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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by sadone on September 21, 2007, at 1:08:23
I am curious to find out from others what their experiences were when they withdrew from an SSRI - in my case 350mg Effexor (not working after 3 years) to an MOAI Parnate? I dont mind skipping the foods on the do not eat list assoc. with these older anti-depressants - but I DO mind the possibility of weight gain issues. I have heard the carbo cravings are particulary bad with Parnate - which in turn would make my depression worse - as I also have many years of eating disorder issues. I am so unsure of what road to take...Do I stay with effexor and coast along in my isolated antisocial suicidal thinking world or try something that may make it worse - or better? any advice would be helpful !
Sad-One
Posted by yznhymer on September 21, 2007, at 2:36:24
In reply to med change, posted by sadone on September 21, 2007, at 1:08:23
> I am curious to find out from others what their experiences were when they withdrew from an SSRI - in my case 350mg Effexor (not working after 3 years) to an MOAI Parnate? I dont mind skipping the foods on the do not eat list assoc. with these older anti-depressants - but I DO mind the possibility of weight gain issues. I have heard the carbo cravings are particulary bad with Parnate - which in turn would make my depression worse - as I also have many years of eating disorder issues. I am so unsure of what road to take...Do I stay with effexor and coast along in my isolated antisocial suicidal thinking world or try something that may make it worse - or better? any advice would be helpful !
> Sad-OneI'm sorry you're feeling so bad. I've been in the same place for lengthy periods of time (years!) myself but somehow held on to the belief - with no real evidence I may add, just on faith - that things would get better eventually. So I kept trying new strategies... a step forward, a step back, spinning in place. I learned to live with depression while working to beat it. I think what kept me going was developing an attitude toward my depression that separates it from myself. There is me, and there is my depression. Lots of people learn to adapt to a disability and I figured I would make adaptations to my life to make mine as bearable as possible. I may be on the verge of kicking its *ss.
I can't speak to Parnate but I gained 20 lbs the first month or so that I was on Nardil, another old MAOI. The antidepressant effect was outstanding, however, especially in terms of social issues and mood. Is there a particular reason you're leaning toward an MAOI at this point? Have you considered the EMSAM patch? Its also an MAOI. I've been on it for a while and have had no weight gain issues whatsoever... no sexual side effects either, which was an issue with Nardil and just about every other AD I've tried. There have been a few other side effects that have passed - none of which were deal breakers.
I'm getting a pretty good antidepressant effect from EMSAM. Not as robust as Nardil, but I'm still on the lowest dose. I should add that I am more talkative, outgoing, and gregarious on EMSAM. My energy and motivation seem to be fluctuating and are still problematic but the higher dose I am anticipating may help.
Anyway, enough about me. I would say, don't settle for your current state - there are many options to try. Shoot for complete remission but accept any partial improvements. Definitely be patient and gentle with yourself. If weight gain is an issue, you're correct to check out Parnate before jumping in. On the other hand, if you get a good antidepressant response and are prepared for possible weight gain, you might be able to mitigate the damage proactively by exercising religiously and shifting your diet away from refined carbs as much as possible. Forewarned is forearmed, as they say.
Also, and I know this is hard to implement when you're starting from a depressed state, but my experience has been that hitting depression from as many angles as possible can yield a much better response. Medication, diet, exercise, therapy, relaxation techniques, supplements, etc. etc. can incrementally improve your mood in combination where alone they don't do the trick. If you can't get going on any of this alone, perhaps the best first move is finding a good supportive cognitive behavioral therapist. They can help you to take the other steps that may appear too difficult to initiate yourself. If finding the right therapist is too big a task (it took me forever - I loathed the process), ask a friend or relative to help.
Best of luck to you.
Y
Posted by sadone on September 21, 2007, at 6:58:50
In reply to Re: med change » sadone, posted by yznhymer on September 21, 2007, at 2:36:24
Y - I appreciate the time and effort you put into responding to my first post on this site. Finally I feel like I am not alone in my isolated world of depression. My pdoc thought I should try Parnate as a last resort - as I have tried every SSRI on the market over the years, and have settled for my current sh*tty state that has now left me unable to work and unmotivated to keep going after so many years fighting with it.
I do exercise - for 2 reasons - weight control and endorphin release, finding it all too much though.
Thanks again
Sadone
Posted by Viking on September 21, 2007, at 10:42:35
In reply to med change, posted by sadone on September 21, 2007, at 1:08:23
> I am curious to find out from others what their experiences were when they withdrew from an SSRI - in my case 350mg Effexor (not working after 3 years) to an MOAI Parnate? I dont mind skipping the foods on the do not eat list assoc. with these older anti-depressants - but I DO mind the possibility of weight gain issues. I have heard the carbo cravings are particulary bad with Parnate - which in turn would make my depression worse - as I also have many years of eating disorder issues. I am so unsure of what road to take...Do I stay with effexor and coast along in my isolated antisocial suicidal thinking world or try something that may make it worse - or better? any advice would be helpful !
> Sad-One
I did take Effexor some years ago and i did not like it very much. It just kept me in a "grey" state, not really depressed but not really well either. I tried different augmentations but without any success. At last my pdoc asked me to stop "cold turkey" from 300 mgs/day! I dont recommend that anyone else do so, it was very unpleasant.After that I was given Marplan (an old MAOI), but that made me sick. I never took it long enough to see any effect on my depression. The pdoc concluded that there were no more options to be tried.
