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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Rainee on January 27, 2004, at 19:35:13
Nothing seems to work for me.. I need some life in me.. weight gain? do they make you gain weight?
Thanks,
Raineeat the end .. I have hardly any life left in me and my family needs me.
Posted by jerrympls on January 27, 2004, at 19:53:59
In reply to Is it hard to get a doc to prescribe a MAOI?, posted by Rainee on January 27, 2004, at 19:35:13
> Nothing seems to work for me.. I need some life in me.. weight gain? do they make you gain weight?
>
>
> Thanks,
> Rainee
>
> at the end .. I have hardly any life left in me and my family needs me.MAOI's are pwoerful antidepressants and usually work whennothing else has. There are two in the US (I believe) Parnate and Nardil. Parnate is more stimulating than Nardil - however I have hear more success stories from Nardil. I gained weight on Nardil, however, that doesn't happen to everyone.
As far as finding a doctor to prescribe one of them - I would try to find a psychiatrist or psychopharmocologist at a Teaching/Research University. Family docs are afraid to prescribe them due to the diet restrictions. I would say your chances are in favor of finding a doc who will prescribe an MAOI.
Good luck....
Jerry
Posted by MelD on January 27, 2004, at 20:21:28
In reply to Is it hard to get a doc to prescribe a MAOI?, posted by Rainee on January 27, 2004, at 19:35:13
Keep trying. You will most probably need to go to a psychiatrist to get it, as was already said, family physicians are woefully uninformed about them. I was where you are now and ended up with Parnate. EXCELLENT results. On Parnate, you typically lose weight and just for fun, get an increased libido. But whether it be Nardil or Parnate for you, i highly recommend the MAOI for you at this point. Good luck and keep us posted! Melodie
Posted by lepus on January 27, 2004, at 20:52:02
In reply to Re: Is it hard to get a doc to prescribe a MAOI? » Rainee, posted by MelD on January 27, 2004, at 20:21:28
I was about to post something similar earlier so I am glad that someone else brought it up.
MAOIs are the ONLY type of anti-depressant I haven't been tried on and seem to be well-suited for the depression I have with my BPII (if that is what I really have). My depressions are atypical in that I sleep too much and am just so lethargic. I asked my pdoc last week why we haven't tried one and she was scared of the suicide risk. To quote, "I have to be able to sleep at night". Well lady, you being able to sleep at night then is the only thing that is preventing you from prescribing what could be a lifesaver for me? How do I get her over this fear and get her to try one on me? It is so frustrating to know that in all the literature I have read it seems like it could be very beneficial but she won't do it.
Any advice on how to approach this subject with her again? I'd be willing to sign contracts that she wasn't even liable if I did commit suicide on a MAOI. God, I would do anything to find something that works! She has seen me for over a decade, I can't understand why she has never brought them up or prescribed one for me. I know she has for others and it isn't like I have a huge history of suicide or anything. *shrugs*
But to answer your question: Yes, for me it has been very hard to get a MAOI prescribed. To me it also seems to border on malpractice when one is clearly indicated given my symptoms and my poor response to SSRIs and TCAs. Any thoughts?
Posted by Rainee on January 27, 2004, at 22:40:36
In reply to Re: Is it hard to get a doc to prescribe a MAOI?, posted by lepus on January 27, 2004, at 20:52:02
you sound just like me the treatment resistent depression lethargy.. no life in me.
BPII I have been told but I feel so unsure of all these diagnosis.. I will research it and present it too my doc.
thanks
Posted by f l y on January 28, 2004, at 2:22:38
In reply to Re: Is it hard to get a doc to prescribe a MAOI?, posted by Rainee on January 27, 2004, at 22:40:36
true bpII's are supposed to get more releif from mood stabilizers than ad's
fly
Posted by cubbybear on January 28, 2004, at 3:32:59
In reply to Re: Is it hard to get a doc to prescribe a MAOI?, posted by lepus on January 27, 2004, at 20:52:02
>
> Any advice on how to approach this subject with her again? I'd be willing to sign contracts that she wasn't even liable if I did commit suicide on a MAOI.First off, I'd say that MAOs have not been implicated in any more suicides than other classes of ADs. It seems that there's been much more publicity about Prozac triggering suicides than any other AD. Suicide is always a risk for depressed people regardless of what AD they're on.
can't understand why she has never brought them up or prescribed one for me. I know she has for others and it isn't like I have a huge history of suicide or anything. *shrugs*
> But to answer your question: Yes, for me it has been very hard to get a MAOI prescribed. To me it also seems to border on malpractice when one is clearly indicated given my symptoms and my poor response to SSRIs and TCAs. Any thoughts?
Of course it's malpractice--I'd also call it criminal negligence. My firm belief is that the overwhelming majority of the medical profession has been manipulated by the pharmaceutical firms into prescribing only the newer generation SSRIs and their chemical cousins, while misconceptions and exaggerations about the risks of MAOIs continue to circulate.
I've had 20 years of success with Parnate and I've been as fortunate as anyone could be, in having my former therapist in New York--who lives thousands of miles away--still prescribe it for me and mail the Rx to my forwarding address. No doubt, some day I'll be faced with the dreaded search for a new doctor and I'll have to do whatever it takes to find one to my liking.
Good luck in your search.
Posted by Metalblade on January 28, 2004, at 13:53:35
In reply to Is it hard to get a doc to prescribe a MAOI?, posted by Rainee on January 27, 2004, at 19:35:13
I have some information that just might be of interest to people trying to get Nardil from a Doc. Email me at Metalblade78@comcast.net if you want to know.
