Posted by malcolm64 on May 11, 2007, at 21:57:29
In reply to Re: Parnate at 30 mgs - still nothing » malcolm64, posted by Jedi on May 11, 2007, at 21:05:58
> > Yes, I was on Phenelzine (Nardil) about a year ago, had a fantastic reaction to it, but it pooped out after just 3 weeks. I don't remember augmenting it with Clonazepam (except possibly at night to help me sleep). The fantastic thing about Nardil when it first worked was that I could have cared less whether someone was friendly to me or blew me off - I was happy regardless. But now the slightlest rejection is painful.
>
> Malcolm,
> Forgive me for my less than acute memory. I now recall that you had posted about your Nardil experience. Ten years of fighting major atypical depression and social anxiety with 40+ combinations of meds has left my mind just a little mushy.
>
> One of the symptoms of atypical depression is rejection sensitivity. Before MAOIs and clonazepam the slightest critisism would wipe me out. I say major depression for ten years, but I fought dysthymia with the social anxiety for another twenty-five years before that. It seems to have started about the time I started high school. When greeting someone my hands would be so sweaty, I would have to wipe them on my pants before shaking hands.
>
> > I still don't understand how a mere medication could so completely wipe away feelings of shame and angst. Hell, when the Nardil first worked, I actually enrolled in a bartending class as a way to make some fast cash. Imagine me, as a bartender!!? I never would have thought in a million years that that was something I could actually do, but the Nardil caused such a miraculous transformation of my personality it was unbelieveable. Needless to say, I dropped out of the class when it became clear that the Nardil effects wouldn't last. And that ended my flirtation with bartending. Never again.
>
> Nardil did exactly the same thing for me. The lifting of the depression and anxiety was indeed euphoric. I think your mistake was believing that this touch of hypomania was going to last forever. When the mania went away, you interpreted that as a loss in efficacy of the Nardil. I wish I could have kept that feeling also, but that was not the true antidepressant effect. For me also, augmenting with clonazepam increased the affect on GABA and really helped with the social anxiety. IMHO if you would of stayed on the Nardil things would have been much better for you. I'm one to talk though, this is my fourth time off Nardil in ten years. The other three times the major depression returned withing several months. Something about how my body reacts with Nardil causes the intense sweet carbohydrate cravings. At one point I was 110 pounds above my normal weight. Parnate doesn't do this to me. I just hope it will hold off the major depression.
>
> > The one thing that continues to piss me off about my doc is that he NEVER told me that the euphoria wouldn't last. I'm still seeing him, b/c he and I have an established, caring relationship for many years, but it still pisses me off that he never told me. Which leads me to believe that he had no real experience with MAOI's to begin with.
>
> > And if he did, why the hell did he wait until I nearly died after OD'ing on 40 tricyclic tabs when there was a med (MAOI's) that had been available for decades before trying it with me. And I was the one who suggested it to him, not the other way around.
>
> > It's a still a sore subject with me.
> > Malcolm
>
> The euphoria side effect(hypomania) is supposed to be quite rare with Nardil. From the postings on this board, which really represent more treatment resistant patients, it seems to be quite common. |I don't know if there is any kind of connection.
>
> Many PDOCS really fight the use of MAOIs. They will do several trials of SSRIs, SNRIs, tricyclics, some even ECT before a trial of MAOIs. Again, IMHO MAOIs should be a 2nd tier treatment for atypical depression; not a last resort.
> Get Well Soon,
> Jedi
>
>Well, again I don't think the term "MAOI inhibitor" was on his radar screen as far as meds go; again, I had to suggest it to him. I sent him a rather blunt e-mail a couple of days ago and his response was that "I doubt that five years ago I, or anybody else, could have done anything different to prevent the suicide attempt. Given that many times I have gone beyond the call of duty with you, insinuating that another medication might have made a difference is pretty nasty."
He's certainly right about him going well beyond the call of duty with me (being receptive to phone calls, charging me 1/2 of his regular fee, etc), and he admits later in the same e-mail that "I have never billed myself as an expert on medications. Although I have a reasonable good knowledge, and more than anything else, a lot of experience in handling medications, my strongest competencies are as a psychotherapist."
I don't mean to sound ungrateful (and I sent him an email response apologizing if it came across that way), but there's also this sense that if meds weren't his competency, why the hell didn't he refer me to someone who had more experience in that area YEARS ago? I've felt that we've spent week after week rehashing the same issues over and over again, and nothing changes! Since I can't change my personality through sheer force of will power (and lord knows I've tried), it will take the right combo of meds and psychotheraphy for things to change.
As I see it meds don't do the work for you, you still have to do the work on changing yourself, but they make it possible for you to attempt the change. It's like the short-lived experience with the Nardil. It didn't create my sunny disposition, but allowed it to come forth from behind the clouds. If I had had been a nasty person, I would probably have remained nasty even while Nardil was at its peak.
So I'm not expecting any med to all of a sudden change my personality. What I'm hoping for is that it will allow the Malcolm that's been hidden for most of my life to finally shine.
Isn't that all any of us can really expect any of these meds to do?
Malcolm
poster:malcolm64
thread:757515
URL: http://www.dr-bob.org/babble/20070509/msgs/757995.html