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Re: What caused SLS remission + zonked

Posted by SLS on June 9, 2023, at 20:58:46

In reply to Re: What caused SLS remission +, posted by zonked on June 9, 2023, at 16:44:05

Hi, Zonked.

I'm sorry for writing so much. It can be irksome to the reader. My refractoryh weakness is that "once I start writing, I'm too lazy to stop." That's my favorite line from the movie "Lincoln".

Still...


> Scott, Nardil stopped having any significant effect for me years ago, nevertheless I still take it because every time I try to taper it, I get worse.
>
> Nardil 90mg
> Lithium 900mg
> Prazosin 15mg (night terrors, only partially effective)
>
> Because of this, I started TMS (theta burst) on Thursday. I already feel better, and it seems too different to be placebo effect. Interesting, we are both on similar drug regimens.
>
> I'm so glad you're doing well. Consider sticking around babble. I'd give you my personal contact info, as I don't have access to babblemail anymore, but this forum is so easily indexed. I think I might change my posting name so I can use babblemail again.
>
> Would you like to hear updates about tms? I'm really excited about it.

The ONLY magnetic brain-tissue treatment I would bother with is Stanford's SAINT device. I can't remember all of the differences, but location of the stimulators cycling of
.
>
> -z

I would leave the Nardil in place and design a combination regime around it. Of course, I am partial to adding a tricyclic to a MAOI because there is nothing that has ever worded for me as well. As I mentioned, I cannot achieve remission without lamotrigine 300mg/day and lithium 300 mg/day. I have tried to lower the dosages of, or remove entirely both drugs. If the state of the art in 1996 was to be able to choose drugs based upon biomarkers, I could have achieved remission that year. With the approval of lamotriginge (Lamictal), all four drugs that I am currently responding to were available. I am 63 now. I began responding to treatment over two years ago. I was 60.

I could have been well at age 36. That's 25 years of guessing wrong.

Because of Hugh and Jay's excellent information, I decided that should I relapse, I would remain on my current regime and add psilocybin microdosing if I can figure out how to get my hands on some. It might take only a few treatments to increase neuroplasticity enough to recapture the antidepressant response. Nardil has a reputation for losing efficacy at some point. I guess I should be more specific here. Nardil will produce more remissions than any other (traditional) antidepressant. However, its liability for relapse doesn't necessarily make it the best antidepressant. Some SSRIs often allow for relapse. Paxil is the worst. In the past, I received a huge improvement from Nardil that lasted for 2-3 days. My first time, remission lasted for about 3 weeks.

Now, this is a crucial observation: After 2 1/2 years, I remain in remission. The difference? Nortriptyline, lamotrigine, and lithium. So, it is not inevitable that Nardil will fail to maintain a remission. Then again, it is disappointing that some people whose remission was maintained by Nardil monotherapy for over a decade will go on to relapse.

Of course, one suggestion that I would make is combining a MAOI with a TCA. I have *never* experienced a robust improvement without both of these drugs on board. There are other valid alternatives, of course. However, if you do opt for a MAOI-TCA combo, your choices of TCA are limited to amitriptyline, nortriptyline and desipramine (and possibly trimipramine). Most of the rest are too strong as serotonin reuptake inhibitors. This and can elicit serotonin syndrome. It is not as rare as some people assert. I experienced SS while I was taking 60 mg/day of Parnate. So, one day in the 1990s, out of in the desperation, I didn't want to exclude the possibility that Parnate + SRI would work, despite my doctor's refusal to use such a combination. So, I nibbled off a very small piece of an Effexor tablet. I figured that if I experienced anything untoward, its relatively short half would limit an SS episode. Well, within a 1/2 hour, I was completely delirious. I told my parents not to worry about me, and that I just needed to reboot my brain. It's kind of funny that I still had the wits about me to ask my mother to take my temperature. I don't remember the number, but it was normal enough. As SS grows in severity, one's body temperature can become dangerously high - hyperpyrexia. After 1-2 hours, the SS dissipated.

Again, I'm sorry for writing so much. I won't proofread it. It's late.


- 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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