Posted by Racer on January 18, 2008, at 22:45:26
In reply to Re: Question about EMSAM versus other MAOIs » Racer, posted by bleauberry on January 18, 2008, at 19:01:24
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> Anyway, I was curious...why are maois viewed as contraindicated in your case?There are a variety of reasons for that. The biggest one, the one that really can't be mitigated by other medications, is that I am also being treated for anorexia. As my therapist points out every time this comes up, the whole idea is to get me to *stop* restricting foods, so any medication which requires me to watch my diet and restrict certain foods is unacceptable. My pdoc agrees, and I kinda agree, too -- particularly since so many things on the list are staples in my diet.
The other reasons involve side effects and suicidal ideation: first, when MAOIs came up at one point, I admitted that it was kinda tempting to say yes, and then try to trigger a crisis -- suicide, without it being obvious. I'm pretty sure she passed that information on to my pdoc. And my blood pressure runs very low to begin with -- it's not uncommon in anorexia. In the past, all the TCAs I've tried, except nortriptyline, lowered my blood pressure a lot. EMSAM lowered it a bit, too -- I was averaging about 80/55 -- so it's obviously something I'm sensitive to. MAOIs are known for lowering blood pressure, so that's a probable problem for me. And -- gee, what a surprise -- weight gain is an issue for me. It's a huge issue for me. It's happened on nearly every drug I've taken, and it's not acceptable. Sedation/insomnia are also problems I've had on a lot of medications, particularly those that affect serotonin. EMSAM left me very isolated, since I had no motivation to speak -- about once a week, I'd make an effort to be around people, but even then I felt isolated and stupid.
I agree with you that the big three neurotransmitters discussed so often are not the whole picture. What I've learned over twenty some years of meds, is that noradrenergic medications are usually more effective for me than any of the serotinergic meds. Otherwise, I've learned that there are some side effects I can't deal with.
I'm just babbling now, so I'll stop...
poster:Racer
thread:807474
URL: http://www.dr-bob.org/babble/20080114/msgs/807531.html