chronic depression. Has anyone been given an older style (or any) medication that worked?

[foreverdepressed]

Name changed for this as although I shouldn't feel ashamed I do. I've suffered chronic depression on and off for 15 years. This has lead to no qualifications, no job, no friends and a crap life.

I've been though so many medications and treatments (CBT) that don't work, I sense the GP is out of ideas. Just increased my medication to the maximum dose 2 weeks ago but I feel worse.

I've been reading about how the older medications are thought to be more effective but just not prescribed much due to the risks. Has anyone tried a tricylic, MAOI, lithium, etc, with any success?

I feel like I am reading the end of the road. If I got hit by a bus tomorrow it would be a relief.

A GP might prescribe a tricyclic but won't get involved with MAOIs or lithium. At this stage I think you would benefit from a referral to a psychiatrist for more specialised treatment.

Mentalpsychiatrist your name implies you are a doctor or medically qualified, is that the case?

If so have you ever heard of anyone being given irreversible MAOI for treatment resistant depression?

My GP has in the past expressed reluctance to refer me to secondary care, I think because services in this area are not great. I wonder if it would be worth seeing a psychiatrist privately for medication advice if the GP could follow that they recommend.

Hi forever. I'm a consultant psychiatrist in the NHS and happen to have a serious mental illness myself. I've prescribed MAOIs but they're not something I prescribe routinely because the side effects and lifestyle changes they come with tend to be hard to manage.

If you can see a psychiatrist privately for a few sessions it might be worthwhile as they'll be much more familiar with treating treatment resistant depression than a GP will be.

Hi Mentalpsychiatrist, that is good to know, thanks.

My understanding is you have to avoid all food high in tyramine and certain OTC drugs when on them due to the hypertensive reaction that may happen.

I'm not hung up on getting that type of medication, it is just I came across a website by a retired clinical psychiatrist who claims they are the best thing for treatment resistant depression and how they are widely underused due to the risks being over estimated. I've tried so many other modern medications, including combinations of.

But I would give most things a go, I just don't know how to find a specialist when the GP is reluctant to refer. maybe it is different if I ask to go privately?

IndeliKate "A little too beautifully" ??

Smelly medications are the least of my worries. How did you find the dietary restrictions, easy or difficult to manage?

I'd be more inclined to look at tricyclics like imipramine or dosulepin. If you want to go private you'll need to identify a psychiatrist and get a referral letter from your GP.

Sorry I should have said I've had Amtriptyline and Lofepramine before, but I was wondering if imipramine or clomipramine be any better?

IndeliKate
thank you. unfortunately I too have learned not to trust pharmacists over the years. Luckily I don't drink or eat much cheese so that wouldn't be a problem. Chocolate though,

I've struggled with depression for many years, and started on Venlafaxine about six months ago (it's an SNRI as the SSRI's I'd tried had been ineffective). It's been very effective although I was concerned about coming off it as there seem to be issues. It keeps depression and anxiety at arms length for me, and I had tried a lot of ADs and CBT.

hi queen, I'm glad you had luck with venlafaxine, it did nothing for me even at high doses. When you come off it make sure they taper you down slowly, some doctors don't know about the withdrawal effects on venlafaxine and they can be quite nasty if you don't go slowly.

not that you should even consider stopping something that works anyway.

I was on a tricyclic Lofepramine about fifteen years ago and it was very effective . Currently on Dosulepin at night .
Much prefer the tricyclic drugs to SSRIs . Have had a relapse recently and my doc won't prescribe me tricyclics anymore sadly .

Hope something else might work for you Forever. Thanks for advice, it took me 6 months to take a punt on it because of what I'd read about coming off it!

I found chlomipramine the best ad I've ever taken....and I've taken most of them. I just couldn't stop eating on them though