Posted by Phoenix1 on February 6, 2008, at 19:45:58
In reply to Thoughts please...next step Nardil?, posted by Four Feathers on February 5, 2008, at 18:08:42
> I have received dx's of both GAD and Dysthymia. I believe that my anxiety is the root cause of the depression symptoms I have experienced. Here is my story, as brief as possible, and I would appreciate any thoughts...
>
> Suffered anxiety my entire life. Used to be much more Social Anxiety in nature, but now is predominately physical symptoms. These symptoms consist of increased blood pressure and headaches in the temple regions. Difficulty concentrating has also been a main issue as well as an uncomfortable restless feeling in my body, and difficulty getting up and going in the morning. I also have constant canker sores currently. All medical tests have been negative.
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> 10 years ago I was put on Atenolol b/c of the high blood pressure, I was 24 at the time. I did not then understand that the feelings I had were anxiety which was likely causing the blood pressure changes. I am in good shape and have previously been very active athletically.
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> I have tried the SSRIs with the only one I could tolerate being Lexapro, and this has done nothing other than make concentration more difficult. Have tried Effexor which didn't help. Tried the mood stabilizers which really made me not feel well physically and mentally. Stimulants in low doses (i.e. Ritalin at 2.5 or 5mgs) creates the temple headaches and physically uncomfortable feeling. Surprisingly Strattera at doses of 80mg actually calmed me down, and made me tired, and allowed me to decrease my Atenolol dosage. Unfortunately, this created untolerable constipation problems. At low doses, below 60mg it was activating.
>
> Recently I tried Wellbutrin SR 50mg per day. I experienced three days of amazing relief (unlike any I had experienced in the last 15 years) at the beginning which all faded quickly and then resulted in headaches, increased blood pressure, etc. I have now stopped this per doc.
>
> Tried Abilify which gave me great motivation, but caused me to get bad muscle cramps at only 2.5mg per day. Lamictal caused panic attacks at 12.5 mg/day. I take Clonazepam at a low dose (.25 to .5 mg per day) as needed.
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> I had a SPECT scan last summer at the Amen clinic which showed significantly increased activity in the limbic region and slight activation in the basal ganglia.
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> If I decrease the amount of Atenolol, currently only on 25mg/day, I get increased concentration and mood. Unfortunately, I also get increased blood pressure immediately.
>
> I recently changed pdoc's and the current one is taking the time to help. He is recommending Nardil and I am hesitant to go this route just yet as I am concerned about the diet and other SE's. He states that he feels it would allevaiate all of my symptoms including the headaches and possibly the blood pressure.
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> I believe that my issues lie in the NE/DA area as the only meds I have received benefit from have been those that affect these. The only ones that I have thought about trying before Nardil are Cymbalta and possibly a dopamine agonist. Could anyone offer any thoughts as to meds to potentially help me moving forward? Does Nardil sound like a logical next step? Are my concerns of this med overexaggerated?
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> Thank you for any information/ideas. Sorry about the long post.
>Hi Four Feathers,
I'm on Nardil and it's been a miracle. I also responded poorly to all the SSRIs: no improvement and lots of side effects. I've had far fewer side effects with Nardil than any other AD i've been on. (and I have tried most of them) I think all the fear around Nardil is greatly exaggerated. As long as you stick to the diet and avoid contraindicated medications, it's pretty darn safe and undeniably effective for many people. And an added benefit for both you and I: it can lower blood pressure significantly.
The diet is very easy to follow once you get the hang of it. I don't really feel deprived or like I'm missing out on anything. And I've made the odd mistake, like eating a taco with some shredded cheese, and have not sufferred any ill effects.
What specifically are your concerns besides the diet?
One question: why atenolol for high blood pressure? If possible, you should steer clear of the beta blockers if you have depression. They can worsen things significantly. You might want to look at switching your antihypertensive to an ACE inhibitor or an ARB. Fewer psychiatric side effects.
PX1
poster:Phoenix1
thread:810906
URL: http://www.dr-bob.org/babble/20080124/msgs/811169.html