Posted by johnsmith12345 on January 17, 2005, at 17:21:35
In reply to Re: Need advice on what to do next. (long) » johnsmith12345, posted by Bob on January 17, 2005, at 14:42:41
You have a challenging case. Here is what I am thinking:
Curing your physical symptoms would make your life a lot better, but since the doctors have not found anything abnormal, you should put this strategy on the back burner for now.
Curing your depression may or may not cure your physical symptoms. But if your mood is improved, you may be able to live with those problems. You seem to be leaning towards this option anyway based on your interest in ECT.
I don't believe negative thinking is causing your physical ailments. But, you say you do have thought problems. How long have you had them for? Were they helped by any of the medicines? Were they helped by the therapist?
>Good point. It's real hard to know when enough is enough. I REALLY had some bad times on some of those meds, and REALLY don't want to go back there.
I understand. But, that limits your options considerably. Maybe just give it one last go of trying the MAOIs before giving up on meds. They are often effective even when many other treatments have failed. If those fail, you can move on to ECT. Or just go straight to ECT without trying MAOIs first. Also there is a new treatment called trans cranial magnetic stimulation (TMS) that may or may not be available to the public at this time. I do not know much about it, except that it can possibly treat depression without taking any meds. There is also this, it doesn't appear to be out yet though:
http://www.washingtonpost.com/wp-dyn/articles/A44636-2004Jun15.html
>I avoided MAOIs because it was so terribly hard, and took so long, to get off meds that I was >>afraid the withdrawl would precipitate suicide, since I wouldn't be able to take other meds at the> same time to fight that.
Yes, that does seem risky. You could always use painkillers, alcohol, and small doses of stimulants (not sure about this third one) during the washout period to stave off the suicidal thoughts. Furthermore, I saw an article on Medline stating that when patients were switched from one MAOI to another using a shorter than normal washout period, there were no ill effects. I can look it up if you are interested.
>Additonally, I have always been a major weight gainer on meds (45 lbs on Anafranil in a matter of months), and always been very adversely affected sexually. I haven't heard a lot of good things about tolerability with Nardil, rigorous diet notwithstanding. I see myself eventually sleeping all the time (happened with Effexor, Paxil, Anafranil, and many others), gaining massive weight, never having an orgasm, and that doesn't even address whether it would address my mental issues. My doctor actually has encouraged my waiting to see, as he doesn't see how drugs are really solving the problem. I won't rule anything out at this point.
I don't know about the weight gain, but Parnate has a reputation for causing insomnia rather than too much sleep. Also to my knowledge it typically has positive effects on libido, but I will need to do more reading.
Your doctor is right that drugs do not seem to be solving the problem, but that does not automatically mean that the alternative strategy (waiting it out, in this case) will be any more effective. Keep waiting if you think it shows promise, but I wouldn't spend more than a month or two on it.
poster:johnsmith12345
thread:443015
URL: http://www.dr-bob.org/babble/20050113/msgs/443294.html