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Re: Anyone prefer TCA to MAOI? SLS

Posted by tom2228 on March 18, 2014, at 10:15:42

In reply to Re: Anyone prefer TCA to MAOI? tom2228, posted by SLS on March 18, 2014, at 1:38:47

> TCA is thought to be better suited to treat melancholic type (endogenous) depression. However, MAOI can work here as well.
> What are your primary symptoms?
> What are you using as evidence that you need pro-noradrenergic drugs?
> - Scott

Thanks for your response, Scott.

I was thinking a TCA bc it's the only thing I haven't tried and the TCA + MAOI combo seems to a good option as this point -- running low on options it seems.

I seem to have both melancholic depression and atypical features if that's possible. I was atypical for most my life but have had periods, including now, where I'm down most of the time, even during the good moments. I'm sure the partial response to my meds covers some symptoms but leaves a mix of others.

Lack of interest in activities and people. Abilify has made this worse but it was present beforehand. Also lack of mental energy to carry out what I still am interested in. Like the Pristiq commercial I am constantly having to wind myself up and don't always want to.

Desoxyn gives me great quality of attention but my concentration is poor because I simply black the interest necessary to follow through. I find Desoxyn's effects are less automatic and pressure-driven like other stimulants and more mediated by my intrinsic motivation and the effort I put forth and to allow the med to work. That being said my depressed mood and lack of mental energy really gets in the way of my functioning and what this med can so for me.

At this point one might wonder why I don't just go for Strattera as an adjunct but it's more than just ADHD, these symptoms are spread across my general mood.

I have plenty of the DA pleasure/ hedonia from Marplan/ Mirapex/ Desoxyn/ possibly Abilify but lack the aspect of pleasure that I would call enjoyment. It's a mindless and empty pleasure. I lack excitement and contentment with what I'm doing. I want to enjoy things, hear the birds sings, read not because I need to amass info to be a pdoc one day but bc I enjoy it.

I have a lot of anxiety/ GAD. It is mostly cognitive anxiety about all of my issues and how I am not meeting my potential because I can't get necessary tasks done at a rate necessary to meet my academic potential and be ready for full-time school. i have trouble relaxing I bc I dont have the interest and mental energy to be able to chill, enjoy a book or TV or online game. I took Ativan for a year and a half but a benzo isn't what I'm looking for, that would make me fade into complacency. I want to light a fire under my recovery *ss.

I am generally not sad but suffer a lot and am always conscious/ anxious about how my mood affects my life -- runs my life.

My idea about the NE comes from the fact that Marplan can lower NE due to inhibition of dopamine beta-hydroxylase, and I believe I read, probably here, that chronic use of MAOIs lowers NE -- it feels that way. Depression is hard to describe.

And recently Saphris, which I know has a lot of different actions but increases NE through alpha-2 antagonism. I felt that I had what has been missing since I was younger and perhaps since I started MAOIs and maybe lithium (same time). Had more interest, excitement, contentment. It was just too sedating (not somnolence though), BID was not feasible because of this and it wore off, interacted with Desoxyn (CYP2D6), and was too antipsychotic to raise the dose after the initial improvement faded./

I feel depressed for seemingly no reason most of the time. I wonder if I am on too much meds/ too much Marplan even though I still have a lot of my original symptoms. I have made a lot of positive changes in my life.




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