Posted by Racer on August 4, 2006, at 18:20:37
In reply to What stage of treatment-resistance are you?, posted by SLS on August 4, 2006, at 8:48:06
> What stage of treatment-resistance are you?
>
>
> * Stage 1: Failure of an adequate trial of 1 class of major antidepressant
>
> * Stage 2: Failure of adequate trials of 2 distinctly different classes of antidepressant
>
> * Stage 3: Stage 2 plus failure of a third class of antidepressant, including a tricyclic antidepressant (TCA)
>
> * Stage 4: Stage 3 plus failure of an adequate trial of a monoamine oxidase inhibitor (MAOI)
>
> * Stage 5: Stage 4 plus failure of an adequate course of electroconvulsive therapy (ECT)
>
>
> - Scott
Hm...See, what if you improve on some of them, but with intolerable side effects? Or some improvement, but not enough to make it worthwhile? Or some improvement, even adequate remission, that only lasts a few months?
I'm not sure what stage I'm in. I haven't tried MAOIs nor ECT. (I don't think I want to try ECT. I've never heard anything about it that would make me all that excited, you know? Sure, improvement, but not lasting improvement, you know?) My T would kick up a fuss if any pdoc prescribed an MAOI -- don't tell an eating disordered patient to restrict foods, you know?
As for me, I've tried a couple of TCAs -- hypotension, weight gain, constipation, sedation, and only just improved depression.
SSRIs -- ranged from weight gain/constipation/sedation/sexual dysfunction to out of control anxiety along with the others. Also insomnia.
SNRI -- Effexor and Cymbalta offered very limited relief, but not remission. Nothing quite like remission. Adding Prozad to the Effexor made it effective enough to stay on it -- not much alternative, anyway -- but it cr*pped out after less than a year. Cymbalta wasn't worth staying on as long as I did. Oh, yeah, and weight gain, constipation, sedation, anorgasmia, and insomnia from the Effexor. Cymbalta caused weight gain, anorgasmia, and the improved pain element faded after about six months.
NARI -- Strattera may have helped, but mixed with whatever it was mixed with -- Dr EyeCandy changed several meds at once each time, so it's hard to remember what I tried, since it was about eight drugs within six months -- increase anxiety way too much. I'd consider trying it again, though.
Wellbutrin -- it's helpful, but either does nothing or increases anxiety for me. It also leaves me with a great deal of residual depression.
Ritalin -- helps tremendously, but headaches, feel "high", and stimulates my appetite. That last part is what kept me from staying on it long enough to see if the other things went away, as I suspect they might.
Amphetamines -- Adderall was miserable, but Dexedrine was somewhat helpful. Not nearly as helpful as Ritalin, though.
Lamictal -- increased depression, sedation, etc.
Remeron -- let's not talk about my reaction to that one... (Could my attitude about taking it have made me more vulnerable to the rage reaction?)
Buspar -- improved anxiety a great deal, but increased depression.
I think they should make a new class for people like me: The SOL Club. Pretty much, we're [----] Outta Luck, you know?
(Thanks for posting this, though, Scott.)
poster:Racer
thread:673609
URL: http://www.dr-bob.org/babble/20060802/msgs/673753.html