Posted by rose45 on May 12, 2019, at 6:45:35
In reply to Re: nardil and parnate have both pooped out on me » rose45, posted by SLS on May 11, 2019, at 11:38:36
Hi SLS,
Im now on 40 mg, and completely constipated, whereas 30 mg worked fine for 5 yrs. Ive been on 40 mg for 3.5 months and the doctors here in the uk dont want me to go up higher. I actually couldnt stand going higher myself, as it is really unhealthy being as constipated as I am now. Am feeling totally suicidal as I cant see any way out. The only drugs that have helped me are nardil and parnate, and the doctors on the nhs here are so conservative.I have no insurance as this is a long standing pre-condition. I must say that when the meds did work, I did become quite over-convident, arrogant, and a different personality in many ways. Ive seen many people say similar things. My mother was on parnate also, and used to gamble a lot. I really dont think this is bipolar, but the result of the meds. Ive read several people say similar things and also that the maois can ruin you. The following article is extremely frightening:
Major depression induced or exacerbated by a substance/medicationHas anyone here ever encountered a significant and long-term increase in the severity of their depression after taking a medication or other substance?
TL;DR: I once had mild depression that was very responsive to treatments. After a 10-month course of phenelzine/Nardil, I was left with severe depression that basically responds to nothing, forcing me to line up for ECT. I feel very strongly the phenelzine caused this increased symptom severity and medication-refractory status, especially after reading a journal article that records this phenomenon has happened in the past (https://www.ncbi.nlm.nih.gov/pubmed/2910838).
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My major depression originally started because of stress caused by my mild-moderate social anxiety. However, the depression was only mild-moderate in severity and quite treatment-responsive: 100 mg/day of sertraline eradicated the symptoms by about 75%. I went on and off sertraline for years, and it never stopped working for my depression during this time.
The sertraline didn't do much for my social anxiety though, so I eventually got fed up and decided to try the gold standard treatment for it: phenelzine. I worked my way up to 75 mg/day. The therapeutic effect was astounding: after three weeks on the medication my major depression went into complete remission, and social anxiety was reduced by 4/5.
However, over the months the anti-depression efficacy of the phenelzine slowly waned (its anti-social-anxiety effect remained constant, though). By about 10 months in it was less effective than sertraline had been for my depression. I went off the phenelzine and went back on the sertraline. When I came off the phenelzine, I found my depression was far more severe than before I began, especially when it came to fatigue and cognition (e.g. word-finding).
Moreover, sertraline no longer worked! Over the next two years I tried just about every medication in the book:
SSRIs and/or NRIs
Tranylcypromine (including high dose 120+ mg/day)
T3 augmentation
Ketamine infusions
Scopolamine [hydrobromide] infusions
Psilocin (i.e. Magic Mushrooms)
Methoxetamine (an NMDA-antagonist dissociative hallucinogen)
Buprenorphine
CERC-501 (a selective kappa-opioid antagonist)
Melanocyte-inhibiting-factor-1 (MIF-1)
Sarcosine (an NMDA modulator)
Tianeptine
Course of rTMS
Of the above, I get partial responses (~25% symptom relief) from tranylcypromine, scopolamine, buprenorphine, and once briefly from MIF-1. Nothing else touches me. I'm in line for ECT now.
There are currently no 'stress' factors in my life - my social anxiety problems are long gone. (I inadvertently learned while injecting testosterone for bodybuilding that keeping my T in the upper end of the normal range 100% obliterates my social anxiety. This was by far the biggest break of my life). My depression is purely 'biological' in nature, and without these depressive symptoms I would be problem-free and happy.
And so I am forced to conclude that a single 10-month course of phenelzine turned my case of mild treatment-responsive depression to a monster case of severe refractory depression that may not even respond to ECT. Although I can't find any anecdotal cases on the internet resembling mine with respect to MAOIs, I did find an academic article describing three patient cases which have a striking similarity to my own case:
The Journal of Clinical Psychiatry. (1989). Tolerance to phenelzine and subsequent refractory depression: three cases. 50(1), 33-35.
PubMed link: https://www.ncbi.nlm.nih.gov/pubmed/2910838
Abstract: Three patients with major depression superimposed on chronic dysthymia were treated with phenelzine. After an initial excellent response, each patient relapsed and developed a severe chronic depression that was refractory to other treatments. The implications for the long-term effects of phenelzine treatment are considered.
By the way, I don't wish to turn anyone off phenelzine. If it did indeed cause this, then it must have been an extraordinarily rare genetic reaction. I think phenelzine is still a fantastic medication (after the first few months I had less side effects on phenelzine than sertraline, believe it or not) for social anxiety and depression.
13 commentsand also:https://www.wallowinmaya.com/tranylcypromine-the-most-powerful-antidepressant-ever/#com
rose45
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thread:1104335
URL: http://www.dr-bob.org/babble/20190206/msgs/1104374.html