Posted by JohnL on February 16, 2000, at 4:47:07
In reply to help help my ship is sinking, posted by ryan_s on February 15, 2000, at 2:23:25
In my book it's perfectly fine--actually a requirement--to screen potential pdocs with particular questions, like whether they would consider prescribing you an MAOI, a stimulant, or whatever. No sense in doing business with a doc who won't cooperate with your wishes. After all, who pays who? In my experience the best docs were the ones that welcomed patient involvement. It gives a sense of ownership in one's own treatment. We are already handicapped as it is. We don't need to be further handicapped by restricting possible treatments.
In your particular case though, there are a couple things you could try before the MAOI route. One is Desipramine, or Nortriptyline. These ADs will target different chemical imbalances than anything you've tried yet.
Another good possibility, in my mind, would be to choose your favorite SSRI so far, get back on a small dose, and try three different stimulants one at a time in short trials added to the SSRI. This combo can work wonders. I read somewhere that 80% of people who respond to ECT also respond equally well to stimulants. And stimulants work fast. Days, not weeks or months. With these things in mind, this might be the place to start next. SSRI + stimulant. If that either doesn't work or makes you worse, then backup and try Desipramine or Nortriptyline. If still no results, then finally the time has come to try an MAOI. Just my thoughts. But nothing is going to work very well if the doctor limits approaches in getting you well. You need a doc who will be comfortable using all available ammunition to battle the beast.
poster:JohnL
thread:21554
URL: http://www.dr-bob.org/babble/20000209/msgs/21767.html