Posted by JohnL on September 22, 2000, at 5:21:50
In reply to Newbie w/treat-res melancholic double depression, posted by MarkinBoston on September 19, 2000, at 3:59:56
> Comments? What meds work best for melancholics?
> Thanks,
> MarkMark,
So sorry to hear of your situation. You've come to the right place though. So many of us have been, or are, in exactly the same boat as you. And there are some real expert regulars here. And lots of desperate experimenters that discover wonderful things via unconventional methods.What meds work best for melancholics? Well, a review of all the literature would probably give the tricyclics a slight edge over everything else. Regardless, most statistics show that any of the psychiatric medications are basically similar in their ability to relieve melancholia. It's just that it varies so much from one person to the next. That leads me to my next comment...
It is my belief system that the dramatic variation we see from person to person is caused by unique chemistry imbalances. Each person has their own unique chemistry, genes, circumstances, metabolism, etc. There are many many chemical imbalances that cause melancholia. Yet they all have the same symptoms. Kind of like diarhhea...the causes are many, the symptoms are the same. So we need to target our own unique chemical/molecular root problem. We can only do that by trail and error.
I've also come to believe though that through trial and error we can gather clues to point us in the right direction. Every medication response we have--positive, negative, partial, whatever--provides clues as to what the underlying problem is. Doctors are not trained to look for these clues. Instead they try this and try that mainly by what has worked with other people, without giving much thought to why this or that didn't work. There are clues not be overlooked. But they are often overlooked because we aren't in the mindframe of seeking them.
As an example, let's say someone has tried several SSRIs, a couple tricyclics, and an MAOI. They worked a little bit, not enough, not very long, or not at all. To me that provides the clue that the underlying chemistry has nothing at all to do with neurotransmitter levels. The neurotransmitter levels in this example do not need to be increased. They are fine. The problem is something else. Perhaps the neurotransmitter levels need to be turbocharged, or maybe tamed. But not increased. That would lead us into completely different categories of medications for trial, from which addition clues are gathered. With some luck, the clue gathering phase will come to an abrupt end when we stumble onto the right medication match for the unique chemistry.
If you want to learn more about this method of anyalyzing, I would suggest buying a book (soft cover manual actually) called "The Successful Treatment of Brain Chemical Imbalance" by Dr Martin Jensen. You'll be amazed. A whole new world will open up to you in understanding why things you've tried didn't work, and where to look instead.
To get right down to bolts and nuts, I would suggest the possibility of acquiring two medications...Amisulpride (a French anitpsychotic that is excellent for melancholic depression with hardly any side effects) and Provigil (anti-narcoleptic). Why? Several reasons. 1)They target completely different chemistries that so far have been missed; 2)They have been proven clinically to be of value in treating the melancholic dysthymic anhedonic apathetic type of depression; 3)my history and type of depression is very much like yours, and these two medications work nearly 100% where all others failed. You can get a prescription for Provigil from your doctor. Or you can order it from International Antiaging Systems overseas. You can get Amisulpride from overseas pharmacies. Post a request to AndrewB for the location of Amisulpride. Or, do a search for Amisulpride posts going back about two months. There is a post with the pharmacy where you can order it without a prescription.
The real tip-off to me was your comment on Ritalin. There are powerful clues there. I think Amisulpride+Provigil stand a real good chance of working for you, with minimum dosing, minimum side effects, abolishment of melancholia, increase of energy and interest, and an increase in mental cognition. I suggest this not just based on the good response I've experienced, but rather by pondering the clues provided in your post. The clues are there. For dysthymic melancholic anhedonic apathetic depression, tricyclics probably have an edge over other antidepressants. But there side effects almost negate the good effects. Amisulpride and Provigil in my opinion are light years ahead in superiority. Try them alone or try them together. For me, 25mg Amisulpride (half the minimum) and 100mg Provigil (very low) work magic on my dysthymic anhedonic apathetic melancholic symptoms. Just about any medication you could name didn't work or left me incapacitated with torturous side effects. Consider the book, and these two medications. If nothing else, try Provigil alone. If you do try either or both of these, let me know. I'll be happy to share with you some tips in getting started.
John
poster:JohnL
thread:44895
URL: http://www.dr-bob.org/babble/20000905/msgs/45047.html