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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Girlnterrupted on May 2, 2007, at 7:48:45
I've been reading the boards and realized that it appears that the only options for atypical depression are MAOIs, and I also noticed that they poop-out sooner or later.
Is there any other option for atypical depression besides the MAOIs?
Once the MAOIs poop out, is there ANYTHING left for us? I have always doubted that therapy would help, since atypical depression seems like such a severe chemical imbalance.
I don't think I can live a life with atypical depression, so I'm really just weighing my options.
Thank you for any info.
Posted by willyee on May 2, 2007, at 7:55:31
In reply to Options for Atypical depression, posted by Girlnterrupted on May 2, 2007, at 7:48:45
> I've been reading the boards and realized that it appears that the only options for atypical depression are MAOIs, and I also noticed that they poop-out sooner or later.
>
> Is there any other option for atypical depression besides the MAOIs?
>
> Once the MAOIs poop out, is there ANYTHING left for us? I have always doubted that therapy would help, since atypical depression seems like such a severe chemical imbalance.
>
> I don't think I can live a life with atypical depression, so I'm really just weighing my options.
>
> Thank you for any info.I agree,i refuse to change my primary med from parnate as i see no viable option as a replacment.
Nardil would have been it,but the formulation change just doesent do it for me.
I think the hope remains,with either maoi,is augmentation,the best way to do this is to keep information moving everytime someone attempts this,i.e the pros and cons of the additional drug.
Until something new comes along,i spent 9 years searching.SSris are simply not for me,for the people it helps i envy them and wish them continued success,but the docs put so much pressure on me to go back i have to remeber the bag under my bed with half full srris of every kind and the damage in my life,i can say i had zero remission on a single one,so for me i simply dont know where to go either from one of the few maois but augmentation.
I guess this is just a I UNDERSTAND kinda of post.
Posted by Girlnterrupted on May 2, 2007, at 8:00:53
In reply to Re: Options for Atypical depression, posted by willyee on May 2, 2007, at 7:55:31
Thanks for your post, Willyee.
How long have you been on Parnate? How would you describe its effectiveness from 1-10?
Also, were you born with atypical depression, or was it the result of some childhood event?
As for me, I had lots of childhood trauma, but.. my siblings had similar events happen and they did not develop atypical depression, which leads me to believe that I was born with something to begin with.
Do you know if ECT might help in any way?
Thnx.
Posted by Viking on May 2, 2007, at 8:29:15
In reply to Options for Atypical depression, posted by Girlnterrupted on May 2, 2007, at 7:48:45
> Is there any other option for atypical depression besides the MAOIs?
>
I have had good success with a low dose of Reboxetine. I take 2 x 2 mg / day. Anything higher and it stops working. Sideeffects are not bad at such a low dose. See some of my previous posts. It can be combined with SSRI's or MAOI's withut problems.Some of the tricyclics are also told to be good, particular the more activating ones like Desipramine or Nortriptyline. I have no personal experience with these.
brgds
Viking
Posted by Viking on May 2, 2007, at 8:58:51
In reply to Options for Atypical depression, posted by Girlnterrupted on May 2, 2007, at 7:48:45
Just found some info on Reboxetine.
Posted by Girlnterrupted on May 2, 2007, at 10:39:59
In reply to Re: Options for Atypical depression » Girlnterrupted, posted by Viking on May 2, 2007, at 8:58:51
Thanks for your message, Viking.
So does Reboxetine actually help with atypical depression, as in, with social anxiety, extreme rejection sensitivity, etc?
Did you try MAOI's before it? How long have you taken it, and does it poop-out?
Thanx for any info =)
Posted by Viking on May 2, 2007, at 11:08:22
In reply to Re: Options for Atypical depression » Viking, posted by Girlnterrupted on May 2, 2007, at 10:39:59
> So does Reboxetine actually help with atypical depression, as in, with social anxiety, extreme rejection sensitivity, etc?
>
Yes it certainly did help me. It made it much easier for me deal with other people and it has reduced me fear of rejection a lot. I dont have anxiety as such so I cant say much about that. It also have stopped all my depressive thoughts (rumination, anger, frustration, suicidal thoughts etc) and relieved me of muscle tension and bruxism.I have taken Rebox for 1-2 month by now so it is a little early to say anything about poop-out.
