Posted by diego on January 25, 2014, at 0:26:59
In reply to Re: Anecdotally The Best Drugs IMO add-on » diego, posted by SLS on January 11, 2014, at 7:35:32
Scott,
We need to define our terms.
To me, "melancholic depression" is an old-fashioned term for depression characterized by physical symptoms: sleep disorder, weight loss and anorexia, and profound "psychomotor retardation"; as well as all the usual crap.
For ME, suffering from what *I* call "melancholic depression" MAOIs are wonder drugs. I was on Nardil for a number of years after running the gamut of TCAs, then switched to Parnate to fend off sexual SE.
I found Parnate more effective and w/ less SE than Nardil for *MY* "melancholic depression" and took it for a number of years, too.
Tried a washout and Zoloft, an SSRI, when they became all the rage after the introduction of Prozac, and became so depersonalized after a day or two I said, "Fusk this carp!" and went back to Parnate.
Marplan wasn't on the market then and I've never tried it.
So if I were shrink and met a patient with predominantly physical symptoms of major depression, I'd prescribe Parnate in an instant and bypass the TCAs, SSRIs and fancy new sh*t like venlafaxine.
IMX, the tyramine interaction of both Nardil & Parnate are over-rated at normal doses. In probably 15 years of using both I had exactly *one* "hypertensive reaction" and that was from eating too much salami (like 1/3 lb), and even it wasn't severe; just a headache and tachycardia and anxiety. Took a couple shots of vodka, a hot bath and laid down. It passed.
Which isn't to say I'm going to wolf down a a bunch of chopped liver or fava beans and a nice Chianti anytime soon, but just that one can be too cautious.
poster:diego
thread:1058183
URL: http://www.dr-bob.org/babble/20140123/msgs/1059468.html