Posted by jedi on May 1, 2010, at 12:36:58
In reply to Re: MAOI replacement options/Jedi, posted by stargazer2 on May 1, 2010, at 10:36:09
Hi SG2,
Sounds like we are very similar. Yes, I have had memory and concentration issues which I blamed on the long term clonazepam use. I actually was on Nardil (90 mg) with bupropion(300 mg) for a long time. I actually prescribed it myself, after much study. Then I was able to get a PDOC to continue it, since it had done me no harm. Pharmacists went nuts. When the doctor who prescribed it retired, another PDOC immediately took me off the combo. I have never seen any data that they are harmful together. MDs like to read the PDR for medical information. It is, in fact, a legal handbook. I've never seen so much misinformation published in one source.I was really thinking a stimulant, because dopamine is the one neurotransmitter that has not been fully explored with me. The opiates sure have worked well short term, since my surgery. But then they have always been that way for me. I've cut back to 3 - 325 mg oxycodone per day, which really is not quite enough. I know that no one will prescribe it for my psychic pain, so why pursue that route. I really do believe that the opioid receptors in the brain are a clue for many of us who are treatment resistant. They were not put there just to make the drug dealers lots of money! LOL I know that many of the addicts, who get caught up on opioids, are self treating for depression. If handled by a knowledgeable MD, there could be a lot less suffering and a lot more WELL people out there. Here is an interesting little article which explains the difference between opiates and opioids (I digress): http://www.drugs-forum.com/opiates.html
I have the misfortune of living in a small community with a dismal ability to handle mental health issues. I went through the yellow pages and counted, I believe, 175 physicians in this little area. One psychiatrist is listed that a person can see if they are not on Medicaid or such. That one MD caters exclusively to the Hispanic community. I'm going to be driving 150 miles one way to find someone who knows more about medications for depression than I do. I don't think that is my inflated ego coming out. It is just a statement to the miserable ability of the medical community, in this area, to handle mental health issues.
I have never been able to talk my GP into trying even a micro dose of stimulant with Nardil. He won't even go modafinal. I can't blame him. I'm probably his only patient on MAOIs, I know I was his first. Before finding him and getting him to put me back on Nardil, so I could survive; I spent 9 months with a PDOC who absolutely refused to get me back on the one medication that had ever worked for me. He saw me as a risk, because I adjust my own medications. Well, the guy was an idiot, out to protect his own *ss and nothing else. I would have died before he would prescribe the Nardil, to save my life.
I've tried Parnate a couple of times. Unfortunately, the last time, I had a very rare, spontaneous, hypertensive episode. It may have been the answer, if not for the blood pressure issue.
I'm in the process of changing insurance. When that comes through, I will travel that 300 mile round trip to maybe find a replacement for Nardil. I think a stimulant may be the next try. I appreciate you responding. I have been through the lost post routine! Very frustrating. And I worked in computer programming for 15 years! How does a complete layperson even use one of these things?
I keep trying to get off Nardil because of the weight gain and sexual side effects. Insomnia is another big one for me, but that can be handled. My initial weight gain from the atypical depression and Nardil was over 100 pounds. I've taken off more than half of that, but have to get beyond this hip replacement to lose the rest of it. I know it would be so much easier without the carbohydrate cravings caused by Nardil. I can lose weight on Nardil, but it takes about two hours, five times per week, of intense exercise.
I know I can always go back to Nardil, unless they quit making it. It has wiped out the major depression every time in the past. It is hard, if in major depression, to make the calls necessary to get the medications that you need. If they made cancer or heart patients go through what they make us go through, there would be a lot more people dying.
Thanks again,
Jedi
> Hi,
>
> You and I are in the exact situation. I'm now off Nardil with the thought to resume a trial of meds to include a stimulant. Besides MAO's, the only other success of any type in the 20+ years of being on meds has been a combo of Wellbutrin, Celexa and Adderall (about 5-7 yrs ago).
>
> I don't think it was so much the Celexa and/or Wellbutrin but the addition of Adderall that made a difference.
>
> My new trial will begin this week and I have a feeling we will try Adderall again as it has worked in the past.
>
> My experimentation with Nardil and a tiny dose of generic Adderall was positive but my doc was never on board with the Nardil/Stim combo. Just to convince him to add wellbutrin (which I'm still on) to Nardil took an act of Congress and was based on research I had done.
>
> But in any event, that is my plan. I thought somewhere I had noted that you had memory and concentration issues but then today I don't see those under your profile. I actaully responded last night to you but unfortunately the post never went thru. This is my followup post as I wanted to answer you right away.
>
> Any ideas for your next meds? I would definately suggest a stim if you have never tried one,as it might be the key for you as well.
>
> I'll follow this post and we can work on our next steps with eachother's help/advice.
>
> Thanks.
>
> SG2
Jedi
Treatment resistant, atypical, double depression with social anxiety.
Nardil + clonazepam
poster:jedi
thread:945733
URL: http://www.dr-bob.org/babble/20100425/msgs/945874.html