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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 Dave001 on October 3, 2004, at 19:45:48
Has anyone here gone through the usual list of anti-depressants and failing to respond, subsequently tried either Parnate or another classical MAOI without substantial benefit, but were eventually able to find relief from some other drug(s)?
If so, what's your story in a nutshell (or shell of your choice)? What was it that finally "worked"? I wonder what the distribution of non-responders to responders would look like if separated into two groups: those whom were treated for episodic depression, and those for whom depression has been chronic and for all intents and purposes, life-long. I would bet very strongly that if there were controlled studies involving only those from the latter group, the placebo response rate would be considerably lower than it typically is.
One thing that I have not seen done but think could be incredibly enlightening -- if not useful, is a collaborative effort to systematically create a categorical outline or hierarchy of medications grouped by a user-rated measure of success and the perceived symptoms which were the object of target. All the input would come from board members and could optionally be expanded to include additional Internet users. The aggregate results could then easily be analyzed by various statistical measures. The method of collecting the data would be extremely simple from a programmatic point of view. Does this sound like it would be of interest to anyone?
The actual results could be structured by a variety of means, but as a simple illustration, let's say someone is suffering from major depression with severe anxiety and insomnia. Here is a gross oversimplification of how the data could be outlined (I had to use the annoying dots because the form processing script does not properly transliterate non-breaking whitespace characters to its corresponding HTML representation " "):
<snip>
Sorry, I had to cut out the entire outline. It won't render consistently across everyone's screen.That's just an example of how the top-level *could* begin, and then you branch out like a tree into further subcategories. Each branch could include all the drugs people used in that category, and the ratio of response to the total number of people who tried a given drug or combination. Given the possibilities, it's difficult to actually describe (and even harder to illustrate graphically with ascii character keyboard input :-), but I think the concept should be pretty clear, especially for those of you with a background in any of the sciences.
Dave
Posted by Squiggles on October 3, 2004, at 21:24:30
In reply to Beyond Parnate, posted by Dave001 on October 3, 2004, at 19:45:48
I wouldn't be at all surprised if
pharmaceutical companies hold such
data and statistics, along with affiliated
insurance companies. Their samples are
likely to be larger than anything you can
get here.But it's an E for Effort :-)
Squiggles
Posted by cybercafe on October 4, 2004, at 2:30:28
In reply to Beyond Parnate, posted by Dave001 on October 3, 2004, at 19:45:48
i have seen such charts on the canadian psychiatric association and american psychiatric association websites, but i'm pretty sure they're mostly ignored by doctors> Has anyone here gone through the usual list of anti-depressants and failing to respond, subsequently tried either Parnate or another classical MAOI without substantial benefit, but were eventually able to find relief from some other drug(s)?
>
> If so, what's your story in a nutshell (or shell of your choice)? What was it that finally "worked"? I wonder what the distribution of non-responders to responders would look like if separated into two groups: those whom were treated for episodic depression, and those for whom depression has been chronic and for all intents and purposes, life-long. I would bet very strongly that if there were controlled studies involving only those from the latter group, the placebo response rate would be considerably lower than it typically is.
>
> One thing that I have not seen done but think could be incredibly enlightening -- if not useful, is a collaborative effort to systematically create a categorical outline or hierarchy of medications grouped by a user-rated measure of success and the perceived symptoms which were the object of target. All the input would come from board members and could optionally be expanded to include additional Internet users. The aggregate results could then easily be analyzed by various statistical measures. The method of collecting the data would be extremely simple from a programmatic point of view. Does this sound like it would be of interest to anyone?
>
> The actual results could be structured by a variety of means, but as a simple illustration, let's say someone is suffering from major depression with severe anxiety and insomnia. Here is a gross oversimplification of how the data could be outlined (I had to use the annoying dots because the form processing script does not properly transliterate non-breaking whitespace characters to its corresponding HTML representation " "):
>
> <snip>
> Sorry, I had to cut out the entire outline. It won't render consistently across everyone's screen.
>
> That's just an example of how the top-level *could* begin, and then you branch out like a tree into further subcategories. Each branch could include all the drugs people used in that category, and the ratio of response to the total number of people who tried a given drug or combination. Given the possibilities, it's difficult to actually describe (and even harder to illustrate graphically with ascii character keyboard input :-), but I think the concept should be pretty clear, especially for those of you with a background in any of the sciences.
>
> Dave
Posted by linkadge on October 4, 2004, at 8:41:00
In reply to Beyond Parnate, posted by Dave001 on October 3, 2004, at 19:45:48
Parnate worsened my depression, but other AD's made it better. It really depends on the person.
The combinations and permutations are infinite.
Linkadge
Posted by Nohope on October 5, 2004, at 5:53:08
In reply to Re: Beyond Parnate, posted by linkadge on October 4, 2004, at 8:41:00
Hi Linkadge.
Your response to Parnate is interesting. Maybe you could briefly describe your Parnate trial?
The reason I say this is that, in 14 yrs of trying medication after medication, I have never come across one like Parnate, where you must wait so long for a sustained response - I suspect that many people may have given up on it too soon.
When I first started at 30mg/day, there was an immediate, enormous improvement in anxiety levels. After about a week, this began to fade. After about 2 weeks, an antidepressant response kicked in that could only be described as a calm euphoria (simply wonderful). After a couple of weeks, this faded and I almost felt unmedicated. I was suspecting the worst, and investigating Nardil as a potential alternative. I then upped the dose (now at 60mg/day): exactly the same response repeated itself. However, after 2-4 weeks of the 'unmedicated' state, a strong, sustained antianxiety and antidepressant effect kicked in (and has remained).
I guess what I am trying to say is that people's response to Parnate can be complex, and it can take many weeks (for me about 10) before sustained, positive results are realized (for other medications, by about week 4 I was pretty much as good as I was going to get.) So, I am wondering if you gave Parnate an adequate trial. If not - maybe it is still an option for you?
Best of luck
Nohope
> Parnate worsened my depression, but other AD's made it better. It really depends on the person.
>
> The combinations and permutations are infinite.
>
>
> Linkadge
>
Posted by Nohope on October 5, 2004, at 6:09:10
In reply to Re: Beyond Parnate, posted by linkadge on October 4, 2004, at 8:41:00
This is the end of the thread.
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