Posted by Judy on May 26, 2000, at 19:52:14
In reply to Re: Social Phobia: Nardil or Paxil ? - Judy again, posted by SLS on May 26, 2000, at 7:42:23
>>Nardil… would still be my drug of choice if I could get around the nasty edema side effect.
>This must be very demoralizing for you. What sorts of things did you try to deal with it? Did the severity of edema change with dosage?
It’s like a cruel joke, really. There is a med that makes me feel better than I’ve ever felt – and I can’t tolerate it physically. The edema set in at about 30 mg/day and was pretty severe at 45 mg/day (my maintenance dose). My feet and ankles were elephantine by the end of the day, and when I awoke in the morning, my face was swollen beyond recognition. To add insult to injury, Nardil made me almost dead from the waist down – I was barely able to urinate and my intestines basically shut down (I could go 7 days and not even feel any discomfort!) That ruled out the possibility of trying a diuretic to alleviate the edema since all the fluid would have ended up in my non-functioning bladder. I just couldn’t figure out a way to make Nardil work – there were too many strikes against me. Trust me, I will be the first person in line if and when the Nardil patch makes an appearance on any market in the world!
>Which is more prominent - depression or social-phobia?
Actually, I don’t suffer from social-phobia. My dx is major depression, dysthymia and unrelenting anhedonia (except when taking Nardil). I guess I misled you by recommending Nardil for social-phobia. I did so because when I was taking it, I became more talkative (would have held a conversation with a wooden Indian!) and enjoyed myself so much more.
>Perhaps there is a "retraining" of the orgasmic pathways - sort of like constructing new highways. If this is true, I encourage you to have as many orgasms as possible, despite your unwillingness to do so. :-) Masterbate if necessary.
This makes a lot of sense. I find my teeth clenched even at the thought of what an ordeal attempting an orgasm has become. Maybe if I relaxed a bit and said ‘screw it’ (no pun intended – I swear!) “if not this time, maybe the next time.’ Fortunately I have a partner who is patient and more than willing to help at any given moment.>Actually, I would really like to know if others have experienced this same sort of recovery of orgasmia.
So would I!
>The first thing that comes to mind would be to add a dopaminergic drug with the hope that it will help with anhedonia, libido, and anorgasmia. If you find the right one, perhaps all three will resolve.
Dexedrine
Adderal
Parlodel
Permax
Mirapex
Symmetrel
>I think either Ritalin or Mirapex would make a good first choice.My doctor is a psychiatrist and admits that he is too busy seeing patients to keep up with the latest in the specific science of drug augmentation. In fact, when I mentioned Ritalin to offset the Nardil Nods, he said, “What are you crazy?! You’re taking an MAOI!!!” He has suggested several times that I see one of the “Big Boys” in Boston (meaning a top psychopharm). I haven’t become desperate enough to drive into the ‘big city’ – as silly as it sounds, that would be a major panic attack situation for me.
>With some people, the dosage of an MAOI must be adjusted from time to time. The therapeutic dosage range of Parnate is 40mg - 80mg (I don't care what the PDR says). Some people need more than 100mg. I have been as high as 150mg. You have some room yet.
I don’t think my doctor would have a problem with increasing my dose. (Don’t know what he considers to be over and above therapeutic, but I’m sure he’s willing to prescribe more than the 60 mg I’m now taking. Do you really think I might see a lessening of the anhedonia at a higher dose?
>Judy - I forgot to ask you if you have ever tried Marplan or moclobemide.
Marplan, yes. Same side effects as Nardil, benefits not as great. I tried for a prescription for moclobemide and was treated to a “There’s a reason this drug hasn’t been approved in the U.S. yadda yadda…” Also took 60 mg/day of Selegiline. Best drug I’ve ever taken for mental clarity, virtually no side effects; but didn’t quite get rid of my depression, much less anhedonia. (A couple of archives back, I posed a question on the BB about combining Parnate and Selegiline because I felt great for the first couple of weeks on Parnate and I assumed it was because I still had Selegiline in my system – but I was pretty much shot down on that theory.)
>Have you tried an SSRI?
Which ones?
Did they help?
Why did you stop them?All the SSRI’s made me so fatigued that I couldn’t get up in the morning, couldn’t function for the rest of the day. No benefit at all no matter how much of a trial period I gave them.
Also tried Effexor and Wellbutrin. Both were terrible experiences. I had flu-like symptoms for the entire time I took them – muscle/joint aches, sore back, tremors, jitters – you name it. No benefit whatsoever.
Remeron & Serzone: more terrible experiences. Made me near comatose – couldn’t even be shaken awake in the morning. Also, Serzone brought out a nasty hostility in me that I’ve never felt the likes of before and don’t want to again.
Desiprimine, Clomiprimine: Weight gain, excessive sweating, not enough benefit to make it worth it.
Ritalin: Nothing at all. Maybe more tired than usual.
Lithium: Another bad near-comatose experience.
There are probably more – I wish I had written it all down. Didn’t know I was going to spend 17 years playing ‘find the right drug’.
Scott, if any of this trigger something in your mind, please let me know. In the meantime, thanks for your kind responses.
Judy
poster:Judy
thread:34436
URL: http://www.dr-bob.org/babble/20000526/msgs/34789.html