Posted by jd on February 18, 2000, at 1:37:38
In reply to maoi or bust, posted by ryan_s on February 17, 2000, at 0:31:29
Hi Ryan,
I was one of the people who replied to your original post about finding a pdoc willing to prescribe MAOIs. (As I said there, any pdoc who is really experienced with refractory depression will likely consider them useful meds for many patients.) Because they affect many neurotransmitter systems at once (particularly dopamine), MAOIs are probably far less likely to cause the "emotional numbness" associated with SSRIs. As for distinctions between the individual MAOIs, Nardil is often considered as the best for people who have significant anxiety--the major drawback is the weight gain it very often causes. (This can be a real dilemma, because Nardil can be extremely effective for some people who respond to nothing else.) On the other extreme is Parnate, which is usually considered the most activating and energizing--it rarely causes weight gain, but it's probably not the best first choice for people with insomnia or serious anxiety. Marplan is often said to be somewhere *between* Nardil and Parnate, though it's perhaps a bit closer to Nardil on most counts. (It's not as well-known a med as Parnate or Nardil.) As for your other question about combining MAOIs with meds like zyprexa or seroquel, this is probably not done very often, but I don't think it's completely off-limits the way SSRIs are in combination. I have seen one reference to nardil being used along with risperdal, which is more or less in the same class as the meds you mention. Combining such meds with an MAOI is a pretty delicate art, so a pdoc will probably be reluctant to try it unless there is a very compelling reason.Hope all goes well for you finding a pdoc responsive to your needs and concerns!
best,
jd
> i have tried almost all of the ssri's with no avail and want to try an maoi, but first i have some questions on its effectiveness. if someone has had any experience with marplan, nardil, or parnate, please reply to this message. first, do the maoi's numb emotions like the ssri's? second, can maoi's be combined with zyprexa or seroquel? third, do the maoi's, in general, have the reputation of producing a sense of well being in the patient. fourth, if you have tried nardil, parnate, or marplan, which do you prefer. please tell of your experiences with maoi's, because i am all ears. write your heart out. a response will be greatly appreciated. hopefully the maoi's will give put me in the right direction in life.
>
> ryan
poster:jd
thread:21954
URL: http://www.dr-bob.org/babble/20000209/msgs/22210.html