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Re: Cycling...YOU ARE RIGHT!! PLEASE HELP!! » Tomatheus

Posted by ed_uk on January 8, 2006, at 7:54:53

In reply to Re: Cycling...YOU ARE RIGHT!! PLEASE HELP!! » bigcat, posted by Tomatheus on January 7, 2006, at 20:29:46

Hi T

>Considering that you took Marplan relatively recently, I'm guessing that you're in the U.K. Am I correct?

Matt lives in the US.

>based on what I've read about the different Nardil formulations being manufactured for consumption in different countries, it seems that the Nardil being made in the U.K. and elsewhere in the world is basically comparable to the "new" Pfizer Nardil in terms of its efficacy and tolerability

UK Nardil has different 'inactive ingredients' to both the 'old' and the 'new' US formulations of Nardil.

>With respect to lithium, I think it might be worth a try, but I will warn you that lithium doesn't have a reputation for being effective at controlling rapid cycling, whether the cycling is endogenous or medication-induced.

Lithium is sometimes (occasionally?) an effective treatment for endogenous rapid cycling. It's not often effective for drug-induced cycling though, but neither is anything else as far as I can tell! There is very little evidence that any drug can prevent medication-induced cycling, although Depakote is a popular choice and it does seem like a reasonable option if withdrawal of the offending AD is not feasible. Combining Lamictal with Depakote is 'tricky' but possible.

>Effexor

Abrupt withdrawal/dosage reduction can induce or aggravate mania in susceptible patients. This is also a problem with many other antidepressants.

>So, given my responses to both the Paxil and the fluoxetine, I've steered clear of SSRIs, SSNRIs, and TCAs since then.

How do you respond to NE-selective ADs such as desipramine?

Regards

Ed


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