> Did you try MAOI's before it? How long have you taken it, and does it poop-out?
>
I have tried Marplan but had to stop as it made me sick. Serotonergic meds have never really worked for me. The only other med that helped was Remeron but it had some bad side-effects.brgds
Viking
Posted by Phillipa on May 2, 2007, at 11:52:59
In reply to Re: Options for Atypical depression, posted by Viking on May 2, 2007, at 11:08:22
Viking I have a friend whose Parnate pooped out and is waiting to start remeron at what dose did it work and did you augment it? Love Phillipa
Posted by cubic_me on May 2, 2007, at 13:46:19
In reply to Re: Options for Atypical depression » Viking, posted by Phillipa on May 2, 2007, at 11:52:59
I have atypical depression and found Remeron worked fantastically within days. My suicidal thoughts and rumination stopped really suddenly, and I had the will and energy to do things that I hadn't been able to before. Unfortunately I put on so much weight that I couldn't continue with them (I went from a BMI of 22 to 31 in 9 weeks, which is pretty unhealthy), but I know it's there if I get into a suicidal depression again.
Posted by Ines on May 2, 2007, at 14:08:06
In reply to Options for Atypical depression, posted by Girlnterrupted on May 2, 2007, at 7:48:45
Hello,
I have atypical depression too, I soooo understand.A couple of points: one about reboxetine. I took it for 3 months and it made my anxiety MUCH worse- I know a couple of other people have posted here saying the same happened to them. So if you do have anxiety along with the depression, I'd tread carefully. When I got referred to a pdoc and I described my case to him, and mentioned I was on reboxetine, he said straight away you have to come off that, it'll only make your anxiety worse. Bingo! It had no effect on my mood either. It did activate me, but in a very retsless, uncomfortable and anxious way. It also made me have a lot of suicidal thoughts, which I didn't before.
Regards alternative treatments, is it really a fact that MAOIs poop out after a while? There seem to be a couple of people who occasionally post here for whom that hasn't happened. If you are just looking at postings on depression forums I'd be a bit careful about assuming they're representative of the wider picture, as it's likely that most people for whom it hasn't pooped out are not here, or don't post often. Just a bit of hope there.
My pdoc said that SSRIs sometimes work for atypical- they didn't for me, but that doesn't mean it wouldn't for others.
Ines
Posted by Ines on May 2, 2007, at 14:13:44
In reply to Re: Options for Atypical depression, posted by Ines on May 2, 2007, at 14:08:06
Forgot to say that there are a couple of 'alternative' treatments for atypical depression that seem to work for some people:
Selegiline (deprenyl)+DPLA - great results for some people; it's supposed to help with dopamine I think (never tried it myself)
Chromium picolinate- one clinical trial that I know of showed it was effective. I have been talking it for a couple of months and it certainly reduces my carbohydrate cravings, but can't say it has had an effect on my mood (also taking rebox, so hard to make an independent evaluation)
I'm starting parnate in a week, btw- so maybe we can share experiences/ concerns.
Posted by Girlnterrupted on May 2, 2007, at 14:52:18
In reply to Re: Options for Atypical depression, posted by Ines on May 2, 2007, at 14:13:44
Hi Ines, thanks for your reply.
I have a question for you, why are you starting on Parnate instead of Nardil? I'm curious because the consensus here seems to be that Nardil is more effective.
Also, have you tried any SSRIs? Has anything worked for you yet?
As for me, I've tried 4 SSRIs, and only Celexa worked, but just for one year. It pooped out, although I don't know if it would have pooped out if I hadn't switched to Lexapro and gone back to Celexa, which is what happened. Once I went back, it was never the same.
Thanks for any info.
Posted by Girlnterrupted on May 2, 2007, at 14:58:09
In reply to Re: Options for Atypical depression, posted by cubic_me on May 2, 2007, at 13:46:19
That sounds great and terrible cubic. Great because it worked, terrible because you gained so much weight.
Just a question: When you say it worked, did it give you some kind of hypomania? As in, feeling so comfortable with people that you couldn't stop talking and smiling? That happened to me with Celexa.
