Posted by sophia04 on June 20, 2007, at 0:29:37
In reply to Re: Going Off Parnate, next drug - your insight? » sophia04, posted by Jedi on June 19, 2007, at 21:50:45
Thank you Jedi for all these wonderful references. What a wealth of knowledge you all are! I'm not sure if my depression is considered atypical. I will have to do a bit of research. I seem to have pretty classic syptoms, just resistent to treatment. I will discuss the nardil/tca options w/ my doc. I know she's typically against the combo, but perhaps isn't aware of these studies. I'll keep you posted.
I've been weaning myself off parnate (down to 30 mg from 60mg) and with every little pink pill I don't take I feel less poisoned and able to actually sleep more! Which was the intolerable side effect for me. No nastly withdrawal effects yet.
Thanks again!Holly
> Hi Sophia,
> Is your depression atypical? If so a combination of the nortriptyline, which worked for a while for you, and phenelzine(Nardil) might be a working combination. They are officially contraindicated but sometimes used in TRD. I know you had a lot of problems with Parnate, but Nardil is a completely different medication and works very well with atypical depression and social anxiety. It is not without side effects but I haven't found an AD that is. Just a thought.
> Take care,
> Jedi
>
> References:
> A 3-year follow-up of a group of treatment-resistant depressed patients with a MAOI/tricyclic combination.
> http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=7560546&ordinalpos=38&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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> Treatment response of depressed outpatients unresponsive to both a tricyclic and a monoamine oxidase inhibitor antidepressant.
> http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8071301&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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> Combined MAO-inhibitor and tri- (tetra) cyclic antidepressant treatment in therapy resistant depression.
> http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=3406429&ordinalpos=16&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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> > Thank you all for your feedback. The SSRIs were prescribed first and not under a psychiatrists supervision, but I do believe I stayed on them long enough to decipher their (lack of) effectiveness. However, it's hard to say - imipramine was the first drug to really *blow* a 5-year treatment-resistent depression away, but this was at a dose of 275mg (which I understand is relatively high). When Nortriptyline (175 mg) started to loose its effectiveness (after about 1 year) i briefly went back to imipramine, but found that I did not respond to it in the same way, and so went back to Nortriptyline. After a short stint back on Nor.. I decided to give Parnate a try, and have found it the most difficult drug to tolerate thus far. I will discuss other TCA options with my doc tomorrow. Thanks so much! You are all so helpful.
> >
> > Sophia
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poster:sophia04
thread:763671
URL: http://www.dr-bob.org/babble/20070613/msgs/764340.html