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Re: If you've always been melancholic, can ADs help? » orochi

Posted by Robert_Burton_1621 on February 16, 2015, at 20:27:58

In reply to If you've always been melancholic, can ADs help?, posted by orochi on December 7, 2014, at 11:30:07

> I'm pretty discouraged right now.
> I simply feel like there is no drug which can help me. I have been melancholic,anxious,depressed since childhood.
>

> What if antidepressants simply cannot help someone like me? My doc once said that an antidepressant is not a "happy pill" but I needed something like a happy pill. :(
>
> So far I tried without success:
> Lexapro,Wellbutrin,Ritalin,Agomelatine,Tianeptine,Remeron
>
> Currently I'm on 75mg Anafranil and I cannot say that it makes me feel any better.

Hello orochi,

I am really sorry to hear of your persistent melancholia and the absence of relief you have experienced.

How are you going now?

Have you been diagnosed with a melancholic depression?

I am no expert by any means, but the medications you have trialed so far don't seem to me as targetted to succeed in melancholic cases.

I wonder whether it is prudent for you to obtain a second opinion about your medication regimes.

In my case, I achieved a moderate response to the combination of sertraline and nortriptyline (a tricyclic). Tricyclics are more likely to be helpful to someone with a melancholic condition. The combination I was on for six months used an SNRI stratgegy but was more potent, particularly on noradrenaline, that the SNRIs with fixed relative potencies like Effexor and Cymbalta.

This was not the solution for me, but it kept me above water. But older psychiatrists attest to its effectiveness in melancholic and some psychotic depressions.

Also, it doesn't seem you've tried an MAOI. Are you confident to raise this option with your psychiatrist? Don't be discouraged if he or she dimisses it: many do not have sufficient learning of the properties of this class of drugs which have been clarified in recent years.

They are reputed to be very effective. I started on parnate 13 days ago and had a positive if mild response within 48 hours. That response is gradually improving and it is early days.

I just wanted to stress: don't give up hope on the basis of inferences drawn from the inefficacy of your previous medications. There is nothing to show from them that your chances of responding to an alternative class like a TCA or MAOI have cumulatively diminished because of the number of drugs of separate classes you have tried thus far.

Best wishes, and make a point of reminding yourself now and then that fatalistic, pessimistic, and black/white styles of thinking are characteristic of what depression does to your cognition and reasoning. If you can, try to step back from those thinking processes and interpret them as symptoms of your depression, and thus unreliable, rather than lucid assessments of the options you have available to you.


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