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  1. Thank you all for your kind responses. I updated my signature. Been taking clomipramine for recently diagnosed OCD and depression. On it for 2 months now started kicking in after 4 weeks. It was a subtle changed over the 4 weeks and I continue to slowly get better after 2 months. I feel like depression is rare to be in full remission fast, and takes time for your brain to heal. The efficacy of most TCAs surpass that of the 3rd gen drugs for depression in resistant patients. Tcas and maois should be prescribed more often. Remission is beautiful. *Also I have been diagnosed with persistent depressive disorder and mdd episodes on top. It got really nasty my mom almost hospitalized me.
  2. I finally caved in to trying a tricyclic medication and it's working wonders. Where SSRI or snri would only curb 30 percent of my symptoms, clomipramine is actually working! Remission is a beautiful thing. My days are full of joy now. Suicide is no more a thought. Keep pushing for full remission guys! https://www.google.com/amp/s/amp.reddit.com/r/depressionregimens/comments/816aka/clomipramine_the_gold_standard_when_it_comes_to/
  3. So recently I have been reading on supplements to help depression. Laughable I completely understand. However I recently stumbled upon a synthetic naturally occurring chemical called S-Adenosyl methionine (sam-e). I reluctantly took sam-e today knowing full well it wouldn't help my depression. (because why the fuck would some random ass supplement help.) and to my surprise it seemed to have lifted the curtains of my depression. Not a cure all, but I have literally been debilitated by my depression for years, with minimal help from countless drugs, and this was a very nice lift today. Now keep in mind sam-e is supposed to take atleast 1 week to 3 weeks to really work, and this was literally my first day taking it, but something is telling me it's not Placebo, as I am not too prone to the Placebo effect. Too lazy to post all details on sam-e, do a quick Google scholar search, it has studies for being a possible augmentation or stand alone pill for depression and a number of other ailments. Could this be what I have needed for years?? Ps. Slightly worried about possible serotonin syndrome as I am on fetzima, and abilify, however both are at lowest doses and my depression was so bad that I was willing to try anything. Maybe not maoi's yet
  4. @sming out of curiosity have you had your CRP (C reactive Protien) levels checked. You could have this chronic inflammation thing which might explain why you dont respond to meds. Try taking an anti inflammatory. see if that reliefs some depression. https://www.sciencedirect.com/science/article/pii/S0006322306012728 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050394/
  5. Any success or failures with rtms, tms, deep brain stimulation? Meds just don't seem to work well for me. My depression is chronic with dips and peaks and my cognition is impaired heavily. I do remember being knocked out violently at 5yo and 8yo, not sure if that caused some sort of brain damage. Ugh another day if this shit...
  6. You know it's the strangest thing. For whatever reason, Strattera (nri) gave me the biggest boost in energy and motivation. But unfortunately it had the poop out effect. But fetzima makes me tired. In fact all ssri type meds do. It doesn't make any sense but I guess everyone responds differently to all meds. Hopefully I can get in to see this doctor for second opinion (top 5% of pharmacology knowledge) https://www.davidwexlermd.com He's supposed to be the best of the best. Lives in la. You know it's the strangest thing. For whatever reason, Strattera (nri) gave me the biggest boost in energy and motivation. But unfortunately it had the poop out effect. But fetzima makes me tired. In fact all ssri type meds do. It doesn't make any sense but I guess everyone responds differently to all meds.
  7. Thnx! The big downside to any ssri snri is that they make me oversleep and more fatigued during the day. But I can sleep and depression are much better. Seeing a second opinion doc within a couple months. He's the best of the best but hard to get in to see. Nuvigil helps a bit but I don't think that's the best option long term.
  8. Long story short I tried parnate for 2 days. And just couldn't. Insomnia was insane! Depression became way worse. I was a shell of a human being and only pacing around helped mildly. Back on fetzima 20mg, Abilify 4mg, and lamictal I am building up the dose on. I can once say I am feeling good about things. Having that washout period and seeing how bad my depression got really gave me an outlook on things. We figured out I'm more efficient on low dose snri as higher doses caused major fatigue. Well maoi I get I won't be seeing you anytime soon. I will not miss you. Hopefully I will never need you.
