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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by mbailey on February 16, 2004, at 20:28:10
My husband was diagnosed with atypical depression and was taking MAOIs. But the MAOIs stopped working in fall and he crashed big time. He just bottomed out the other day and is now on his way back up. He is taking: norpramin (50 mg), lithium (900 mg). He is also on testim (1.5%).
The norpramin is scheduled to go to 75 then 100 then to 150 every two days.
Today he was told by his doc that he has refractory depression. I looked online but I couldnt really find anything on it that explained what it was.
Can someone tell me what it is? I know he takes meds, they work for a while then dont and he starts again with something new. (Usually its not so bad as it was with the MAOI.) But looking on this site it seems like that is typical.
What do you know about htis combo of meds? Has it been helpful?
Thanks!
Jean
Posted by francesco on February 17, 2004, at 6:12:01
In reply to Refractive depression and meds, posted by mbailey on February 16, 2004, at 20:28:10
If he has just depression I can't understand the reason why he's on lithium. Refractary depression doesn't mean anything, just a depression that the p-doc didn't manage to cure. Just my personal opinion anyway.
Posted by Bill LL on February 17, 2004, at 7:49:31
In reply to Refractive depression and meds, posted by mbailey on February 16, 2004, at 20:28:10
Refractory depression is just a tougher than normal case to alleviate.
Sometimes docs give up on a med instead of raising the dose to an adequate level. I wonder if this has been the case with your husband.
Lithium has a good reputation in helping with tough cases.
Posted by terrics on February 17, 2004, at 9:48:20
In reply to Re: Refractive depression and meds » mbailey, posted by francesco on February 17, 2004, at 6:12:01
Lithium is being used to treat unipolar depression too and it is helpful. Pdoc told me this and I looked in med book. terrics
Posted by Chairman_MAO on February 17, 2004, at 10:37:08
In reply to Refractive depression and meds, posted by mbailey on February 16, 2004, at 20:28:10
Norpramin + Lithium sounds like it could work. However, I'd have him drop the lithium and try adding a dopamine agonist before the lithium, although I will admit that the lithium has more data backing it up--doesn't mean it is as fun to take, though, or even more effective for your husband. It's just been around longer. Both mirapex and requip (new DA agonists) show promise as stand-alone antidepressants, augmentation agents, and mood stabilizers (requip seems to be anxiolytic in mice, too). Far too many psychiatrists never seem to try these before TCAs, etc. An MAOI + dopamine agonist is a safe and effective combination, too. I wish the pdoc hadn't dropped the MAOI, since the withdrawl is a pain and there was hope. Hell, he could've taken MAOI + norpramin + lithium.
Good luck!
Posted by c ubbybear on February 18, 2004, at 2:53:19
In reply to Re: Refractive depression and meds » mbailey, posted by francesco on February 17, 2004, at 6:12:01
> If he has just depression I can't understand the reason why he's on lithium. Refractary depression doesn't mean anything, just a depression that the p-doc didn't manage to cure. Just my personal opinion anyway.
I'm glad you said that this is your personal opinion. Fact is that refractory depression means a lot. It is depression that is terribly stubborn and resistant to treatment with several ADs from more than one group (e.g. SSRIs and TCAs). Second, pdocs don't cure depression. Chronic depression is never technically "cured;" it will go into long-term remission when treated properly, with an appropriate AD, or even ECT for the most refractory depressions.
I'm very curious, so I'll ask mbaily: what was the MAOI that pooped out on your husband--Parnate or Nardil? What was the dose he was taking and for how long?
This is the end of the thread.
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