Posted by Tomatheus on July 24, 2012, at 14:42:13
In reply to Recommendations for an Atypical Depressive, posted by Cupcake1985 on July 23, 2012, at 20:06:44
Hello Cupcake1985, and welcome to Psycho-Babble.
I just thought that I'd chime in and say that one thing that I've come across a lot as I've read the psychiatric literature is that the MAOIs tend to be more effective than the tricyclics at treating atypical depression. However, the side effects that you're looking to avoid (weight gain, sedation, and sexual dysfunction) can occur in patients taking MAOIs. From what I've read and experienced, it seems that Nardil is a much bigger offender than Parnate when it comes to weight gain and sexual dysfunction. And in my experience, sedation occurred with both Nardil and Parnate (although with Parnate, it only occurred when I took the American version of the medication). With Nardil, I remember feeling sleepy during my first few weeks on the medication before that particular side effect began to subside. Nardil was actually quite energizing for me when it worked, though. It's really the only medication that ever had a pronounced effect on my hypersomnia, reduced energy levels, psychomotor retardation, and anhedonia for more than a few days.
So, what do I advise that you do? I think that MAOIs would be worth taking a look at since they tend to be the treatment of choice for atypical depression, but I think that you also need to carefully evaluate the risks of MAOIs before determining whether to ask your doctor about one of those antidepressants. Another option you may want to consider is augmenting the Effexor that you're taking. Some here have already suggested Abilify, which is an option, but it's not the only option for the adjunctive treatment of depression. Other options include the antipsychotic Seroquel (although it's highly sedative), as well as the prescription "medical food" Deplin and the supplement SAM-e.
Unfortunately, finding a successful treatment or combination of treatments for a depressive disorder is a process of trial and error, and it seems that what works best for one patient doesn't necessarily work the best for the next patient. I wish that I could tell you based on experience what medication might work best for your symptoms, but unfortunately, my treatment history consists of a lot of temporary responses, some of which have been more pronounced than others. I do hope that the posts here, including mine, could be of some help to you, and I wish you luck in getting your symptoms under control.
Tomatheus
Dx: schizoaffective disorder
Taking Abilify and 6 supplements
tomatheus.blogspot.com
poster:Tomatheus
thread:1022017
URL: http://www.dr-bob.org/babble/20120718/msgs/1022050.html