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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Christina on February 12, 2001, at 19:19:22
I've been on several SSRIs for depression. Nothing seems to be helping. My doc has switched me several times and tried to augment with Ritalin, depakote and Lithium.
He's never said i was treatment resistant.. but that's how I feel.
I'm wondering if I should try MAOIs or the older trycyclics.
Does anyone have any success stories about this?
Posted by allisonm on February 12, 2001, at 19:49:54
In reply to switching from SSRIs to MAOIs or Trycyclics - HELP, posted by Christina on February 12, 2001, at 19:19:22
You only mention SSRIs. Have you tried Effexor, Remeron, Wellbutrin? I would look into those before the others.Good luck.
Posted by Phil on February 12, 2001, at 21:18:45
In reply to Re: switching from SSRIs to MAOIs or Trycyclics - HELP, posted by allisonm on February 12, 2001, at 19:49:54
I agree with Allison. Unfortunately, the best AD for me has been Amitriptyline.
If you have tried the others(Wellbutrin, Remeron, Effexor)without success, you might want to try some of the 'gentler' tricyclics first.
Lots of options out there...
Posted by shellie on February 12, 2001, at 21:51:16
In reply to switching from SSRIs to MAOIs or Trycyclics - HELP, posted by Christina on February 12, 2001, at 19:19:22
Christina. I have always had more success with an MAOI than with any other kind of antidepressant, and much fewer side effects. People shy away from MAOIs because of the dietary restrictions, but slowly I added different things on the "no" list to my diet and I've never had a bad reaction. I'm not saying don't try the tricylics, but don't eliminate
the possiblility of nardil or parnate--I've seen lots of people have success with those who haven't had success with any other antidepressant.Another suggestion would be to add lamictal to your SSRI. Lamictal is the favorite mood stablizer of my pdoc, plus two other pdocs I interviewed. Shellie
Posted by Christina on February 13, 2001, at 8:04:35
In reply to Re: switching from SSRIs to MAOIs or Trycyclics - HELP, posted by allisonm on February 12, 2001, at 19:49:54
I have tried Effexor and Wellbutrin, but I thought they were classified as an SSRI. If not, what are they?
> You only mention SSRIs. Have you tried Effexor, Remeron, Wellbutrin? I would look into those before the others.
>
> Good luck.
Posted by Christina on February 13, 2001, at 8:06:59
In reply to Re: switching from SSRIs to MAOIs or Trycyclics - HELP » Christina, posted by shellie on February 12, 2001, at 21:51:16
The dietary restrictions don't bother me regarding MAOIs, it's just that I always thought side effects with them were worse than SSRIs.
My main complaint with many ADs, especially Effexor, was extreme fatigue and weight gain.
Currenly, I am on Celexa, and I feel like it's not working.
I'm tired of the med roller coaster.
> Christina. I have always had more success with an MAOI than with any other kind of antidepressant, and much fewer side effects. People shy away from MAOIs because of the dietary restrictions, but slowly I added different things on the "no" list to my diet and I've never had a bad reaction. I'm not saying don't try the tricylics, but don't eliminate
> the possiblility of nardil or parnate--I've seen lots of people have success with those who haven't had success with any other antidepressant.
>
> Another suggestion would be to add lamictal to your SSRI. Lamictal is the favorite mood stablizer of my pdoc, plus two other pdocs I interviewed. Shellie
Posted by shellie on February 13, 2001, at 10:45:38
In reply to Re: switching from SSRIs to MAOIs or Trycyclics - HELP, posted by Christina on February 13, 2001, at 8:06:59
> The dietary restrictions don't bother me regarding MAOIs, it's just that I always thought side effects with them were worse than SSRIs.
>
Christine, I personally had many more side effects with the SSRIs. I personally didn't gain any weight with Nardil and it helped me tremendously for many years. Last year it sort of pooped out, but that was after many years of what I consider "saving my life". So now I have added lamictal. The only side effect I had from nardil was problems with sleep; I could only sleep three hours at a time and I get tired in the afternoon (like really tired). But when I added more thyroid, that helped alot with afternoon tiredness, and when my dose is low, I don't go through that intolerable sleep cycle. Otherwise, no bad effects. The only down side I can think of is that it took a full five weeks for it to kick in. But I didn't feel at all drugged while I was waiting. Of course, because I had no side effects, that doesn't mean you won't. But there are so few meds I can take, because almost everything I can't tolerate. I couldn't tolerate trycyclics (they made me feel totally disoriented) and SSRIs either had lots of side effects or didn't work for me; same with any anti-psychotic I tried to suppement Nardil.As you can probably tell, I think Nardil is a really good medication, and I had no withdrawal at all when I went off. Just crashed from depression. Shellie
Posted by allisonm on February 13, 2001, at 17:38:17
In reply to Re: switching from SSRIs to MAOIs or Trycyclics - HELP » allisonm, posted by Christina on February 13, 2001, at 8:04:35
> > > I have tried Effexor and Wellbutrin, but I thought they were classified as an SSRI. If not, what are they?< < <
According to a med source I use online (Rxlist):Wellbutrin is an antidepressant of the aminoketone class chemically unrelated to tricyclic, tetracyclic, selective serotonin re-uptake inhibitor, or other known antidepressant agents.
Effexor is a structurally novel antidepressant chemically unrelated to tricyclic, tetracyclic, or other available antidepressant agents.
Have you tried combinations of these drugs? Effexor and Remeron is supposed to be a potent combination, for example. There are lots of others. Lithium often is used to augment an AD to help it work better. Wellbutrin can be used the same way.
Shellie is right, too. MAOIs have helped a lot of people who got no relief from the other ADs. Tricyclics have also.
Good luck.
Posted by Sulpicia on February 16, 2001, at 23:40:12
In reply to switching from SSRIs to MAOIs or Trycyclics - HELP, posted by Christina on February 12, 2001, at 19:19:22
> Christina -- I've used tofranil successfully 3x and am in the process of changing from paxil back to tofranil.
I was silly, not to mention depressed, and was swayed by seductive talk of fewer side effects and faster efficacy.
It wasn't as effective, I didn't sleep well, constantly craved sugar, and couldn't run from some funny weakness
in my muscles.The only side-effect I ever experienced aside from dry mouth is ortho-static hypotension. I'm tall and have
low blood pressure to begin with so before I stand up I DO need to remember to do it slowly.
It takes a bit longer to work than the SSRIs -- but there is some physical changes [for me] in as little as
a week.I hope things work out for you.
S.
Posted by Lorraine on February 18, 2001, at 10:47:17
In reply to Re: switching from SSRIs to MAOIs or Trycyclics - HELP » allisonm, posted by Christina on February 13, 2001, at 8:04:35
> I have tried Effexor and Wellbutrin, but I thought they were classified as an SSRI. If not, what are they?
>
According to Stephen Stahl, Effexor is an SNRI--a serotonin norepinephrine reuptake inhibitor. It also effects dopimine at higher doses. Wellbutrin is an NDRI--a norepinephrine dopamine reuptake inhibitor. So both of these drugs are very different from SSRI's.By the way, Serzone (an SSRI doggy downer) is not supposed to cause weight gain or sexual dysfunction. I couldn't take it because it sedated me.
This is the end of the thread.
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