And another question:
Did you gain weight because Remeron slowed your metabolism, or because it increased your appetite? Do you think there might be away to continue it if let say, you keep a daily food log and eat only a certain amount of calories?Thanks in advance
Posted by Ines on May 2, 2007, at 15:13:23
In reply to Re: Options for Atypical depression, posted by Girlnterrupted on May 2, 2007, at 14:52:18
Hello again,
I'm starting parnate because that's what my psychiatrist decided, not my choice. But it's actually the MAOI I would have chosen to start with because I have a problem with binge eating as it is, and really don't want to make that worse, or to put on more weight.
Nothing has worked for me so far, but I haven't tried that much. I didn't have any luck with the SSRI I tried -escitalopram- it just numbed me out. I also tried St John's Wort, which is supposed to act a bit like an ssri, and that did absolutely nothing. Reboxetine was as I said in previous post. I also tried mirtazapine brief but couldn't tolerate it due to sedation and constant urge to eat. I've been depressed for 15 years, but spent most of thosenot talking about it and trying to fight it myself- stupid really.
Ines
Posted by cubic_me on May 2, 2007, at 16:26:35
In reply to Re: Options for Atypical depression » cubic_me, posted by Girlnterrupted on May 2, 2007, at 14:58:09
Remeron = mirtazipine, so it sounds like you've tried it already and had similar effects (though I didn't have the sedation problem). But I'll answer the questions anyway.
>
> Just a question: When you say it worked, did it give you some kind of hypomania? As in, feeling so comfortable with people that you couldn't stop talking and smiling? That happened to me with Celexa.No, I didn't get hypomanic at all. It was just like being "normal" - magic!
>
> And another question:
> Did you gain weight because Remeron slowed your metabolism, or because it increased your appetite? Do you think there might be away to continue it if let say, you keep a daily food log and eat only a certain amount of calories?
>I tried it twice. The first time I calorie counted and started going to the gym to try to keep the weight off, but still it went up significantly (20lb in 2 months). The second time I couldn't seem to control my eating at all, I was constantly ravenous and ate up to 6000 calories a day! It didn't help that I was working at an eating disorders unit at the time...
Good luck in finding something that works for you.
Posted by Viking on May 2, 2007, at 19:38:18
In reply to Re: Options for Atypical depression » Viking, posted by Phillipa on May 2, 2007, at 11:52:59
> Viking I have a friend whose Parnate pooped out and is waiting to start remeron at what dose did it work and did you augment it? Love Phillipa
I am not quite sure about the dose but I think it was at least 60 mg Remeron after several months. Then my doc added a little Mianserin and the next day I was completely changed (strange since Remeron and Mianserin basically is the same drug).
The result is a little bit difficult to describe. I still had the very strong sedation but at the same time I was somewhat agitated and agressive (very unlike me). It was either full speed ahead or I would just fall asleep. And I slept a lot.
Shortly after I was referred to a pdoc who changed my meds to Cipramil + Mianserin. This was more benign. Unfortunately the effect just gradually faded away and after a year or so I concluded that it did not work any more.
During that year I gained 20-30 lbs. My usual weight is 190-200 lbs so no disaster, but still ...
Not a very great success.
I did not take any other meds during this period.
brgds
Viking
Posted by Viking on May 2, 2007, at 19:41:47
In reply to Re: Options for Atypical depression, posted by Ines on May 2, 2007, at 14:08:06
I just wonder what dose of Reboxetine you were taking. It is my personal experience that the recommended dose is way too high.
brgds
Viking
Posted by Ines on May 3, 2007, at 13:14:08
In reply to Re: Options for Atypical depression » Ines, posted by Viking on May 2, 2007, at 19:41:47
Hey Viking,
I was on 8 mg initially, but then dropped to 4 mg and was on it at that dose for a couple of months. At 8 mg it was just unbearable- it got better at 4mg but never made it for me, still made me feel very anxious. I seem to remember you posted before that you didn't have a problem with anxiety. I wonder whether that could be the key... if you have anxiety to begin with it activates you in an axious wired up way but if you don't it activates you in a good way... completely wild guess. But I do know several people here had the same experience as me when on reboxetine. Just goes to show how the wonder drug for one person is all wrong for someone else....
Ines
This is the end of the thread.
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