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Re: maoi's next choice? » dondon

Posted by Oppycat on September 30, 2006, at 7:45:42

In reply to maoi's next choice?, posted by dondon on September 26, 2006, at 20:19:10

> I don't respond to ssris anymore. SHould I try an maoi now or a tca? Is there anyone here who don't respond to ssris but find relief from maois ?


MAOI's are the only ADs I've been able to tolerate consistently. I've been on Parnate for most of the past 18 years. There is a quick onset of activity for most people and it didn't cause any weight gain for me, which is not to say that I didn't gain weight during this time period.

My experience with Nardil wasn't as positive, but I did take it for about a year. That was in the early 1990s and, in retrospect, I don't believe my dose was high enough. I think I was taking 60mg daily. Of course, doctors may have been more cautious then. In any event, it seemed to take forever to work and I did gain weight on it. However, I quit smoking during that time (one of the many times), which I'm sure played a large part. I also had more sexual dysfunction than I had on Parnate. I did try Nardil again recently after reading so many positive things about it on this board over the past several years. However, after a week, I abandoned the trial because I couldn't wait it for it to start working. Of course, I went through a 10 day wash out before I started taking it. In retrospect, I wish I had stuck with it since I had to wait another week to restart the Parnate and took very small doses for the first several days.

The first time I took Nardil, I didn't start feeling any better after the first week or two like most other medicines. It took about a month to work. I was almost suicidal by then, but I woke up one day and, all of a sudden, felt much better. I did sleep very well on it, though, compared to Parnate, where I always needed some sleep aid.

The psychopharmacologist who prescribed Parnate first back in 1988 told me at that time if I didn't feel any benefit from it after 2 or 3 days, it probably wouldn't work at all for me. I've read a lot of postings counter to that on this board, but I remember feeling an improvement the first day.

TCAs and Remeron also have fairly quick onsets of activity, but the weight gain and other side effects are pretty difficult to tolerate.

Good luck, but I recommend trying the MAOIs before the TCAs. Some people take both medications so if they don't work, the transition to a TCA should be easy. Sorry about the wordy reply, but I hope it helps.

Michael


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