when patients can't tolerat SSRI,SNRI, Welbutrin and lexaprol

[luvcthateba]

what is the next course of action for medication in patiens who have depression?

[SammyTheSnail]

There are so many studies (don't have ref's on hand) that conclude that approx. 30% of patients taking A/D's are "treatment-resistant" (formerly it was called "refractory depression," but the pharmaceutical folks like wordplay -- SSRI and SSNRI's had "withdrawal effects," but now it's "discontinuation syndrome"), and other studies not sponsored by Eli-Lilly, Wyeth et al. practically debunk the whole A/D industry, particularly their laughable pseudo-trials and placebo results (which sometimes prove more effective than the questionable chemicals foisted on the public) that I gave up on them quite a while ago.

Not to say some of these drugs are ineffective for everyone -- I know people who are doing fine on them, but searching for a "happy pill" usually means taking a dozen or so spooky chemicals for extended periods.

However, if you're thinking about MAOI's, you HAVE to let the SSRI's/SSNRI's clear your system first.

St. John's Wort, by the way (it's available in health food stores) is an MAOI, used in Europe for centuries.

But check this out with your doc. And get a second (medical) opinion.

Good luck -- depression is my life.

[Hensley258]

Ask your Psychiatrist about the new MAOI Patch that is now avalible.
It's an MAOI in a transdermal patch form.

With this new method of delivery, much of the food interaction risk is removed because the drug is delivered thru the skin rather than by tablet thru the digestive system.

This new patch is sometimes a good alternative for people that can not tolerate SSRI and SNRI medications. MAOI's are mostly used only for patients that have built of a resistance to other forms of AD medications, but this new patch (because it is safer than the old MAOI's) is fast becoming a more frequently used option for patients that can not tolerate other meds.

Above all it's important to keep in mind that all Antidepressant medications (including MAOI's) have side effects. There is not one that does not cause at least some unwanted side effects in the user.

In order to get any benifit from these types of medications, one must be willing to accept a certain level of uncomfortable side effets. If the side effects are worse than your level of Depression and anxiety then most likly the condition is not at point to where taking meds is a viable treatment.

Good luck.

[luvcthateba]

SSRI and SNRI increase my migraine frequency and severity, they are already intractable.  the others 2 I am allergic to.  

[sebastiancat]

I've had similar problems but was ok with Lexapro - or Escitalopram/Cipralex as it's called in the UK.  A few years ago I had success with one of the antidepressants from the MAOI group, I think it was called Nardil.  Unfortunately, you do have to be very careful about what you eat and drink because it can cause some very bad side effects - not a problem if you're aware of it though.