Posted by Jack Smith on March 12, 2003, at 14:03:58
In reply to Re: Thanks but. . . ., posted by SLS on March 12, 2003, at 0:26:38
I found the post below from another ng. It was posted a few years ago by a Dr. Steven B. Harris (sbharris@ix.netcom.com). Perhaps you have heard of him? I don't know if the email address is still functional (would guess that it is not).
JACK
--
Agree with all the above. Can also add that patients with a big
component of anxiety along with depression who fail multiple SSRIs are
good candidates for an MAO inhibitor, which also isn't considered in
this situation nearly often enough (since these drugs have all those
dangerous dietary rules and problems). Too often, Nardil is left to
the psych guys, and severe anxiety/depression is too common for that.I've had one patient who failed everything but 8-10 mg a day of
Xanax. And that did the trick and she's been on it for years, no change
in dose, and is happy as a clam. She was a mess for a decade, who had
previously seriously been contemplating suicide. ECT had even failed.
Now, she is completely functional. She doesn't need psychiatry or
doctors, except to write that scrip. Othewise, she's out golfing or
doing community work or playing bridge. What can I say. My one regret
is that I didn't try the MAO, just to see if that would have worked.
For obvious reasons, she's not anxious to do the experiment just to
please me, and I can't really ethically argue too hard for it either.Steve
poster:Jack Smith
thread:208210
URL: http://www.dr-bob.org/babble/20030310/msgs/208460.html