Posted by Peter S on December 3, 2000, at 19:23:40
In reply to Calling Dysthymics-My recent diagnosis-Help-Long , posted by shar on December 3, 2000, at 13:43:30
Hey Shar, I know where you're coming from. That has been my diagnosis too and so far I've come up empty after trying many meds. The drugs that I think really might work for me are Parnate and Nardil (Monoamine Oxidase Inhibitors). I tried both of them for a long time and they were effective but at some point they began to wear off and I needed to increase the dose. I could not do this mainly because of the side effect of constipation that I could not find a way to cope with.
If you try a number of the more modern drugs (SSRIs, Effexor, remeron)at adequate doses and times and they don't work, I would really suggest you give the MAOIs a try. I think you can judge how experienced a doc is if they have used MAOIs in relatively high doses (100mg+). I got up to 60mg of Nardil which is pretty low. The main drawback to these drugs is the potential for hypertensive reaction if you go off of the diet of no cheese or other things that have a high tyramine content. I really didn't find the diet a problem. I found Nardil to be more tolerable than Parnate generally- but everyone's different.
Good Luck- I hope you continue to come back and let us know your experiences.
Peter
> I finally met with a real pyschopharmacologist, hoping at long last that I would be able to get above my depression. My diagnosis is dysthymia (I've heard that before but did not realize it was essentially a death sentence for feeling good). I also have double depression (dys+major depressive episodes) at times. Doc said it is hard to treat, I might be able to find something that will help a little, but in her opinion I was doing quite well.
>
> By this she meant I was not being frequently hospitalized, I was functional in terms of being able to accomplish tasks of daily living, I wasn't trying suicide, etc.
>
> I was hoping for much more. I actually was hoping to feel good. Not Pollyanna good, just good (ie, no cloud over my head, weight on my shoulders, less anhedonia, etc.) more than bad. I have my head above water now, and that's about it. She said that it might be possible to enhance energy level, and help me enjoy occasional moments of pleasure when the situation presented itself.
>
> MEDS. She said she thinks I need higher doses than most people because I smoke. I did some research and it looks like the most common meds that work (or are used for dysthymia) are Zoloft (sertraline), amisulpride, moclobemide (Manerix), and Prozac (fluoxetine). It also appears that researchers believe it can take longer (up to 6 months) for meds to kick in for dysthimics.
>
> I tried Zoloft, the drug from heaven for me and it pooped out really fast. Prozac did nada but I only did 20 mg. Haven't tried the others. Right now I take Effexor XR 300 mg, Wellbutrin SR 200 mg, klonopin to sleep.
>
> I was crying at my lousy prospects of a whole life of depression. She said don't lose hope. My thought was that the most she could do was keep me where I am. You all have any advice, suggestions, etc?
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> I am planning a physical, and a thorough blood workup.
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> Don't know if I will go back to her, my first visit was $200.
>
> Shar
poster:Peter S
thread:49856
URL: http://www.dr-bob.org/babble/20001130/msgs/49866.html