[Danny Leary]

I'm diagnosed GAD, SAD, agoraphobia. Today was my first appointment with my new psychiatrist. I told him I wanted to try Nardil; I've already tried 4-5 SSRI's, 2 SNRIs, and an assortment of other medications. I've done a lot of research on Nardil and it sounds like the best medication for me. He said he is open to going down that path but he would like to try Lamictal first because of Nardil's food restrictions.

Before I even mentioned Nardil, he took notice of all the SSRI's I've been on and said he won't be trying those anymore as they aren't working... I was extremely relieved to hear this. The insistence on beating the dead horse that is SSRI's is partly why I ditched my previous psychiatrist.

I'm extremely skeptical Lamictal will do anything for me, but I decided to humor him and agree. I was so relieved to hear him say he's open to trying Nardil that I took it for what it was, didn't want to sound irrationally dead set on Nardil and scare him into changing his mind.

I feel like if I pressed him he might have agreed to start Nardil straight away, but I was too worried he'd change his mind. Guess I'll have to wait a month or two to see how it goes. Very sick and frustrated about how many months it takes to get an appointment and then waiting more months to try a new med, but it is what it is.

[pinkflower17]

Originally Posted by Danny Leary

I'm diagnosed GAD, SAD, agoraphobia. Today was my first appointment with my new psychiatrist. I told him I wanted to try Nardil; I've already tried 4-5 SSRI's, 2 SNRIs, and an assortment of other medications. I've done a lot of research on Nardil and it sounds like the best medication for me. He said he is open to going down that path but he would like to try Lamictal first because of Nardil's food restrictions.

Before I even mentioned Nardil, he took notice of all the SSRI's I've been on and said he won't be trying those anymore as they aren't working... I was extremely relieved to hear this. The insistence on beating the dead horse that is SSRI's is partly why I ditched my previous psychiatrist.

I'm extremely skeptical Lamictal will do anything for me, but I decided to humor him and agree. I was so relieved to hear him say he's open to trying Nardil that I took it for what it was, didn't want to sound irrationally dead set on Nardil and scare him into changing his mind.

I feel like if I pressed him he might have agreed to start Nardil straight away, but I was too worried he'd change his mind. Guess I'll have to wait a month or two to see how it goes. Very sick and frustrated about how many months it takes to get an appointment and then waiting more months to try a new med, but it is what it is.

Frustrating he wants to try lamictal first ( I don't think much of it, but some people have responded really well), but really cool he's willing to try nardil. I've always wanted to try the MAOIs, especially since they're so effective for eating disorders. If you remember, and you end up switching, will you let me know how it turns out for you?
Thanks. Hope it works out.

[PinkFlamingo99]

I'm on Parnate now (it's been about a month) and just getting to a therapeutic dose, but I think it's already helping so I'm really pro MAOIs now.

Lamictal was the other option I was given, and I know it's held in high regard. I agree with you about SSRI's and why I switched pdocs.

[Danny Leary]

Thanks for the replies. I'm already having some interesting effects from the Lamictal. I am noticing a subtle lifting of my depression. I don't think it's environmental, it's definitely a medicated feeling. While its very small, it definitely is an improvement and a vastly different feeling then the way SSRI's make me feel. I also feel a little bit sedated, not tired in a sleepy sense but still sedating. A little bit dizzy, shallow breathing, speech is a little bit more difficult but it's extremely subtle and very tolerable. It's sort of similar feeling-wise to a moderate dose of Benadryl/Unisom (dextromethorphan) but more mild in the sleepiness category. Yesterday I had itchiness all over my body, especially on my scalp. The itchiness appears to have subsided today. I know my doctor told me to look out for a rash because it can become serious and require hospitalization, so the itchiness has me a little concerned but I think I will be fine.

So far it's done absolutely nothing for my social anxiety and agoraphobia. I am interested in possibly keeping this on board and combining this with Nardil, if my doctor is willing.

[Lauliza]

I went to a new pdoc years back for the same reason - I needed someone willing to take chances. He out ms on Nardil and stimulants which worked beautifully for my depression and social anxiety. I'll warn you that I had an issue with weight gain and had to stop but the same might not be true for you. I was on Parnate too and while it worked Nardil was far superior. I'm glad your doctor is open to it- I wish more doctors were. I really think they are under utilized and so many people would find relief from serious anxiety and depression. I've been on all the SSRIs too and while they help in their own way there is really no comparison for social anxiety.

