Posted by nmk on September 7, 2004, at 17:38:50
In reply to Re: Milnacipran » nmk, posted by SLS on September 7, 2004, at 16:53:35
Hi Scott,
It should. I once looked into it for a friend as a treatment for endometriosis. It has a reputation for doing some pretty scary things. I would have thought Yasmin to be the better choice for PMDD. I have never heard of your doctor's strategy. Maybe he has had success with it personally? I don't know. I hate to disuade people from trying something that their doctor feels strongly would work.>>He did try me on Yasmin but the progestin in the pill sent me spiraling downward into a serious depression. The day after discontinuing the pill, I felt better. My pdoc is was an OB/GYN for the first 10 years of his career. His approach with the Lupron is to shut down my ovaries so that I do not have any hormonal flucuations throughout the month. It is the flucuations that cause my anxiety/depression at certain times of the month. Once we can get the hormonal flucuations out of the way, we can deal with whatever is left. He said that it has worked for many women but one must give it a three month trial period. He said the first month is the worst as far as side effects.
If you have never tried a TCA, I guess that is the logical choice. I am not a big fan of clomipramine, even though it probably gets more people well than any of the others. It carries a pretty big burden of side effects, many of which are anticholinergic, and many of which are similar to the SSRIs. I would probably be more apt to try nortriptyline first. However, your doctor might have very good reasons for choosing clomipramine first, and I wouldn't want to second guess him.>>He doesn't have very good reasons because I asked him the same question. Can you please tell me how they compare? Particularly, which works best on anxiety, depression, and insomnia?
MAOIs are always worth trying. I think Nardil makes more sense given your symptoms of anxiety and agitation. Why is your doctor leaning towards Parnate? I don't know why, but it seems to me that women do better on Nardil. That is ONLY a personal opinion based on some intuitive notions and observations. Make believe I never said it. Actually, there is some evidence that women respond less often to TCA than do men.
>>He said the side effect profile is kinder with Parnate. Which works best on anxiety and depression with the fewest s/e's? You can say men are from mars and women are from venus. There is probably some truth to your theory since female reproductive hormones can effect the efficacy of a med so that the response is different in women.
I think you should post a question on the Alternative board regarding the connection to your menstrual cycle. There are some things I'm sure Larry Hoover can suggest. I could list a few, but I feel more comfortable deferring to the people there who certainly know more than me.>>Thanks Scott. I will.
> Now that I have thoroughly confused you...
Not at all. You have been a great help and I appreciate your response and your time and consideration. As you mentioned, trying a TCA would seem to be the next logical approach but part of me wants to say the #@*! with it....lets go for the MAOI. Then again, that scares me because a)the side effects and restrictions and b)fear that I will have experienced another failed trial. I wish I had a crystal ball.Please convince me why you would try the nortrip. and the nardil. I am trying to research as much as I can but I wind up even more confused.
I truly hope this is the med for you Scott and I wish you good days ahead.
Nicole
poster:nmk
thread:380308
URL: http://www.dr-bob.org/babble/20040904/msgs/387753.html