Posted by Questionmark on November 26, 2004, at 11:46:18
In reply to Re: Finding a pdoc who prescribes MAOIs, posted by CareBear04 on November 26, 2004, at 0:17:40
> hey questionmark,
> i'm wondering the same thing about doctors and MAOIs. i've been through most all of the new generation antidepressants. the expert psychopharmacologist i consulted said tricyclics are evil for bipolar patients, ruling those out. i asked about MAOIs, and he said they're an option, but he was concerned about the side effects and interactions. i feel willing to take on the risks. i know that MAOIs can be powerful meds for depression, I'm conscientious and don't eat most of the restricted foods, anyway, and i'm not suicidal and not about to use the drugs to cause death. most all of the psychiatrists i've seen are too young to have been around before SSRIs and such, and they are super-wary of the old. it's like my experience recently with lithium. i've been getting very toxic at low doses and no doctor has been able to explain it. when i started to crash, i saw about four psychiatrists who agreed that lithium was needed in theory, but only one was willing to write the script. i think it's the same with MAOIs-- good in theory but risky in practice-- and i don't know how to find a doctor who is willing to try them with me. if you find out, please let me know. cb
Yeah, i understand what you're saying. It's so frusterating. It's so frusterating for mE to even hear about this stuff with other people. It drives me nuts. But..
Yeah, here are potentially worthwhile suggestions: try to find a pdoc who-- if you can find out-- is willing to prescribe MAOIs, or if you are not able to determine this about any, then try to see the oldest pdoc you can find (most everything else being equal, at least). The older doctors, as you basically pointed out, are much more likely to prescribe an MAOI. Next, after you have a psychiatrist, tell him/her that you want to try an MAOI and that you have tried many of the newer medications, etc. And if s/he is reluctant, show him/her as many positive research articles on an MAOI as you can, as well as even good nonresearch articles such as the one from a webpage that was given by someone previously in this thread (www.currentpsychiatry.com/2002_06/06_02_maoi.asp). But be sure to try and act as innocent and nonconfrontational and etc. etc. etc. as possible (because many psychiatrists react very poorly to a patient who tries to direct his own treatment or questions the judgement of the doctor a lot and such-- quite unfortunate but it's true in my opinion). After doing that, and after being as patient and courteous (etc.) as possible, if the doctor still wants to prescribe something other than an MAOI, then (unless you want to try it) tell him/her that you do not want [prescribed] drug and will no longer be seeing him/her anymore, since it is your sincere and strong conviction that you should be able to try, and should try, and MAO inhibitor. Then, unless the doctor has an extremely unlikely, miraculous turn-around and conceeds to prescribe an MAOI... try another doc. It may take awhile, but stubborn and/or ignorant psychiatrists such as these should not be supported, if possible, and also, once you get on an MAOI (especially Nardil, IMO), if it is effective (which it should be), it will have been well worth the effort and the wait.
Oh, one more thing. Be sure to somehow convince your psychiatrist that many of the foods/drinks on the dietary restrictions list should not be on there-- because it's the truth. Use research articles/abstracts, scientific non-research articles, and maybe even a collection of anecdotes from people on an MAOI from places such as this (Dr-Bob/PsychoBabble)-- or whatever else.
Best of luck to you.
poster:Questionmark
thread:417162
URL: http://www.dr-bob.org/babble/20041123/msgs/420501.html