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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 tensor on February 11, 2012, at 12:04:28
If Zyprexa doesn't work for me, is it ECT next? I don't think there are any other options left. With all the stigma aside, how safe is it, how effective is it? Have you tried it? What is it like?
/t
Posted by ed_uk2010 on February 11, 2012, at 13:01:42
In reply to ECT next?, posted by tensor on February 11, 2012, at 12:04:28
> If Zyprexa doesn't work for me, is it ECT next? I don't think there are any other options left. With all the stigma aside, how safe is it, how effective is it? Have you tried it? What is it like?
>
> /tHi Mattias,
I don't think ECT is next. Since your depression is chronic rather than being an acute crisis, ECT does not seem the best option. One of the main problems with ECT is the risk of relapse.
If Zyprexa doesn't work, how about an MAOI? I can't remember whether traditional MAOIs are available in your country. If not, the pharmacy would have to obtain from another European country eg. the UK, where all three MAOIs are sold: phenelzine (Nardil), isocarboxazid and tranylcypromine (Parnate).
Posted by tensor on February 11, 2012, at 13:10:34
In reply to Re: ECT next?, posted by ed_uk2010 on February 11, 2012, at 13:01:42
> > If Zyprexa doesn't work for me, is it ECT next? I don't think there are any other options left. With all the stigma aside, how safe is it, how effective is it? Have you tried it? What is it like?
> >
> > /t
>
> Hi Mattias,
>
> I don't think ECT is next. Since your depression is chronic rather than being an acute crisis, ECT does not seem the best option. One of the main problems with ECT is the risk of relapse.
>
> If Zyprexa doesn't work, how about an MAOI? I can't remember whether traditional MAOIs are available in your country. If not, the pharmacy would have to obtain from another European country eg. the UK, where all three MAOIs are sold: phenelzine (Nardil), isocarboxazid and tranylcypromine (Parnate).Hi Ed!
You read my mind :) I've been thinking of MAOIs, and yes it would probably be no problem getting them here. Although I don't want to get ahead of myself and give Zyprexa an adequate trial, it's good to have a backup plan. Which one is preferred for my condition? Nardil?
/t
Posted by ed_uk2010 on February 12, 2012, at 13:49:13
In reply to Re: ECT next? » ed_uk2010, posted by tensor on February 11, 2012, at 13:10:34
>Which one is preferred for my condition? Nardil?
Either phenelzine or tranylcypromine could potentially work well. It's very difficult to predict which would work best. Phenelzine is often chosen when anxiety is a problem, but I believe your anxiety is fairly well controlled on clonazepam. Tranylcypromine is more stimulating, which could also be useful.
Posted by jono_in_adelaide on February 12, 2012, at 16:39:45
In reply to Re: ECT next? » ed_uk2010, posted by tensor on February 11, 2012, at 13:10:34
I would try Parnate first (fewer side effects), if that doesnt work, try Nardil, and if that doesnt work, try Nardil + Nortriptyline.
That is assuming that you have already tried
Effexor plus Remeron
Zoloft plus Welbutrin
Zoloft plus Nortriptyline
Posted by tensor on February 13, 2012, at 3:21:41
In reply to Re: ECT next?, posted by jono_in_adelaide on February 12, 2012, at 16:39:45
> I would try Parnate first (fewer side effects), if that doesnt work, try Nardil, and if that doesnt work, try Nardil + Nortriptyline.
>
> That is assuming that you have already tried
>
> Effexor plus Remeron
>
> Zoloft plus Welbutrin
>
> Zoloft plus NortriptylineYes I've tried them, and many many others. Yesterday and today I have felt more energy, I have gotten things done, it feels like Zyprexa is kicking in, hopefully it's not a transient surge just because of a dose increase (10mg). I agree that parnate seems like a slightly better option than the rest of the MAOIs. Are sexual side effects an issue with Parnate?
Thanks
/t
Posted by ed_uk2010 on February 15, 2012, at 15:10:13
In reply to Re: ECT next? » jono_in_adelaide, posted by tensor on February 13, 2012, at 3:21:41
Hi T,
Are you still finding Zyprexa beneficial? I hope so.
Posted by tensor on February 16, 2012, at 4:32:00
In reply to Re: ECT next? » tensor, posted by ed_uk2010 on February 15, 2012, at 15:10:13
> Hi T,
>
> Are you still finding Zyprexa beneficial? I hope so.Not so much, but if I take modafinil I get plenty of things done. Sometimes I think if I would be better off just taking clonazepam + modafinil, I have forgotten why I take mirtazapine and escitalopram. Thanks for asking. :)
/Mattias
Posted by ed_uk2010 on February 16, 2012, at 14:04:32
In reply to Re: ECT next? » ed_uk2010, posted by tensor on February 16, 2012, at 4:32:00
>I have forgotten why I take mirtazapine and escitalopram. Thanks for asking.
Perhaps you would feel better on a simpler combination?
Posted by tensor on February 17, 2012, at 4:52:20
In reply to Re: ECT next? » tensor, posted by ed_uk2010 on February 16, 2012, at 14:04:32
> >I have forgotten why I take mirtazapine and escitalopram. Thanks for asking.
>
> Perhaps you would feel better on a simpler combination?
>
>
Hi Ed.Please tell me if you have any ideas, it looks like this now:
Zyprexa 10mg, Remeron 45mg, escitalopram 10mg, modafinil 300mg, clonazepam.
I have run out of ideas, with modafinil onboard I get things done (it usually don't last), and I don't want to be a walking pharmacy for nothing. I read that modafinil induces an enzyme which increases clearance of Zyprexa, don't know the significance of this.Thanks.
Posted by SLS on February 17, 2012, at 6:45:53
In reply to Re: ECT next? » jono_in_adelaide, posted by tensor on February 13, 2012, at 3:21:41
> Are sexual side effects an issue with Parnate?
Not in the long run. Early in treatment, you might find a change in your orgasm and ejaculation, but it is not due to a loss of erection or sensitivity. It is not more difficult to reach orgasm. Sex drive is not reduced by Parnate. Oh yeah... Erections can last for quite awhile after orgasm. All of these things eventually disappear.
- Scott
Posted by ed_uk2010 on February 17, 2012, at 14:05:22
In reply to Re: ECT next? » tensor, posted by SLS on February 17, 2012, at 6:45:53
>Erections can last for quite awhile after orgasm.
Really? Interesting.
This is the end of the thread.
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