Posted by europerep on January 25, 2015, at 10:17:07
In reply to feeling like im out of options, posted by hello123 on January 24, 2015, at 16:02:14
Hey there...
I can really only echo what Ed has already said. Irreversible MAOIs like tranylcypromine and phenelzine are definitely one of the things to look at for treating refractory depression.
And I can also confirm from experience that MAOIs are in no way to be considered stronger SNRIs or something like that. Trancylpromine and phenelzine affected me in a way entirely different from venlafaxine (up to a dose of 600mg/d), or any other antidepressant for that matter. Incidentally, this was not in a positive sense, as I experienced strong side effects and an actual worsening in depression, but at least that second part is actually really rare. The forum here is full of positive and even life-saving experiences with irreversible MAOIs.
By the way, tranylcypromine also has a weak but not negligible stimulant component. I definitely felt it when I took my first dose of the day, it kind of reminded me of methylphenidate. So if you have felt some benefit from stimulants, tranylcypromine might be preferable to phenelzine as a first choice.
But, in essence, I really agree that MAOIs are probably worth exploring in your case. Of course there are things you must learn about them and of which you are already aware, namely risks for drug-drug and food-drug interactions, but these should really not be blown out of proportion. I mean, those things that you have to avoid on MAOIs you *definitely* do have to avoid, without any ambiguity, but it's really not that difficult to build a diet around the restrictions that will be perfectly safe.
I hope this helps...
poster:europerep
thread:1075467
URL: http://www.dr-bob.org/babble/20150102/msgs/1075527.html