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Re: Best starting med for atypical depression?

Posted by bmwfan07 on December 9, 2010, at 23:32:21

In reply to Re: Best starting med for atypical depression?, posted by Tomatheus on December 9, 2010, at 21:06:16

> bmwfan07,
>
> Hello, and welcome to Psycho-Babble. I'm afraid that I don't have a whole lot of advice to give you other than to tell you to probably expect an SSRI, an SNRI, or possibly something like Wellbutrin as the first medication you'll be prescribed for your atypical depression. There is some evidence to indicate that MAOIs may be more effective than the TCAs when it comes to treating atypical depression, but for a doctor to prescribe an MAOI as first-line treatment for any type of depression these days is pretty unheard of, for better or for worse. I would express the concerns that you listed here about taking an SSRI to your prescribing doctor and then work with him or her from there to figure out which antidepressant you should try first.
>
> I'm sorry if I couldn't be of more help, but I figured that I'd reply to your post.
>
> Tomatheus

I appreciate the reply. I suppose it is a little unrealistic to expect a p-doc to start out with what is decidedly a third-plus line AD these days, but I'm convinced it will be the best mainstream drug to start with for both social phobia and atypical depression.

I've yet to hear of anyone who has had long-term efficacy (12+ months) on an SSRI or SNRI for both social phobia and atypical depression, let alone either one! Atypical depression seems to be a whole different animal than melancholic depression and appears to be more related to bipolar disorder--as does social phobia (both appear to involve dopamine dysregulation in some way).

I bought some DLPA tonight on impulse, because I know people combine it with deprenyl sometimes for atypical depression. I figured I'd try it alone to see if it did anything, but I didn't notice anything (in fact, I felt worse, but that could be purely coincidental). Has anyone here had success combining deprenyl and DLPA? I know that too would likely only be possible from a practical standpoint well into the future, as deprenyl is a MAOI as well.

Just wondering what other combinations and cocktails, creative or otherwise, people have devised to treat this awful condition.


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