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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by swim on January 8, 2016, at 12:31:11
Hi
So, I have tried most of the AD's from every possible group, Nardil being the only one that worked long-term but had too many side-effects unfortunately. Some of the other ad's i'v tried kick in for a short period giving me glimpse of what life used to feel like and then i'm back to the everlasting deep void of nothingness.Anyways, I have been Nardil free for 4 months and looking for something else with less side-effects. Is there anything left i could try? For me it seems like i'm fuc*ed..
If anyone has this treatment resistant depression/anxiety, what has helped you?
Posted by Christ_empowered on January 8, 2016, at 13:58:59
In reply to What else could work for TRD?, posted by swim on January 8, 2016, at 12:31:11
have you tried stimulants? atypical antipsychotics?
I knew a lady...she had mood problems and anxiety and...she was all over the map. She's on Seroquel and Adderall...works quite well for her.
Ummm...there's supplements, psychotherapy, group therapy, art and/or writing as therapy...
...some people get relief, at least in part, from tramadol (Ultram) at varying doses. Anticonvulsants (Lamictal, for instance) can be helpful.
Do you have any health problems that might be contributing to the problems and/or making the depression more resistant to treatment? Major psychosocial stressors?
I'm no expert...but I thought I'd throw out some ideas off the top of my head.
Good luck!
Posted by SLS on January 8, 2016, at 14:14:47
In reply to What else could work for TRD?, posted by swim on January 8, 2016, at 12:31:11
> Hi
> So, I have tried most of the AD's from every possible group, Nardil being the only one that worked long-term but had too many side-effects unfortunately.How long were you on Nardil for?
What were the side effects of Nardil that you found intolerable?
- Scott
Posted by linkadge on January 8, 2016, at 17:15:32
In reply to Re: What else could work for TRD? » swim, posted by SLS on January 8, 2016, at 14:14:47
Have you tried venlafaxine + remeron?
Linkadge
Posted by swim on January 9, 2016, at 2:46:54
In reply to Re: What else could work for TRD?, posted by linkadge on January 8, 2016, at 17:15:32
Thank you for your feedback!
I have tried venlafaxine and mirtazapine, separately and together, they do keep the suicidal thought away but are far from giving me any real relief.
I was on nardil with few occasional pauses since 2006. My major concerns were weight gain, disturbed sleep(nightmares, sleep-talking) and it also produced kind of a dopamine depletion by the evenings, which was easily cured by few beers though :) Nardil gave me me the best years of my adult life, if it only didn't have the side effects.
Lamictal, wellbutrin, atypical ap-s i have tried- they did not work.
I have not tried stimulants though, i don't know how much they could help long term since i believe they tend to deplete dopamine leaving me crashing be the end of a day?
During the many years of depression i have observed that my depression seems 90% biochemical, therapy didn't do the trick for me. Only thing that do lift the black cloud are meds, most of them unforunately only work for few days or for a week.
I'm really looking forward for the NMDA antagonists to hit the market! As i remember there are close to ten of them in clinical trials.
Posted by SLS on January 9, 2016, at 5:48:57
In reply to Re: What else could work for TRD?, posted by swim on January 9, 2016, at 2:46:54
I would either try another MAOI or go back to Nardil. I understand your dilemma. I guess it's a cost versus benefit thing.
Speaking only for myself, I would jump back to Nardil immediately and take it forever if it would work for me as well as it works for you, despite the side effects.
- Scott
Posted by Hugh on January 9, 2016, at 12:21:45
In reply to What else could work for TRD?, posted by swim on January 8, 2016, at 12:31:11
Here's a thread about how Deep TMS helped johnLA's TRD and anxiety, after he'd tried numerous meds and even ECT. His insurance paid for it.
Posted by baseball55 on January 9, 2016, at 18:54:52
In reply to Re: What else could work for TRD? » swim, posted by SLS on January 9, 2016, at 5:48:57
Im inclined to agree with Scott, though I the degree of weight gain would make a big difference for me. I had to stop AAPs that worked for me because of rapid (2-3 pounds a week) weight gain. If Nardil produced less gain, personally, I would stay on it and start working with a trainer and nutritionist, which might stabilize your weight. Some people swear by metformin as well.
As far as nightmares and talking in your sleep go - did this start in 2006 and end when you stopped nardil? I also have nightmares and talk A LOT in my sleep, but it started before I took parnate and continued after I stopped, so, in my case, it wasn't caused by the MAOI. Can you take a benzo to improve sleep? Probably you've already tried this.
But I guess the side effects must be pretty disruptive if you're going off something that works for TRD. So few meds do.
> I would either try another MAOI or go back to Nardil. I understand your dilemma. I guess it's a cost versus benefit thing.
>
> Speaking only for myself, I would jump back to Nardil immediately and take it forever if it would work for me as well as it works for you, despite the side effects.
>
>
> - Scott
Posted by swim on January 10, 2016, at 5:24:48
In reply to What else could work for TRD?, posted by swim on January 8, 2016, at 12:31:11
Yes, MAOi's seems to be ad's that really work, though i'm on 2x150mg pregabaline at the moment which has made me better for 30-40%.. at least i don't lie in bed most of the day because of feeling so sick.
I'll ask my shrink if she could rise the dosage to see if it gives more relief, i really do feel better after a week on pregabaline, sometimes i get really down though... If this does not work i'll go back on Nardil.
I haven't tried selegeline, how would this compare, is it similar to parnate? Parnate was like amphetamine to me, i was flying high after each dose for 4 h and then crashed really bad.
Posted by SLS on January 10, 2016, at 8:19:06
In reply to Re: What else could work for TRD?, posted by swim on January 10, 2016, at 5:24:48
You might be able to avoid weight gain and dizziness with Marplan, despite its being chemically related to Nardil (both are hydrazines). I preferred the way I felt on Marplan as compared to Nardil. Unfortunately, the response only lasted for a few days. I really should have given it more time at a higher dosage, but I was impatient to go back to Parnate or Nardil. In the past, Marplan had been considered to be a "weaker" Nardil. However, there are plenty of people who respond to nothing else.
Emsam (transdermal selegiline) seems to be better for anxiety disorders than it is for depression.
Given that you are less than happy with Nardil, and that Parnate is not the answer, I think that Marplan deserves a trial. You can go as high as 90 mg/day, despite the recommendation by the manufacturer that 60 mg/day not be exceeded. You can continue with pregabalin.
http://www.rxlist.com/marplan-drug/indications-dosage.htm
- Scott
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