Question:
Does anyone have any suggestions for treatment of atypical
depression, the kind where you sleep and eat too much? I read somewhere
that the monoamine oxidase inhibitors such as Nardil are most effective
with this type of depression. Any thoughts?
Answer:
The effectiveness of phenelzine (Nardil) for treating atypical
unipolar depression was first established in the early 1980s.
I think the SSRIs (selective serotonin reuptake inhibitors) are
currently considered to be a better first choice for this type of
depression as compared to tricyclics. You should be aware,
however, that bipolar depression (the depression that occurs as
part of bipolar affective-disorder / manic-depression) resembles
atypical depression a great deal. Tranylcypromine (Parnate),
another MAO-inhibitor, is generally thought to be more effective
for this condition. It might therefore be important to first
establish whether or not you are bipolar before choosing a
treatment strategy. However, if you fail to respond to one MAOI,
you might still respond to another.
Bupropion (Wellbutrin) is another drug that has proven itself
valuable in treating bipolar depression.