I then made the same decision as I sense you are about to make. I completely ditched all meds and decided to live the best I could without meds. I deeply regret this decision. After 1-2 years the suicidal thoughts became unbeareable and I had no other option than to start taking meds again. I did a lot of trials of different meds (without any docs assistance) and came up with a few good options.
I was very impressed with Reboxetine (Edronax). It brought me from the worst mood I have ever been in to euphoria in 8 days! And I did not even take a full dose. Unfortunately it had some very peculiar sideeffects which became untolerable after some months.
Amisulpride (Solian) worked well for some time but pooped out. It did not so much lift my mood, but it sure gave me a lot of initiative.
Abilify is definitely the best I have ever tried. The effect is somewhat similar to Amisulpride, but stronger and more lasting. And it made me far more social, than I have ever been.
My present meds are:
2.5 mg Abílify
20 mg Prozac
30 mg RemeronI know from personal experience that Remeron causes weight gain, but I have not gained weight on this combo. My life still leaves a lot to be desired, but I am optimistic at the moment.
My advice to you is not to give up and accept the present situation. Antisocial and suicidal thoughts should be and can be treated. You have to find the right solution for you. There must be many options that you have not tried yet.
I hope this can help you.
Viking
Posted by Justherself54 on September 21, 2007, at 10:56:29
In reply to Re: med change, posted by Viking on September 21, 2007, at 10:42:35
After trials of multiple SSRI's and a weight gain of 80 pounds, I was put on Parnate..I've lost 20 pounds in 3 months..it's like it turned off my appetite switch..I had to go off it for a short period as I recently had surgery, and as soon as I'm finished with the pain meds, I'm restarting it..I'm looking forward to continued weight loss with Parnate..not to mention getting back focus and concentration..
Posted by Phillipa on September 21, 2007, at 12:18:33
In reply to Re: med change, posted by Justherself54 on September 21, 2007, at 10:56:29
How's your depression without any meds now? And losing any weight med free? And do the pain killers I'm thinking you must be on helping the depression? Phillipa
Posted by Justherself54 on September 21, 2007, at 14:10:19
In reply to Re: med change » Justherself54, posted by Phillipa on September 21, 2007, at 12:18:33
> How's your depression without any meds now? And losing any weight med free? And do the pain killers I'm thinking you must be on helping the depression? Phillipa
Depression is creeping back slowly..have lost another couple of pounds just from not feeling well after surgery..have not taken any pain meds for 2 days now but am going to wait another 3-4 days just to make sure nothing pops up where I have to take pain meds..so far so good..Parnate has been the best med bar none for lifting my depression..I was only at 20 mg..didn't go higher as surgery was coming up..now will try to get to 30 mg..my biggest fear is it won't work for me again..
SSRI's made me constantly carb-crave..with Parnate I have to "listen" to my body to make sure I eat..
Posted by rskontos on September 21, 2007, at 18:03:00
In reply to Re: med change, posted by Justherself54 on September 21, 2007, at 14:10:19
That is why I don't want another SSRI is the carb crave and my topamax could not offset it. I wanted candy so bad while I was on it. I had lost a significant amount of weight on topamax so I could afford it but whew not another SSRI. So any p-doc I see that wants to att that I don't think so. Is parnate good for anxiety? HOpefully? As I am getting close to that menopausal state I don't anything that messes with weight issues.
Posted by Justherself54 on September 21, 2007, at 18:57:18
In reply to Re: med change, posted by rskontos on September 21, 2007, at 18:03:00
> That is why I don't want another SSRI is the carb crave and my topamax could not offset it. I wanted candy so bad while I was on it. I had lost a significant amount of weight on topamax so I could afford it but whew not another SSRI. So any p-doc I see that wants to att that I don't think so. Is parnate good for anxiety? HOpefully? As I am getting close to that menopausal state I don't anything that messes with weight issues.
I haven't been able to take a high enough dose of Parnate yet to compare anti-anxiety properties..at 20 mg. I was still not very social, but that is also my nature..I was able to cope fairly well with anxiety..but still felt I had to ramp it up one more "notch" to try to get more benefit from it..that being said, Parnate is not without it's own little glitches..nausea, hypotension, dietary and medication restrictions, afternoon fatigue..but the focus and concentration I had was much better than any SSRI I've been on..it's what you're willing to "trade off". Would I rather be able to stay on task and complete a project than be more social..for me yes..do I put up with dietary restrictions and nausea than eat myself into oblivion..yes..
Hope this helps a bit.
Posted by rskontos on September 22, 2007, at 10:24:56
In reply to Re: med change, posted by Justherself54 on September 21, 2007, at 18:57:18
Yes it does thanks.
Posted by elanor roosevelt on September 27, 2007, at 20:54:39
In reply to med change, posted by sadone on September 21, 2007, at 1:08:23
I lost weight on Parnate
Posted by sadone on September 28, 2007, at 5:29:20
In reply to Re: med change, posted by elanor roosevelt on September 27, 2007, at 20:54:39
good news at last !!!! how long have you taken parnate ?
This is the end of the thread.
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