  9. According to phyciatric times http://www.psychiatrictimes.com/geriatric-psychiatry/not-obsolete-continuing-roles-tcas-and-maois/page/0/1 "TCAs were found to be most effective in severe depression, especially with melancholic features. MAOIs, on the other hand, were more effective in less severe, chronic depression with prominent anxiety, without melancholic features, and often in the presence of reversed vegetative symptoms.35,36" So well a couple things. As others have stated you might want to augment ur ad with abilify, or Lamictal. However if you do not experience Lethargy, and can deal with a but of weight gain, tca's might be the best option for you. Now this is mostly a case with severe depression, since yours is dysthymia. Well i'dk I'm not a doc. So maybe bring up the options of either tca's or maois. Tbh though if you are getting some benefit from ur current AD. It's usually better to augment that one instead of jumping around different ADs as this can actually make depression worse in some cases *melancholy is a synonymous with anhedonia
  10. My depression is very hard to explain, I will do my best to. I suffer from adhd, depression, anxiety, and capd. I feel veerrrrry slow cognitively. And also have very bad anxiety and depression. Extreme lack of motivation, I have hypersomnia, and insomnia. My depression is chronic, it doesn't come or go in waves, it just is. And it sucks. Ssri and snri don't work so we are trying maoi now. My chemical imbalance most likely lies within dopamine, and norepinephrine, which is probably why most meds don't work. So back to how exactly it feels. Well put it like this. It feels like a Coke addict withdrawing from there drug, but constantly. Definitely dysphoric instead of euphoric. Or... Have you ever really been looking forward to a particular event, and everything leading up to it sounds awesome and exciting, and right as your about to go to this epic event. Last minute your told you can't go. Right there in that instant you experience a drop in dopamine. (dysphoria) ya so it's that feeling, but chronically. You release dopamine when you eat food and have sex. My depression is the opposite of that feeling. OK maybe it's not as baaaad as a Coke addict withdrawing, but it's the same principle. Starting parnate (maoi) in 2 weeks. God please let parnate make me feel even a little better...
  11. @coralreef77 I have gotten the genetic test done and am compliant with most meds, including maoi's @BiranOCD I will 100% keep yall updated on my run with parnate. I get agitated very quickly as well. I recommend you ask your doc to try and augment abilify with your current AD as not only can It potentiate your AD, it can also help with Agitation. Unfortunately it didn't help me much. Agitation it actually did help with. But everyone is different. What meds, augmentations have you tried Brian?
  12. @mikl_pls Thank you for your thourough, and thoughtful reply. You covered a lot of territory so I will respond as best as possible. In short my pdoc is a very good pdoc. He is in the top 15% in terms of his knowledge on pharmacology in his own words. He is a therapist as well. He states that he has on occasion prescribed an maoi for patients who are very med compliant and have tried various other antidepressants. He fully admits he is not an expert in the field of maoi's so what he wants me to do is try parnate 10mg, going up to 20mg if necessary. And if after doing this, If I don't get the benefit I need, then he will direct me to another psychiatrist who strictly deals with pharmacology only, and would be in the top 5% in terms of med knowledge. A second opinion essentially. Based on what my doc said, and being that many pdocs are completely uninformed or even misinformed on maoi's, it seems like it takes a serious expert, top 5% of Pdocs, who are properly informed in the field of maoi's. I'm am in my washout phase right now. Which utterly sucks BTW, not because of withdrawls, just because my depression sucks that bad. I am still taking abilify, as i have done my own research on maoi's, and just like you stated, can ease the washout period. My biggest fear is the insomnia associate with parnate, as I already suffer from insomnia. It sucks because once I do fall asleep, I can easily sleep for 16 hours. I forgot to ask my pdoc if I can take something for sleep, so once he prescribes parnate, I will ask. Hopefully he knows trazadone, and even remeron are safe with parnate. He preferred parnate over the other 2 as I suffer from adhd, oversleepping, and very low energy during the daytime. According to https://www.mdedge.com/psychiatry/article/66132/depression/mao-inhibitors-option-worth-trying-treatment-resistant-cases/page/0/1 ^Emsam is better for people who are bipolar, as you are. And parnate for endogenous depressions. Lack of energy and motivation, which I am. Thanks again for your reply!
  13. Mental illness 100 percent. My addiction is subtle if an addiction at all. Used to smoke weed every day. Drink 1 beer 4 times a week. I think my case is that my meds arnt working well so a beer or a bowl will help my depression temporarily.
  14. For vegetative symptoms the tricyclic antidepressants are considered most effective. Whereas reverse vegetative symtoms benefit most from a maoi. If you have insomnia, and anhedonia, I would second the tricyclic route.
  15. Just saw my pdoc. Will be titrating off viibryd and abilify for parnate. We both agreed the pros might out weight the cons of maoi's. From what he states emsam is not much more beneficial than your standard snri, so he thinks it's better to get a clear view on the potential of a full mao a and b inhibitor. I'm really hoping parnate eases my depression and Lethargy because I cannot handle feeling like this 24/7. My depression is chronic. Doesn't come or go in waves. It just is. And it sucks... One thing I'm afraid of is obviously the interactions but also not sleeping well. As if I get no sleep It makes everything worse.
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