Questions and Answers
I have been diagnosed since February of 1996 with RSD. I have also been clinically depressed for over 15 years. Before being injured in September of 1995, (the cause of my RSD), I had finally found a successful treatment for my depression. I started taking Nardil in June of 1995 and had wonderful response. Of course, the side effect was a weight gain of 40#. I just recently switched to Parnate, which is slowing the weight gain, but since starting Physical Therapy, it has been determined that the weight gain, which I carry primarily in my abdomin is aggrevating the RSD in my back and legs. I am currently taking Neurontin with good success in pain management for my RSD.
My primary question is: Is there a suggestion you might have for an antidressant, (I think I have tried them all), that would not cause the weight gain and basically has the opposite effect of the SSRUI? I have severe reactions to the SSRUI's and seem to be one of those odd patients that has the opposite reaction to antidepressants. I am very prone to anxiety, panic attacks and severe aggitation, when taking an antidepressant. I had taken desipramine for over four years and stayed pretty stable for the most part. I wonder if there was a similar drug you were aware of that would have less aggitation effects.
Thanks for your input, I really need to lose the weight in order to help my pain.
Sorry to hear about your problems - pity about the weight gain with the MAO inhibitors and the tricyclic, desipramine, an unfortunate and common feature to all of them - another common effect of the MAOI's you have experienced is Central Nervous System stimulation which will occur in some proportion of treated patients no matter how carefully the physician tailors the dosage and the patient is 100% complient.
You mention severe reactions to Selective Serotonin ReUptake Inhibitors - I wonder if those were dose-related or of an allergic nature - if the former, a possible candidate that has been used is sertraline(Zoloft) - it has a decreased incidence of CNS effects compared to others and, because of its shorter half-life (25 hours compared to 7 to 15 days for Prozac and its active metabolite), and because of its reliable pharmacokinetics in the elderly, make it an attractive alternative if you fall into that population.