Posted by FredPotter on November 28, 2007, at 13:52:55
In reply to Re: MAOI's, Treatment resistant depression/Fred., posted by stargazer2 on November 26, 2007, at 15:30:25
Stargazer sorry to be so long replying to your kind post
> Sorry to hear of your 40 year struggle. That is remarkable that you had the will to persist and continue to fight on despite feeling depressed, etc. Did you have any periods of time during that 40 years that your symptoms receded to the point you could function relatively well and work?
The sad thing is that Nardil was available when I was first assailed with nocturnal panic/depersonalisation/derealisation which is how it started. Then it started happeneing in the daytime. It took several years for depression to creep in I would say. Yes I had many periods of normality and happiness. eg my first year in university in a hall of residence was very neurotic and anxious, but I managed to get involved and passed my part 1 exams, started a band, became secretary of the Jazz Club etc.
As the past recedes it becomes clearer what was happening. In my second year I lodged with a family. That year was completely untroubled and happy. 3rd year in hall of residence and I eventually cracked up again. The same symptoms - they came as a terrible shock as I'd forgotten about them. Lying on the bed afraid to move, but if I did there was a terrible surge of panic.
In my first job I lodged again for a year and was very happy. I then shared a flat and these were very happy years. In other words I needed acutely the presence of others around me, although it was my tendency to run away and hide from the very thing that would make me well.
> Where do you live? Were you hospitalized because of it? Did you have ECT or other procedures like TMS or VNS?
I did live in Wales but for the last 11 years in New Zealand
I persuaded the psych to take me in voluntarily for a week. It did no good as they just ignored me except for a tiny dose of valium
> I have a > 30 year history overall, but really a 25 year history starting with a therapist, then a pdoc that put me on Nardil as the second med I tried and bingo, I was cured until 2 years later when it pooped out. I then had 2 years of success with Marplan until Roche pulled it off the market in 1994. Then I had probably 10 years where my treatment was marginal taking every SSRI known to man until a combination of Celexa, wellbutrin and adderall helped for about 3-4 years.
I'm sorry to hear MAOIs pooped out for you. I didn't think they were supposed to do this. Did you try raising the dose or augmenting? SSRIs have been no use for me
> This led up to the past year and a half when I crashed an becam unable to work or really do much of anything productive. I asked my pdoc if I could retry Marplan again (with no relief), Cymbalta and Emsam with various adjunctive meds,including Risperdal, Zyprexa, Geodon, Abilify, Lamictal and Seroquel. Probably not all of them, just the ones I remember.
>
> Then at my insistence I retried the "New, unimproved" Nardil this past May and worked up to 60 mg with one relapse at 45 mg.
>
> Nothing is easy as far as Treatment resistent depression(TRD) is concerned. There were many times I almost gave up.
>
> Today I take Nardil, Synthroid (after seeing an endocrinologist)for his input on TRD, and just recently Deplin. I stopped the nortriptylline I was taking for about 4 months as I didn't think it was doing much of anything and there have been no changes at all having stopped it.
>
> I'm happy to hear so many of us have responded to nardil and disappointed so many pdocs are not familiar with it, since it can work well for those with TRD, and I don't find the diet or precautions very difficult to follow.
>
> StargazerI suggested Nortriptyline augmentation to my Dr with the hope of lowering the Nardil dose and perhaps losing some weight. He concurred, but my pharmacist was horrified. Oh well nothing bad has happened yet
All the best
Fred
poster:FredPotter
thread:797131
URL: http://www.dr-bob.org/babble/20071125/msgs/797444.html