Posted by kate9999 on March 31, 2001, at 5:19:37
In reply to Nardil patient@ dead end??, posted by drew on March 29, 2001, at 21:20:53
What about a mood stabilizer? There aren't problems with Nardil and these drugs (at least none that I'm aware of - but always always check with a good pharmacist), and it sounds like you might be cycling.
Also lithium and thyroid can be added to Nardil.
Even though Nardil has been a "miracle drug" for my depression and social anxiety, my mood is definitely more unstable on it than off it. Also -you know what, I've found that when I start to be very unstable LOWERING the dose helps. In fact an optimal dose for me is only 30 mg. I'll sometimes push it a little higher depending on how I'm doing, but if I stay at 45 very long my mood swings become pretty wild. And depression becomes WORSE. The first time around I thought that meant I should push it up to 60 which was a BAD mistake - I was bouncing around like a pinball - and ended up getting fired from a job over my behavior.
I'm experimenting with mood stabilizers myself now to see if that helps. Right now I'm trying Neurontin which seems to be helping, but it's too early really to know if it will last.
Your doctor, frankly doesn't sound like the sharpest knife in the drawer. There are a lot of meds you CAN'T take with Nardil, but there are a lot you CAN. He's being unreasonably overcautious. And, IMO, it's not cautious or responsible to keep someone on an antidepressant without a mood stabilizer if they appear to be experiencing increased cycling because of it. Even if you are by every other criteria unipolar.
What's the problem with finding another pdoc? I don't totally understand the problem.
Last thing - IMO it's better to take an "underachieving" job than disability if you can. Are you putting too much pressure on yourself to launch a high-powered career?
> After reading the large number of posts pertaining to Nardil, I must add my two cents worth. I've been actively searching for a pdoc in my state who will try augmentation w/ Nardil. The reason? After six years on this med (I have tried numerous others)I believe that things are as good as they are going to get: I am what might be termed a "partial responder", although "inconsistent responder" may be just as accurate. My pdoc steadfastly refuses to mix Nardil with anything else, even though he suggested I go on disability-at least for the time being. Since neither of us can realistically expect a more beneficial response with the treatment as it stands, we both know that I could wind up on disability for an indefinite period of time.
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> I loathe to pursue this advice, and will refuse until I absolutely have to resort to such a measure. Unfortunately, this may come to pass if my symptoms remain as they are. While I always feel at least somewhat better, my depression and/or the Nardil jerk me around pretty damned good. My "average" mood, for lack of a more precise term, is about a 60% relief of symptoms. At times, the Nardil hits the bulls-eye, and things are almost asymptomatic for a brief period (a few hours to a few days)before peetering out. At other times, the opposite happens; I reel from the return and intensification of symptoms. The worst episodes occur just after one of these nearly symptomless periods, when I can feel my mood rapidly deteriorating. The slide doesn't bottom out until I'm left feeling very apathetic, sluggish, drowsy (talk about hypersomnia!!), irritable, et al. (I exprience tachycardia as well, much to my dissatistaction and concern). This is NOT quite like the unpleasant symptoms I must tolerate when I have to go off of Nardil, although there is some overlap. (As a matter of fact, I am right now in the midst of one of these drop-offs, and the symptoms are only now just beginning to fade after crashing Monday. It will be back, however, this I can count on).
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> The effect of depression on my life is al-encompassing: Although I graduated from college recently, I will have a great deal of dificulty holding a steady job-unless it is something where I am underachieving (hence, the disability business). I can work for myself a bit (although a career is problematic), and I find this preferable to a handout; my social life barely exists, though I have a close friend or two; although I have never admitted it, I've all but given up on the idea of marriage-for me, this kind of relationship is the most difficult of all. On and on I could go, but we've all heard enough of these stories.
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> Right now I just don't know what to do. Just too many leads end up as dead ends. I really ought to pursue the polypharm business, but I hate to get the run around from providers.(By the way, what is this about pdocs prescribing meds w/o seeing patients in person? Do I understand this correctly, or not?).
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> Anyhow, I'm not about to get all the help I need from my present providers. Anything helpful would be appreciated.
>
poster:kate9999
thread:58001
URL: http://www.dr-bob.org/babble/20010327/msgs/58190.html