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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by sregan on August 13, 2010, at 9:39:21
Please,
I need a recommendation.
I believe the depression is atypical because I can enjoy myself when out of my regular routine. Just went on vacation and had a great time and many normal days.
Back in my normal routine depressed again. Even worse than before vacation.
I've previously tried Wellbutrin with some success. I felt somewhat better but I ended up getting fairly agressive tendencies (from the NE?). Doc kept wanting me to increase from 150's to 300's...Maybe that would have helped?
Just tried LDN which didn't help, seems anything that might boost my immune system makes me feel worse.
I've tried Prozac, Paxil, Effexor (SSRI's just don't work. The Prozac was the worst week of my life).
Tried imipramine..The 3rd day was terrific...after that worsening of symptoms.
Amitryptyline in low dose can help me sleep and does Flexeril.
I think I am suffering from some form of PTSD also.
Symptoms are mostly depression with some anxiety at times.
Posted by Phillipa on August 13, 2010, at 10:39:44
In reply to Please! Need AD recommendation for Atypical depres, posted by sregan on August 13, 2010, at 9:39:21
I'm glad you had a great time on vacation. Could it be that you're in a rut when back home hence feeling worse again? Just a thought. Phillipa
Posted by sregan on August 13, 2010, at 12:17:10
In reply to Re: Please! Need AD recommendation for Atypical depres » sregan, posted by Phillipa on August 13, 2010, at 10:39:44
> I'm glad you had a great time on vacation. Could it be that you're in a rut when back home hence feeling worse again? Just a thought. Phillipa
Yes, I'm in a rut, life for many is a rut. I have a large burden to bear and also have to deal with my depression/anxiety. If life could be a vacation I would be cured! Is there a pill for that?
My depression has been happening for over 7 years. Better and worse at times. Life events/stress or lack of have a definite influence in the way I feel.
Posted by ed_uk2010 on August 13, 2010, at 12:44:22
In reply to Please! Need AD recommendation for Atypical depres, posted by sregan on August 13, 2010, at 9:39:21
>Back in my normal routine depressed again...
What is it about your normal routine which contributes to your depression? How could you change this?
>Just went on vacation and had a great time
I get the impression that perhaps you do not need a different antidepressant. You say that most the ADs have not helped. Perhaps what you need is help with changing your 'routine' so that your depression is relieved. Could you see a therapist/psychologist at all?
Posted by sregan on August 13, 2010, at 13:46:07
In reply to Re: Please! Need AD recommendation for Atypical depres, posted by ed_uk2010 on August 13, 2010, at 12:44:22
> >Back in my normal routine depressed again...
>
> What is it about your normal routine which contributes to your depression? How could you change this?
>
> >Just went on vacation and had a great time
>
> I get the impression that perhaps you do not need a different antidepressant. You say that most the ADs have not helped. Perhaps what you need is help with changing your 'routine' so that your depression is relieved. Could you see a therapist/psychologist at all?Mostly job stress, I provide for a wife and 3 kids. Changing jobs won't help I need a career change.
I'm NOT currently on an AD...I want to get something that will work.
I've tried therapy for 6mos+ didn't resolve the issue. I think there's HPA damage. The kind that some AD's are supposed to repair.
Posted by ed_uk2010 on August 13, 2010, at 15:01:19
In reply to Re: Please! Need AD recommendation for Atypical depres » ed_uk2010, posted by sregan on August 13, 2010, at 13:46:07
>Changing jobs won't help, I need a career change.
Would a career change be possible? If your current job is contributing to your illness, a change in career has to be considered. So long as you are in a job which is causing you severe stress, no antidepressant drug is likely to be very effective.
>I've tried therapy for 6mos+ didn't resolve the issue.
The thing about therapy is that there are many different types of therapy....and many different types of therapist. Just because one therapist couldn't help doesn't mean that a different therapist wouldn't be able to help.
>I think there's HPA damage.
If your body was damaged, how did you have such a good time on vacation? Just a thought.
I get the impression that your depression is the result of your extremely stressful circumstances. Without a change in circumstances, it's not going to be easy to treat. ADs can only do so much.
Posted by Phillipa on August 13, 2010, at 19:42:05
In reply to Re: Please! Need AD recommendation for Atypical depres, posted by ed_uk2010 on August 13, 2010, at 15:01:19
I do have to agree with Ed Phillipa
Posted by sregan on August 13, 2010, at 22:51:31
In reply to Re: Please! Need AD recommendation for Atypical depres, posted by ed_uk2010 on August 13, 2010, at 15:01:19
Please if anyone has any drug recommendations....I'm in the US by the way...
Posted by Tomatheus on August 14, 2010, at 0:06:28
In reply to Re: Please! Need AD recommendation for Atypical depres, posted by sregan on August 13, 2010, at 22:51:31
sregan,
There is some research that suggests that MAOIs tend to be more effective than tricyclics in treating atypical depression. Specifically, Nardil and Parnate tend to show efficacy in treating atypical depression, but I am also aware of some evidence showing that selegiline may be helpful for patients with atypical features.
Tomatheus
Posted by Tomatheus on August 14, 2010, at 0:31:35
In reply to Re: Please! Need AD recommendation for Atypical depres » sregan, posted by Tomatheus on August 14, 2010, at 0:06:28
Here's a reference to a review article suggesting that MAOIs tend to be more effective than tricyclics in treating atypical depression:
Thase, M.E., Trivedi, M.H., & Rush, A.J. (1995). MAOIs in the contemporary treatment of depression. Neuropsychopharmacology, 12, 185-219. Abstract: http://tinyurl.com/273mhw7
And a reference to a study suggesting that selegiline may be effective for atypical depression:
Quitkin, F.M., Liebowitz, M.R., Stewart, J.W., McGrath, P.J., Harrison, W., Rabkin, J.G., et al. (1984). L-deprenyl in atypical depressives. Archives of General Psychiatry, 41, 777-781. Abstract: http://archpsyc.ama-assn.org/cgi/content/abstract/41/8/777
Posted by sregan on August 15, 2010, at 21:09:43
In reply to Re: Please! Need AD recommendation for Atypical depres » sregan, posted by Tomatheus on August 14, 2010, at 0:06:28
Tomatheus
Thank you, just what I'm looking for. I was reading some posts here about both of those recently. Nardil apparently works well for those it works for. There is a side effect of serious weight gain it seems. I'll do a little research on the two and decide if either is for me.
Thanks again.
> There is some research that suggests that MAOIs tend to be more effective than tricyclics in treating atypical depression. Specifically, Nardil and Parnate tend to show efficacy in treating atypical depression, but I am also aware of some evidence showing that selegiline may be helpful for patients with atypical features.
>
> Tomatheus
Posted by bearfan on August 17, 2010, at 20:54:53
In reply to Re: Please! Need AD recommendation for Atypical depres » Tomatheus, posted by sregan on August 15, 2010, at 21:09:43
I'm in the same boat as the poster. People talk about the maois but its not easy to get it rxed or deal with the lifestyle changes
This is the end of the thread.
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