Psycho-Babble Medication Thread 889185

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treatment resistant depression and anxiety

Posted by deerock on April 7, 2009, at 9:57:49

ive been getting treated for years. here is what i have tried and what the effects are. i am not only on klonopin.
im seeing pdoc tomorrow. not sure what to ask for. please make any suggestions.

depakote - helped me feel more grounded and calm, weight gain stopped
neuroleptics made me worse
effexor, helped. high doses made me agigtated.
prozac, felt nothing.
lexapro got better than felt agitated
trileptal got better. then felt it pooped out.
benzos, help with anxiety, not depression
lamictal- did nothing
straterra was horrible made me feel suicidal
ritalin helps me focus but doesnt help depression

 

Re: treatment resistant depression and anxiety deerock

Posted by myco on April 7, 2009, at 12:55:55

In reply to treatment resistant depression and anxiety, posted by deerock on April 7, 2009, at 9:57:49

If anxiety is your primary symptom coupled with a depression state that may or may not be there all the time....or you have symptoms of excessive worry and social issues like social anxiety and/or generalized anxiety....I would recommend, as I dont see it on your list, a MAOI.

In fact Nardil is the preffered MAOI for people who suffer anxiety as a root cause with depression as a "side effect" or result of anxiety. You can research about 'atypical depression', 'social anxiety (SAD)', generalized anxiety (GAD)'...you will see nardil over and over again the literature.

See many people who are considered "treatment resistant" have not actually been investigated for 'atypical' signs or their dr's are not open to the use of MAOIS.

Ask his/her opinion about Nardil or Parnate...first Nardil though...start their based on your symptoms...if you are more heavily depressed with little anxiety then parnate. Nardil is an excellent med for anxiety and panic. Loosens me up tons.

I do find it odd that MAOIS do not appear on your list since youve deemed yourself "treatment resistant"....studies show that no one should be classed as this until they've had a trial of MAOI's. Nardil...ask.

:o) Let us know how it goes

Myco
--------------


> ive been getting treated for years. here is what i have tried and what the effects are. i am not only on klonopin.
> im seeing pdoc tomorrow. not sure what to ask for. please make any suggestions.
>
> depakote - helped me feel more grounded and calm, weight gain stopped
> neuroleptics made me worse
> effexor, helped. high doses made me agigtated.
> prozac, felt nothing.
> lexapro got better than felt agitated
> trileptal got better. then felt it pooped out.
> benzos, help with anxiety, not depression
> lamictal- did nothing
> straterra was horrible made me feel suicidal
> ritalin helps me focus but doesnt help depression
>

 

Re: treatment resistant depression and anxiety

Posted by Phillipa on April 7, 2009, at 13:20:00

In reply to Re: treatment resistant depression and anxiety deerock, posted by myco on April 7, 2009, at 12:55:55

Luvox and read Lar's article above. Love Phillipa

 

Re: treatment resistant depression and anxiety

Posted by bleauberry on April 7, 2009, at 17:05:58

In reply to treatment resistant depression and anxiety, posted by deerock on April 7, 2009, at 9:57:49

I agree with the MAOI suggestion. Not many doctors are up on them these days except the ones that really know what they are doing. Doctors who don't know them well dramatically blow the risks, dangers, side effects, and diets way out of proportion to reality. Nardil and Parnate are gold standards, nothing like anything you've tried before.

If you can't get a prescription for those, consider finding a second opinion from someone who will.

Another option. Return to Depakote. Add to it Zoloft and Nortriptyline, not one or the other. Both.

Of course, any choice we all make, and our doctors make, is nothing more than an educated guess. You kinda have to go where the odds look the best. We don't really know much about you or your history, and we are not doctors, though some people here are better than doctors, but we get to play doctor in our efforts to help others through their troubles and confusions. That said, my pretend prescription pad in this 5 minute consultation says:
Nardil or Parnate or Zoloft+Nortriptyline(+Depakote).

 

Re: treatment resistant depression and anxiety

Posted by desolationrower on April 8, 2009, at 9:01:53

In reply to Re: treatment resistant depression and anxiety, posted by bleauberry on April 7, 2009, at 17:05:58

yeah there might be other things you could figure out might be helpful but MAOI is pretty much always the right answer for pseudo- treatment resistance (not responding to an MAOI=real TRD, sign up for ECT)

-d/r

 

Re: treatment resistant depression and anxiety

Posted by bleauberry on April 8, 2009, at 17:03:31

In reply to Re: treatment resistant depression and anxiety, posted by desolationrower on April 8, 2009, at 9:01:53

> yeah there might be other things you could figure out might be helpful but MAOI is pretty much always the right answer for pseudo- treatment resistance

>"(not responding to an MAOI=real TRD, sign up for ECT)"
>
> -d/r

I must politely humbly respectfully disagree, but keep in mind I am pounding my fists on the table as I say that. :-)

If MAOIs do not work, there are several avenues I would suggest, but ECT is not on that list. As an ECT survivor, and ECT failure, an ECT studier, and an ECT critic, I am obviously biased. Set that aside for a minute. Cost was $22,000. Memory loss was, and is, massive. The response rate and remission rate is not better than meds. The relapse rate is extremely worse than meds, with 85% of responders relapsing within 4 weeks.

Try Parnate, Nardil, or Zoloft+Nortriptyline. When those are exhausted, then reconsider. But to be treatment resistant after all three of those has a very low percentage of happening.

In the meantime, go to PsychoTropical.com and read the writings of Dr Gillman. You can come up with good stragegies and ideas there.

ECT = no.

 

Re: treatment resistant depression and anxiety

Posted by Emily Elizabeth on April 8, 2009, at 20:32:02

In reply to Re: treatment resistant depression and anxiety, posted by bleauberry on April 8, 2009, at 17:03:31

It might be too late, but I just wanted to tell you what I take, as I struggle with the same two conditions. I take: 20 mg Lexapro, 15 mg Abilify, and 600 mg Lithium. I must say I have been doing pretty well. The Abilify really made the difference for me. The lithium got me about 1/2 way there. I'm not sure that the Lexapro does much, but I think my pdoc figured I should be on an SSRI too.

Good luck!

Best,
EE

 

Re: treatment resistant depression and anxiety

Posted by desolationrower on April 9, 2009, at 6:50:46

In reply to Re: treatment resistant depression and anxiety, posted by bleauberry on April 8, 2009, at 17:03:31

by the time someone gets an maoi, they've tried those combinations at least once before.

-d/r


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