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Re: Treatment Resistant (Refractory) Depression

Posted by CaptainAmerica1967 on December 13, 2008, at 14:24:43

In reply to Re: Treatment Resistant (Refractory) Depression, posted by polarbear206 on December 13, 2008, at 8:25:35

No, I live in Houston, TX (I grew up in upstate
New York around the Finger Lakes), but I know Dr. Goldberg and have gotten a consult with him via the email. He's one of the most knowledgeable people on TRD.

His emails to me

" Hi . . .

The short answer is that the combinations most often used are:
phenelzine + amitriptyline and tranylcypromine + amitriptyline

Best regards . . .

Ivan

Hi . . .

I find the combination of one of the MAOIs + (TCA or psychostimulant) to be a very powerful treatment for people with hard to treat depressions. The combination is even more effective when potentiated by lithium.

I am not convinced that TMS is a very useful treatment, but of course the people I get to see are the TMS failures. It looks as if deep brain stimulation, currently being researched at Columbia and Mass General is going to turn out to be a much better treatment.

Best regards . . .

Ivan

Thanks for suggesting Dr. Goldberg though and your thoughts.

I applied for the deep brain stimulation study in Dallas, TX, but because I had several seizures while on trazodone and at one time was diagnosed as having petit mal seizures (although they went away after going off trazodone and never had any more seizures and don't take any meds for it), I couldn't enter the study. I don't think the vagus nerve stimulator is effective nor were the 70 ECT's I had in 1985-1986.

Regards,

Jeff


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Psycho-Babble Medication | Framed

poster:CaptainAmerica1967 thread:868231
URL: http://www.dr-bob.org/babble/20081204/msgs/868531.html