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Author Topic: A lifetime of depression  (Read 186 times)

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Offline bluerose

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A lifetime of depression
« on: March 06, 2014, 11:09:56 PM »
I've been depressed as far back as I can remember which is age 3.  I had a very abusive mother who had no business having children.  Since my mid 20's I've tried all kinds of psych meds and the only one which really worked for the depression was the MAOI Nardil.  I had really bad side effects on it, but for the first time in my life I felt so happy and the OCD thoughts faded into a tiny echo which no longer bothered me.  I would've stayed on the Nardil but it quit working.  I'm on psych meds now that relieve severe OCD and severe anxiety so that they're almost non issues.  But the darn depression still dogs me.  Some days I feel ok, or more likely parts of days and then the black mood will come sweeping in.  I feel exhausted most days when I wake up whether or not I've slept well and feel like I have to keep mentally winding myself up so I can tackle even easy chores.  I know exercise can help, but I've developed arthritis in my knee and am not able to go for my daily half hour walks anymore.  I'd like the last 10 or 20 years of my life to be happy ones.  Does anyone know of a medication that works like Nardil but is not an MAOI??  Any suggestions would be appreciated.
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Offline insights

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Re: A lifetime of depression
« Reply #1 on: March 06, 2014, 11:44:45 PM »
I'm on psych meds now that relieve severe OCD and severe anxiety so that they're almost non issues.  But the darn depression still dogs me. 

...Does anyone know of a medication that works like Nardil but is not an MAOI??  Any suggestions would be appreciated.

What medication are you now taking, and what other meds have you taken for depression in the past?

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline bluerose

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Re: A lifetime of depression
« Reply #2 on: March 07, 2014, 01:49:56 AM »
I'm now taking 20 mg. of  Lexapro which knocks out the OCD.  For anxiety I take zyprexa, clonazepam and hydroxyzine.  I know that's a lot but sometimes even with all that bad anxiety still breaks through.  I can't remember everything I've taken for psych meds, but I'll list what I can remember.  Tricyclics -- asendin, imipramine, doxepin, pamelor, anafranil.  MAOI's -- Nardil, parnate, eldapryl.  SSRI's -- prozac, paxil, celexa.  Others -- time released lithium, I believe depakote, remeron, wellbutrin, risperdal, abilify.  Natural -- valerian, St. Johns Wort, passion flower, tryptophan, tyrosine.  I also had ECT when I was in dire straights back in 1998. 
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Offline insights

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Re: A lifetime of depression
« Reply #3 on: March 07, 2014, 06:12:58 AM »
I'm now taking 20 mg. of  Lexapro which knocks out the OCD.  For anxiety I take zyprexa, clonazepam and hydroxyzine.  I know that's a lot but sometimes even with all that bad anxiety still breaks through.  I can't remember everything I've taken for psych meds, but I'll list what I can remember.  Tricyclics -- asendin, imipramine, doxepin, pamelor, anafranil.  MAOI's -- Nardil, parnate, eldapryl.  SSRI's -- prozac, paxil, celexa.  Others -- time released lithium, I believe depakote, remeron, wellbutrin, risperdal, abilify.  Natural -- valerian, St. Johns Wort, passion flower, tryptophan, tyrosine.  I also had ECT when I was in dire straights back in 1998.

Wow, that's quite a list.

I suspect that the Lexapro isn't knocking out the OCD, or doing much of anything. You were on Celexa before, I assume unsuccessfully, and it contain the same active chemical. The only difference between Celexa and Lexapro is that Celexa also contain the mostly inactive isomer too. Plus if it was having an effect on OCD it would be likely be doing a better job of controlling your anxiety levels and depression. Anxiety disorders (including OCD) and depression are differing points on the continuum of affective disorders mediated by the same underlying biology. So I think the OCD is being mostly controlled by the Zyprexa and to some extent clonazepam.

If you're taking clonazepam I don't see the point of taking hydroxyzine too. It is an antihistamine with mild anti anxiety properties which might be adding a bit extra, but nothing that upping the clonazepam dose by 0.125mg wouldn't trump. Unless you're on the maximum 20mg of clonazepam, or there is some other reason why you can't increase its dose, then upping it and dropping the hydroxyzine is going to do far more for your high anxiety levels.

As for the depression, your list doesn't include what is often, with Remeron (mirtazapine), the most powerful antidepressant for very severe depression, Effexor (venlafaxine). If it works well then you may not need anything else for anxiety either, though you may need to still take Zyprexa for OCD as it is the hardest disorder to successfully treat. However, you will probably need to take almost the maximum 300mg/day dose, and may even need to exceed it a bit for good results. Effexor doesn't become an SNRI until the dose gets up to at least 150mg/day, and many need to take 225mg before it begins to inhibit norepinephrine, aka noradrenaline, reuptake. If you, or your doctor aren't willing to go right to the edge then you could be wasting your time. Some of us just need to max out our meds to get good results.

Have you tried Nardil again since it pooped-out on you the first time? If not, it might be worth another shot. Antidepressants can sometimes come back after an absence.

There are two things you need to know about antidepressants. Firstly, they don't work for everyone. IME, about a third get very good results and essentially become symptom free, another third get moderate to good results which are enough to make taking the med worth while, but they will experience some symptoms from time to time, and the remaining third might as well take M&Ms. At least they taste good. Your long list of meds suggests you might be in the treatment resistant third. Secondly, as an added complication there is growing evidence that the more often antidepressants are stopped and restarted the less effective they become, and the greater the odds of total resistance.

I think Effexor is worth rolling the dice for again, and possibly the Nardil too, but your med options are becoming limited. Have you tried the cognitive/behavioural/mindfulness therapies? They can be at least as effective as antidepressants, though the 'rule of thirds' also seem to apply. Just a thought.

Ian

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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline stevo1111

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Re: A lifetime of depression
« Reply #4 on: March 07, 2014, 08:28:34 AM »
+1 to insights on trying the Nardil again.
 
MAOIs are generally best when administered in monotherapy, but TCAs can be administered concurrently with other things. Recently, the combinations of Pindolol (a beta- blocker) and an antidepressant or Deplin (a medical food) and an antidepressant have shown some increased efficacy.

Personally, 75mg daily of clomipramine is about 15% effective for treating my panic disoder and dysthymia, when 1mg of L-methylfolate (I guess you could call it generic Deplin, in a way)is added, it works 100%. Point being, often monotherapy is not missing the target by much. Previously, I had tried 8-9 medications with 0 success.
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