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Re: Considering an MAOI » christophrejmc

Posted by Crotale on August 3, 2008, at 19:27:59

In reply to Re: Considering an MAOI » BrightEyed+Blueberry, posted by christophrejmc on July 18, 2008, at 2:07:28

> Actually, most people find the pill form of selegiline quite pro-sexual

That's interesting...I took it a number of years ago and I just found it jittery.

Do you think the patch would be less so?

> It's interesting what you said about Effexor/Wellbutrin cancelling the effects of buprenorphine, I've never heard that.

Me neither, I wonder where it came from.

> I think bup may be my next step, but I'll have to wait until my sleep/narcolepsy stuff is treated and see how that goes.

I didn't know you have narcolepsy. MAOIs should be helpful with that.

Good luck with the buprenorphine thing. I've had some problems with it because a lot of doctors seem to misunderstand the Drug Addiction Treatment Act (DATA, the 2000 law that allows for the use for Schedule III-V drugs for treating drug addiction by doctors who have a special waiver, so that addicts can get substitution treatment without having to go to a methadone clinic). They have this idea that they can't prescribe buprenorphine, period, without a waiver. (In fact it only applies to treating addiction. A physician doesn't need a waiver to use opioids to treat depression or pain.) I started taking buprenorphine in 1999 and after Subutex and Suboxone became available I began having real problems. I even brought a copy of the law to show the doctor that it didn't require a waiver except for treating addiction, but he insisted that I was wrong. Eventually I found a doctor who had a clue, fortunately. He's about an hour and a half away, less fortunately, but I'm generally happy with him. This might seem surprising, but I've found psychiatry residents to be some of the best doctors. Maybe they're more open-minded or less arrogant; maybe they keep up with recent research and new ideas; maybe it's a combination of factors.

> I've thought about CBT, too. I know it's supposed to be quite effective but I'm not sure if I really have the time to invest in it (which is silly, because I have an enormous amount of free time compared to most people... it all just seems to get used up).

Well, I don't know if this is a problem for you, but therapy is quite expensive as well as time-consuming, and insurance may or may not cover it.

My experience (personal and otherwise) with CBT has been that it's better for anxiety disorders, personality disorders, and specific problems like relationship issues or substance abuse or low self-esteem or posttraumatic stress (technically an anxiety disorder, but one that I think is particularly responsive to therapy). Also, it's really important (this from personal experience) to have a good therapeutic alliance. If you don't really respect, trust, and like your therapist, it's hard to get much out of it, no matter how effective the technique theoretically is.

-Crotale


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poster:Crotale thread:826622
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