Posted by Phoenix1 on January 13, 2008, at 18:20:38
In reply to Re: Tried it all... MAO's and Lithium as sole AD ?, posted by francineus on January 13, 2008, at 15:14:13
>
> Thank you so much Philipa, Phoenix and Racer! Your responses made me cry (tears of gratefulness for not being alone, and knowing that people care and are willing to take time out to respond etc). And I don't feel like quite the freak I felt before reading your posts!
>
> The doc doesn't think I'm bipolar. I'm just treatment resistant dysthymia and now I can diagnose myself as just a big pain in his butt! All of my calls to him start out "Sorry to bother you again...."
>
> But my moods ARE up and down so I may have some bipolar sx and may benefit from a mood stabilizer. Perhaps I may be more in the cyclothymic range.
>
> ( I'm a social worker LCSW , 41 y/o (in semi retirement-due to my depression and to stay at home with my kids) so luckily I am pretty familiar with the terminology/meds and dx stuff. But that works against me at times bc/ sometimes I think I have everything....my worst fear being that I have BPD. I don't think I do, but still, we all have sx of that don't we? Who really is good at being rejected?
>
> Yes, I've read about the Remeron dosage differences. Interesting how it's used..
> I tried it at 15, 30 and now 60 and the only difference seems to be that now I have trouble sleeping (leg restlessness)...but that could be the ritalin. The remeron has had no bad side effects,just no real response.
>
> The news on the MAO's being different IS hopeful. My doc seemed to imply that if Emsam didn't work that Nardil would probably offer me the same response. Perhaps the Emsam was a fluke and nardil will help. I'll mention trying that and perhaps the lithium too. The Emsam just made me very agitated and I couldn't stop crying. And I had red marks on my skin.
>
> But, your notes were uplifting in and of themselves. Thank you thank you thank you!I'm glad that you feel a sense of community here. You aren't alone, and you certainly aren't a freak. I was in your boat just 2 or 3 months ago. Thought I'd tried everything and should just give up. Now on Nardil, I'm feeling (almost) like my old self. Actually, it's been so long that I wouldn't recognize my old self so I'll just say I feel like a new person. And my side-effects are so minor, gastrointestinal distress and insomnia (which I had before treatment anyways). The biggest MAOI drawback is the diet, which may or may not have come into play when you tried EMSAM. There are lots of food to avoid while on Nardil/Parnate.
What's your worry with personality disorders about? They're just a diagnosis on paper, and your depression outweighs any PD a hundred fold in terms of deserving adequate treatment. I seriously think after reading DSMIV criteris for the PD's that a large portion of society meet enough criteria for a dx...
OK, so MAOI's. They are all very different. I can only speak for Nardil because it's the only one I've tried. I can guarantee you that failure on EMSAM doesn't mean DEFINITE failure on Nardil. They are SO different. Only the very basic mechanism of action is supposedly the same, and we (science) don't even understand those mechanisms fully.
I've found Nardil to reduce agitation and anxiety quickly, strongly, and powerfully. Everyones mileage varies though. If you are cyclothymic or have bipolar tendencies, MAOIs have less potential of causing manic swings than other AD's from what I've read.
Anyways, don't give up, you still have lot's of things to try. I would start by asking for a trial of another MAOI. Nardil, Parnate, Marplan... If agitation/anxiety is an issue, Nardil seems to be the preferred choice among prescribers.
Feel free to ask any and all questions here.
Phoenix1
poster:Phoenix1
thread:806143
URL: http://www.dr-bob.org/babble/20080105/msgs/806237.html