[PinkFlamingo99]

Originally Posted by Lauliza

I went to a new pdoc years back for the same reason - I needed someone willing to take chances. He out ms on Nardil and stimulants which worked beautifully for my depression and social anxiety. I'll warn you that I had an issue with weight gain and had to stop but the same might not be true for you. I was on Parnate too and while it worked Nardil was far superior. I'm glad your doctor is open to it- I wish more doctors were. I really think they are under utilized and so many people would find relief from serious anxiety and depression. I've been on all the SSRIs too and while they help in their own way there is really no comparison for social anxiety.

What did you notice in differences between Parnate and Nardil?

[Lauliza]

I found that while Parnate was great for lifting depression, it didn't help as much with the anxiety as Nardil did. I also had serious water retention and weight gain- about 35 pounds total. My doctor and I decided it was best I come off Parnate because of this.

Also, for what it's worth, I went on Lamictal after coming off Parnate. Like you I found it helped with the mood stability, but did nothing at all for social anxiety. I had some cognitive side effects too, so while it's not the case for everyone and probably dose dependent, it is something to watch for. I also had a rash or sorts with small bumps that were pretty painful. I actually thought I had shingles but the doctor said it was probably a rash from the Lamictal (which I didn't think of for some reason). That did go away right after I stopped taking it.

Right now I take 20-40 mg Prozac and 60mg adderall daily (and klonopin a couple of days a week), and this is he best combo after Nardil. I highly recommend trying Nardil however, since it really is the best med out there for our specific symptoms (if you can tolerate it of course). My dad took not for 30 years and wouldn't try anything else because it worked so well. He was agoraphobic and had severe depression and social anxiety, but with Nardil he was a different person and it really changed his life so much for the better. I don't understands why doctors are so reluctant to give a medication that has such a high success rate. Even with the risk, fatalities are extremely rare. I wonder if they just don't want to be bothered with the monitoring required when you have patients on meds like this. It's more work I suppose but it seems worth it to me.

[Danny Leary]

Originally Posted by Lauliza

I found that while Parnate was great for lifting depression, it didn't help as much with the anxiety as Nardil did. I also had serious water retention and weight gain- about 35 pounds total. My doctor and I decided it was best I come off Parnate because of this.

Also, for what it's worth, I went on Lamictal after coming off Parnate. Like you I found it helped with the mood stability, but did nothing at all for social anxiety. I had some cognitive side effects too, so while it's not the case for everyone and probably dose dependent, it is something to watch for. I also had a rash or sorts with small bumps that were pretty painful. I actually thought I had shingles but the doctor said it was probably a rash from the Lamictal (which I didn't think of for some reason). That did go away right after I stopped taking it.

Right now I take 20-40 mg Prozac and 60mg adderall daily (and klonopin a couple of days a week), and this is he best combo after Nardil. I highly recommend trying Nardil however, since it really is the best med out there for our specific symptoms . If you can tolerate it of course. It really is the one med that seems to change lives. My dad took not for 30 years and wouldn't try anything else because it worked so well. He was agoraphobic and had severe depression and social anxiety, but with Nardil he was a different person and it changed his life.

Thanks, great to hear your father was doing well.

Question about the cognitive problems - how do you mean? I noticed something funny the other day. For some reason I threw out my bottle of medication in the trash, it was like a second nature "do it without thinking" thing. Shortly after, I realized I couldn't find my medication and had to dig through the trash to fish it out.

Also, I play slide guitar, and when I was playing I noticed it felt wrong. Then I realized I put the slide on the wrong finger! I am extremely proficient, so doing something like that is highly unusual for me. Were your cognitive symptoms similar?

[Lauliza]

Yes, very similar. The first thing I noticed was losing my car keys. I had come in as usual and put them somewhere, but couldn't remember where. Like you I searched everywhere and even went through all the trash but I never found them. This happened soon again with my cellphone. The thing that stood out as different was that I couldn't re trace my steps to even attempt to locate either the cellphone or keys. I felt like I had "lost time" without actually blacking out, if that makes any sense. I was losing my vocabulary and making mistakes at work too. I told my pdoc that I felt like I was becoming stupid and was really distressed by it. He took me off it immediately.

[Danny Leary]

Update - second week in I upped the dose of Lamictal to 50mg, third week now and it's 75mg (doctor approval). I am definitely noticing an increase in the effect it is having on my anhedonia. It also makes me feel a little uncoordinated, and again, I am noticing cognitive things (losing things, confusion), but bizzarely, there's also positives, like increased focus. If upping the dose will only continue to increase the things I am currently feeling, it's helpful, but I don't think it alone will make me functional.

My next doctor's appointment is only with an underling to my psychiatrist (backlog - the disadvantage of seeing a reputable doctor at a reputable agency), so I don't know if she'll be willing to start Nardil, but I definitely want to start it ASAP.