Psycho-Babble Medication | about biological treatments | Framed
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Posted by SLS on December 4, 2022, at 18:58:20

In reply to Re: MAOI vs SSRI, posted by ed_uk on December 4, 2022, at 13:38:33

> Difficult to say. Escitalopram is usually well tolerated, so I'd expect a lot more drop outs in the Parnate group. This could make it difficult to interpret the results. I'm not sure first time patients would be willing to tolerate many side effects.

I tolerated 150 mg/day just fine. Sure, I had hypotension as a startup side effect, but it disappeared after a couple of weeks. I understand that some people react to Parnate with hypertensive episodes. No drug is right for everybody.

Along with the 150 mg/day of Parnate, I took desipramine 300 mg/day, methylphenidate, supratherapeutic dosages of T4 and Parlodel at some point. I switched from methylphenidate to amphetamine for a trial of about3 weeks. This regime didn't bring me a hell of a lot of improvement, but it was worth a try.

Line up 100 people with atypical depression:

How many will respond to escitalopram?

How many will respond to a MAOI?

Of those people who have taken 3 SRIs and failed to respond, how many would you expect to respond to escitalopram?

Of those people who have taken 3 SRIs and failed to respond, how many would you expect to respond to a MAOI?

Of those drugs you recommended to Linkadge that he takes and plans to continue with, which are the ones capable of bringing him to remission? Take into consideration that Linkadge is not naive to treatment with a huge array of antidepressants and adjuncts.

Time for a change, perhaps?

Taking Effexor for a few days every now and then as a strategy to begin a new career path? A few beads worth?

I can appreciate decades of failed treatment attempts and the torturous nature of the illness, but while working with palliative measures to make life as endurable as possible, why now look for a true remission at the same time.

Palliative measures as my ultimate goal? No chance.

Did I get lucky. Damn right. But I got lucky with:


Ed, which of these four drugs were chosen for their palliative short-term benefits?

Let's get real.

I know my tone is currently challenging and even belligerent, but I am biased by my 40 years of history being treated by and learning from the biggest names in the fledgling practice of psychopharmacology. My remission is the product of being exposed to the developing insights of very innovative minds who had no treatment guidelines to follow. As a cohort, these first psychopharmacologists developed a mentality impelled by a sense of urgency and a dearth of information and understanding. My point is this: In the absence of established information, it takes a great deal of empirical observation and intuition to produce therapeutic success. I learned from this first wave of psychopharmacologists their style of critical thinking fashioned to work as much intuitively as factually. My impression is that these doctors were able to treat mood illness with a rate of success that doesn't seem to me to be much lower than what I see today. It's a matter of approach.

Something is missing today.

- Scott

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

The only thing necessary for the triumph of evil is that good men do nothing.




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