Posted by SLS on June 9, 2000, at 14:08:24
In reply to Re: history and pharmacists, posted by Elizabeth on June 9, 2000, at 4:22:38
Dear Elizabeth,
I must tell you that I am a bit disappointed in you for not coming up with a cure.
> Whatever happened to clorgyline, anyway? I don't think it was ever in clinical use for anything.
I swallowed quite a few pink capsules containing this gem of a compound. It is probably the best antidepressant in the world. It has been the single most effective drug I have ever tried. Unfortunately, the IND protocol in 1992 did not allow for its being combined with anything else but lithium. I am pretty sure that if I had been allowed to add desipramine to it, I would have maintained a robust response. I had no better option than to discontinue it and move on to other things. I wish that I had twisted my doctor's arm. Liability stuff.
The NIH is the only place I know of that had used clorgyline clinically. It is no longer available as a preparation for human consumption. I envy rats.
> > Does Mirapex, or any of the other DA agonists, potentiate the hypotensive effect of Nardil or any of the other MAOIs? I didn't experience this when I added Parlodel to Parnate + desipramine.
>
> I have no idea! (Did the Parlodel do anything useful, BTW?)Yes. I added it to an ongoing trial of Parnate 120mg + desipramine 200mg. I experienced a mild improvement for the first three days, and then watched it fade. This has also been my experience with other drugs, including Dexedrine, so I wouldn't use Scott as a showcase of effective therapies. As you know, adding stimulants and DA agonists to Parnate are considered to be good strategies in treatment-resistant cases. I recently paid a visit to Pat McGrath. :-) He expressed an interest in Mirapex. I like him.
> > Oh, and while I've got you here, I'm having trouble deciding whether to use Nardil or Parnate for treating my bipolar depression. I am aware of the traditional choice of Parnate in this situation.
> Really?
Yes. However, my doctor does not commit himself to this convention. He has left the decision to me. Dr. McGrath is definitely partial to Parnate.
> > However, having experienced a partial response to both, I like the way I feel on Nardil better.
>
> Go with it, then.Man, it is really a tough decision. The only time I experienced a robust sustained response to treatment was using a combination of Parnate and desipramine. I no longer respond adequately to this combo. It won't get me allow me to return to the work force. I probably wouldn't be here on Babble if the doctor that got me well hadn't discontinued the medication. Long story.
> > It is becoming increasingly apparent that anhedonia can persist in many people who otherwise respond robustly to Parnate.
>
> OH *YEAH*. (Although actually I have to say, most of my other symptoms are still here too, though somewhat improved. The only thing that is a lot better is mood.)I am confused by your response. Do you feel that Parnate effectively treated anhedonia?
How do describe the word mood?
What are the components of your depression that remain?I find your description interesting. I am under the impression that energy and cognition improve before mood does.
By the way, I am very disappointed to hear that you have not responded as well to treatment as I hoped you had. When you "left" here at the start of your classes, I assumed that things were Ok.
> > Any opinions on Gabitril?
>
> No clue -- that's an interesting one. Huh. I mean, my thought when I first read of how it works was, "hey, has this been tried for anxiety?" But I don't know anyone who's actually taken it.I hear of doctors recommending it, but I don't here of people using it.
> > What is your gut-reaction to Tegretol?
>
> I think it's worth a try, but you do have to monitor your white cells and liver enzymes. Actually I was talking to my pdoc just today (err, yesterday) about whether it would be worth it for me to try Tegretol if the lithium doesn't work any magic, and he thought it would be. He mentioned that he's used it as a PRN for anxiety, which I thought was interesting, and he thought it might help with the insomnia.Wow. That is interesting.
So, you are adding lithium to Parnate? Low-dose? Supposedly, if it's going to work in this situation, you'll see a response between 3-10 days.
What *exactly* is you diagnosis? (if you don't mind my asking)
> > I will be eternally grateful if you would be kind enough to cure me.
> I don't think kindness is always enough! :)/:( But I'm always willing to contribute whatever I can.
This means a lot to me coming from you.
Sincerely,
Scott
poster:SLS
thread:34894
URL: http://www.dr-bob.org/babble/20000603/msgs/36732.html