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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by dondon on September 26, 2006, at 20:19:10
I don't respond to ssris anymore. SHould I try an maoi now or a tca? Is there anyone here who don't respond to ssris but find relief from maois ?
Posted by gardenergirl on September 26, 2006, at 21:56:25
In reply to maoi's next choice?, posted by dondon on September 26, 2006, at 20:19:10
I never had any significant response from SSRI's. Nardil is the only AD that I've taken which has given me relief from my atypical depression.
gg
Posted by notfred on September 26, 2006, at 22:22:14
In reply to maoi's next choice?, posted by dondon on September 26, 2006, at 20:19:10
> I don't respond to ssris anymore. SHould I try an maoi now or a tca? Is there anyone here who don't respond to ssris but find relief from maois ?
SSRI's (none of them) work for me. MAOI and TCA's have worked in the past.
Posted by NYCguy on September 27, 2006, at 2:22:34
In reply to Re: maoi's next choice? » dondon, posted by gardenergirl on September 26, 2006, at 21:56:25
> I never had any significant response from SSRI's. Nardil is the only AD that I've taken which has given me relief from my atypical depression.
>
> ggHi GG! I'm keen on starting Nardil soon as none of the SSRIs have worked very well for my atypical depression/SP. The weight gain stuff scares me... does everyone gain a lot on the stuff? Is there anything one can do to keep fit when on Nardil?
Warm regards,
NYCGuy
Posted by Jost on September 27, 2006, at 15:22:04
In reply to Re: maoi's next choice? » gardenergirl, posted by NYCguy on September 27, 2006, at 2:22:34
I've also had very bad SEs from all the SSRIs I've tried. Parnate helped and Emsam helped a lot.
So I'd count myself as someone who can't use SSRIs for whom Maois worked.
Jost
Posted by jedi on September 28, 2006, at 0:40:03
In reply to maoi's next choice?, posted by dondon on September 26, 2006, at 20:19:10
> I don't respond to ssris anymore. SHould I try an maoi now or a tca? Is there anyone here who don't respond to ssris but find relief from maois ?
Hi,
If your depression is diagnosed as atypical (overeat, oversleep, leaden paralysis, sensitivity to rejection) chances are good that a MAOI will be the best treatment. The problem is that many PDOCs will not prescribe a MAOI until most all other options are exhausted. Nardil augmented with clonazepam is the only combination that has worked on my atypical depression and social anxiety. I've been on 35+ different combinations of meds. For some people, Parnate or EMSAM work; these are less likely to cause weight gain. For me, the only thing that keeps me from gaining weight on Nardil is a couple of hours of exercise daily. Complete elimination of carbohydrates will stop the weight gain short term, but when you stop this kind of diet the weight comes right back. Another benefit of Nardil is it treats my borderline high blood pressure. While taking Nardil, I don't have to take any other blood pressure medication. Of course, you must follow a low tyramine diet and be very careful about any other medications you take.
Good Luck,
Jedi
Posted by gardenergirl on September 28, 2006, at 12:42:26
In reply to Re: maoi's next choice? » gardenergirl, posted by NYCguy on September 27, 2006, at 2:22:34
Hi,
I can't say if everyone has gained weight on MAOI's, but it is a common effect. I've gained a lot, but it's starting to come off now, slowly.I just read an abstract about reducing the chances of weight gain with atypical antipsychotics, but I can't seem to put my fingers on it at the moment. The main point was patient education to prepare them for this, which included proper nutrition, exercise, etc.
What helps me is 600 mcg of chromium picolinate and 200 mg of Provigil. I tried Topomax, which can also help with weight gain, but it made me more depressed.
What I notice with Nardil is a strong increase in carb cravings and a decreased inhibition with regard to bingeing. It's as if whatever part of my brain would trigger me to stop eating when I've had too much just doesnt' work anymore. I can almost "feel" the "void" of this. It's an odd thing.
So I suppose having good habits and a plan for this before going on them could help.
Good luck whatever you decide.
gg
Posted by Andrew78 on September 28, 2006, at 16:10:20
In reply to Re: maoi's next choice? » NYCguy, posted by gardenergirl on September 28, 2006, at 12:42:26
Could Nardil be helpful in depression with anxiety and panic?
I've read that nardil can cause insomnia.Anyone experienced it on Nardil?
Posted by jedi on September 28, 2006, at 21:25:59
In reply to Re: maoi's next choice?, posted by Andrew78 on September 28, 2006, at 16:10:20
> Could Nardil be helpful in depression with anxiety and panic?
> I've read that nardil can cause insomnia.Anyone experienced it on Nardil?IMHO Nardil is one of the best meds for anxiety and panic. I have had quite a bit of insomnia on Nardil plus daytime somnolence. I wish I could figure a way to talk my MD and my insurance company into letting me try Provigil. I'm pretty certain this would help my sleep cycle and give me more energy during the day. It seems to have helped GG.
Take care,
Jedi
Posted by Oppycat on September 30, 2006, at 7:45:42
In reply to maoi's next choice?, posted by dondon on September 26, 2006, at 20:19:10
> I don't respond to ssris anymore. SHould I try an maoi now or a tca? Is there anyone here who don't respond to ssris but find relief from maois ?
MAOI's are the only ADs I've been able to tolerate consistently. I've been on Parnate for most of the past 18 years. There is a quick onset of activity for most people and it didn't cause any weight gain for me, which is not to say that I didn't gain weight during this time period.My experience with Nardil wasn't as positive, but I did take it for about a year. That was in the early 1990s and, in retrospect, I don't believe my dose was high enough. I think I was taking 60mg daily. Of course, doctors may have been more cautious then. In any event, it seemed to take forever to work and I did gain weight on it. However, I quit smoking during that time (one of the many times), which I'm sure played a large part. I also had more sexual dysfunction than I had on Parnate. I did try Nardil again recently after reading so many positive things about it on this board over the past several years. However, after a week, I abandoned the trial because I couldn't wait it for it to start working. Of course, I went through a 10 day wash out before I started taking it. In retrospect, I wish I had stuck with it since I had to wait another week to restart the Parnate and took very small doses for the first several days.
The first time I took Nardil, I didn't start feeling any better after the first week or two like most other medicines. It took about a month to work. I was almost suicidal by then, but I woke up one day and, all of a sudden, felt much better. I did sleep very well on it, though, compared to Parnate, where I always needed some sleep aid.
The psychopharmacologist who prescribed Parnate first back in 1988 told me at that time if I didn't feel any benefit from it after 2 or 3 days, it probably wouldn't work at all for me. I've read a lot of postings counter to that on this board, but I remember feeling an improvement the first day.
TCAs and Remeron also have fairly quick onsets of activity, but the weight gain and other side effects are pretty difficult to tolerate.
Good luck, but I recommend trying the MAOIs before the TCAs. Some people take both medications so if they don't work, the transition to a TCA should be easy. Sorry about the wordy reply, but I hope it helps.
Michael
Posted by NYCguy on October 2, 2006, at 3:35:11
In reply to Re: maoi's next choice? » NYCguy, posted by Jost on September 27, 2006, at 15:22:04
> I've also had very bad SEs from all the SSRIs I've tried. Parnate helped and Emsam helped a lot.
>
> So I'd count myself as someone who can't use SSRIs for whom Maois worked.
>
> Jost
Jost, are you currently taking Parnate or Emsam? In your experience, does Parnate make one more or less "focused"? Which of the two did you find most useful and how long did it take for the effect to kick in? I only tried Emsam at 6mg for two weeks... perhaps not a high enough dosage or time given for the med to take effect...NYCguy
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