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Re: Depression, depression, depression » Chris O

Posted by SLS on September 17, 2012, at 15:40:12

In reply to Re: Depression, depression, depression » SLS, posted by Chris O on September 17, 2012, at 14:47:56

> Scott:
>
> Thanks for the suggestion. I've read your posts many times and appreciate your excellent suggestions, even as a bystander. I think I mentioned prazosin once to my psychiatrist based on what you had written months ago. I believe he was open to it. I'm going to start Nardil in the next few days. I'll see how that goes and then figure out what's next from there. Thanks.


If Nardil is even partially effective, it might be a reasonable strategy to build a treatment regime around it rather than immediately abandoning it. I would be more optimistic for your chances of responding to prazosin were you to add it to Nardil rather than switching from one drug to the other. Prazosin was first used as a single dose at bedtime to prevent nightmares and disrupted sleep. However, it was learned that it will also help with daytime anxiety and depression if it is taken three times a day. I would consider starting at 1 mg to be given at bedtime for a few days. This will help reduce dizziness and the risk of developing syncope. Thereafter, you can take 3 mg/day taken as 1 mg t.i.d. Startup side effects include dizziness, fatigue, weakness, and even mild depression. However, these things usually disappear within a week. When combining prazosin with Nardil, dizziness might be particularly problematic. It might limit your rate of titration, but not necessarily your final dosage. For me, prazosin was most effective at 10 mg/day. Currently, dosages of 6 - 20 mg/day are being investigated. It is conceivable that you will experience an improvement at 3 mg/day. However, if such an improvement dissipates, I would continue raising the dosage gradually rather than discontinue it.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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