Posted by SLS on March 13, 2013, at 7:00:43
In reply to Anyone else fail trials of the MAOIs?, posted by Roslynn on March 12, 2013, at 15:41:31
> Hi all,
>
> I have now failed trials of EMSAM, Nardil and Parnate, in that order, due to intolerable, and one dangerous, side effect. Am I the only one here unable to take an MAOI? I feel very alone and these were my last hopes.
>
> Thank you, for any input,
> RoslynnI am sure that you will get a bunch of ideas from the people here.
How do you react to lithium?
If you haven't tried combining drugs, it might be time to consider some aggressive polypharmacy. It is not rare that someone will need 4 - 5 drugs to obtain a robust therapeutic effect. I have my own favorites based upon my personal experience and what I have observed in others. When a MAOI is contraindicated, I think the following combinations are worth considering.
(Effexor or Pristiq) + Wellbutrin + Lamictal + Abilify
(Effexor or Pristiq) + nortriptyline + Lamictal + Abilify
(Effexor or Pristiq) + nortriptyline + Remeron
If it is determined that Lamictal is helpful, but not sufficient, adding minocycline may produce a more robust response. There is very little overlap in the actions between these drugs. If Remeron makes you feel worse, substituting it with prazosin might be worth a try.
I am under the impression that Pristiq has some clinical advantages over Effexor. Side effects of Pristiq might be more moderate, and its therapeutic effects occurring more frequently.
I hope Linkadge offers some input. His experience has been different from mine, and he might offer some very different ideas.
What other medical conditions have been screened for to explain your depression? Thyroid? Cortisol? Prolactin? Lyme? PCOS? Food sensitivities? CFS? Lupus? Diabetes? Kidneys? Estrogen? Progesterone? B12? Beta-blockers? Cortisone? Calcium?
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1040142
URL: http://www.dr-bob.org/babble/20130308/msgs/1040195.html