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Re: Dear SLS re Effexor » Roslynn

Posted by SLS on July 22, 2013, at 21:48:32

In reply to Re: Dear SLS re Effexor » SLS, posted by Roslynn on July 22, 2013, at 19:39:48

I can appreciate your doctor's lack of surety in choosing a treatment for you.

> > What were the problems with Nardil and Parnate?

> Nardil, basically bed-ridden with dizziness at smallest dose..Parnate, painful heart palpitations that were not going away and woke me up at night.

Marplan might be worth considering (MAOI). It should be less apt to produce the side effects you experienced with Nardil and Parnate.

I am not a big believer in the efficacy of moclobemide, but I should at least mention it. Moclobemide is a special MAOI that has almost no side effects. It is not available in the US. I imported it from Canada. I did not react well to it.

Keep the lithium. You might want to lower the dosage if you never had a manic episode. (300 - 600 mg/day). This will help prevent kidney and thyroid toxicity.

What happens when you bring the dosage of Seroquel up to 400 mg/day? Have you thought to try Saphris (asenapine) along with the Seroquel? I've seen this combination act to treat bipolar depression with anxiety and panic attacks.

Because of my success with prazosin, I sometimes mention it to people who have some history of trauma or PTSD. The severe depression itself can be traumatic. Prazosin helps me quite a bit. For me, it feels like a clean antidepressant.

If you are totally lost, you might try starting with clomipramine and lithium, and use that combination as a core around which to build a treatment regime. I have been taking 7 drugs. I started with TCA + MAOI and through some experimentation, added drugs to it until I reached an effective regime.

Remeron sometimes works as an adjunct to Effexor and TCA.

Don't forget about TMS. I am waiting for "deep TMS" (Brainsway) to become available. My therapeutic response has plateaued, and I am experiencing diminishing returns. I am hoping that TMS sparks a more robust improvement.

There are still alternatives.


- 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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