares? Everything we do is experimental. My belief is that we should not limit our experiments to only things that look obvious. We have to give the unobvious lesser suspects a fair look also, or we might be missing out on something great. We would never know otherwise. Brain chemistry and biochemistry are too complex and mysterious for us to even begin to figure what will do what.
Low dose lithium? Zyprexa add-on? Abilify add-on?
Any of the above Dr Goldman recipes? Ritalin mono or combo?Ever tried an antimicrobial herb to see if you get a Herx reaction? I mean, if you have something...unsuspected bacteria, fungi, virus...and you don't know it, the toxins they produce are NOT going to be reversed by any psychiatric drug. Those toxins cause really stubborn depression that has nothing to do with anything the psychiatric meds do. I think this has to be ruled out by trial, not assumed. Easy and cheap to do.
What about natural stuff? Ever had a really good brand of Rhodiola Rosea? Rhodiola combined with your best SSRI or SNRI?
And of course we kind of have to give some weight to what has worked for people right here at pbabble when Parnate failed. Which happened to include all of the above; as well as a Effexor+Zyprexa combo. But still, when someone gets this far into the game and an MAOI doesn't do the job, I cannot help but think it is time to start broadening the horizons for what the real cause is...if it was simply a neurotransmitter deficit, that would have already been fixed by now. It is something else, which brings me back to the antimicrobials.
No matter what, there is no shortage of great ideas when Parnate fails. And you would not be the first one to fail Parnate and do great with a different approach.
poster:bleauberry
thread:922132
URL: http://www.dr-bob.org/babble/20091021/msgs/922280.html