Posted by ditzypixy on January 28, 2004, at 16:25:05
In reply to Is it hard to get a doc to prescribe a MAOI?, posted by Rainee on January 27, 2004, at 19:35:13
rainee,thats great youre family needs you,but you need you,too,dont ever forget that. cos you are the one person who is always gonna be there for you,no matter what,so that makes you important, the most important person to you.
i dont know anything about maois except that a lot of medications seem to interact badly with them.theres a new anti depressant out called cymbalta and its meant to be great,but i havent tried it,cant wait to,though!
Posted by djmmm on January 28, 2004, at 20:31:06
In reply to Is it hard to get a doc to prescribe a MAOI?, posted by Rainee on January 27, 2004, at 19:35:13
If you have exhausted trials on most popular antidepressants, most knowledgable psychiatrists would then consider a MAOI
Posted by micro on January 28, 2004, at 21:28:44
In reply to Re: Is it hard to get a doc to prescribe a MAOI?, posted by lepus on January 27, 2004, at 20:52:02
> I was about to post something similar earlier so I am glad that someone else brought it up.
>
> MAOIs are the ONLY type of anti-depressant I haven't been tried on and seem to be well-suited for the depression I have with my BPII (if that is what I really have). My depressions are atypical in that I sleep too much and am just so lethargic. I asked my pdoc last week why we haven't tried one and she was scared of the suicide risk. To quote, "I have to be able to sleep at night". Well lady, you being able to sleep at night then is the only thing that is preventing you from prescribing what could be a lifesaver for me? How do I get her over this fear and get her to try one on me? It is so frustrating to know that in all the literature I have read it seems like it could be very beneficial but she won't do it.
>
> Any advice on how to approach this subject with her again? I'd be willing to sign contracts that she wasn't even liable if I did commit suicide on a MAOI. God, I would do anything to find something that works! She has seen me for over a decade, I can't understand why she has never brought them up or prescribed one for me. I know she has for others and it isn't like I have a huge history of suicide or anything. *shrugs*
>
> But to answer your question: Yes, for me it has been very hard to get a MAOI prescribed. To me it also seems to border on malpractice when one is clearly indicated given my symptoms and my poor response to SSRIs and TCAs. Any thoughts?I can only say: Find a new DOC!! Please and Best wishes. Micro
Posted by stoked on January 28, 2004, at 23:44:55
In reply to Re: Is it hard to get a doc to prescribe a MAOI?, posted by lepus on January 27, 2004, at 20:52:02
Dude, that is totally messed up. I've had pretty bad depression, and my friend had it basicly all the time for years, and he was really thinking about suicide. Now he's on Parnate, and he says he feels "normal" for the first time since he was like 13 years old, isn't that sick? Depression kills people. And you're doctor is worried about her beauty sleep? What the f*? She needs to take you more seriously or else you need a new doctor.
Besides, what does she think you're going to do? Say, Oh, I can't take it anymore and eat a pound of chedder cheese? That's just dumb.
Hey, good luck, and don't give up.
Posted by francesco on January 30, 2004, at 18:26:36
In reply to Re: Is it hard to get a doc to prescribe a MAOI? » lepus, posted by stoked on January 28, 2004, at 23:44:55
people euphoric.
This is the reason why they work when TCAs and SSRIs failed. I think hypertensive crisis are not a big risk if we consider statistics and 'big numbers' but are a big deal for the doctor that don't want to have troubles with that single patient or assume responsability. I hope you have luck.By the way, does any of you which is the kick-in time of Parnate and the average terapeutic dose ?
Thanks
Posted by stoked on January 30, 2004, at 21:51:28
In reply to maois are the only meds that made non depressed .. » stoked, posted by francesco on January 30, 2004, at 18:26:36
> people euphoric.
> This is the reason why they work when TCAs and SSRIs failed. I think hypertensive crisis are not a big risk if we consider statistics and 'big numbers' but are a big deal for the doctor that don't want to have troubles with that single patient or assume responsability. I hope you have luck.
>
> By the way, does any of you which is the kick-in time of Parnate and the average terapeutic dose ?
> Thanks
>Hey man! Actually, I think you mean this for lepus, he's the guy with the doc who won't give him MAOI's. I doing pretty well, personally. It's just my friend who was really bad and got such an amazing improvement from the Parnate.
I think it started to work for him around 40 milligrams, and now he takes 50. I hear they work really fast once you get to the right dosage, but his doctor only wanted to add 10 a week, so I guess it took about 4 weeks or so.
Posted by jealibeanz on June 27, 2006, at 12:05:24
In reply to Re: maois are the only meds that made non depressed .., posted by stoked on January 30, 2004, at 21:51:28
Bringing this one back to life... what to know if I should put any thought into asking my family doc or hoping he'd suggest one for me.
Posted by jedi on July 2, 2006, at 0:04:27
In reply to Re: maois are the only meds that made non depressed .., posted by jealibeanz on June 27, 2006, at 12:05:24
> Bringing this one back to life... what to know if I should put any thought into asking my family doc or hoping he'd suggest one for me.
Hi,
Generally a MD will only prescribe a MAOI after many other options have tried and failed. Some MDs and even PDOCs will not prescribe them at all; probably out of a perceived fear of lawsuits or the patient hurting themselves. This is too bad because IMHO a MAOI should be 2nd tier and not last resort when it comes to major atypical depression and social anxiety.Not just any patient can be trusted with a MAOI. You have to show your MD that you are knowledgable and stable enough to follow an ordered regiment of meds and diet. The diet really isn't that difficult, but you can't space out and take three tablespoons of some over the counter cough syrup. I have known many depressed people that I know could not be trusted taking a MAOI, so I can see the doctor's point when they refuse to prescribe them.
When I ask a new doctor to prescribe Nardil for me, I write a letter outlining the medications I have taken and include several research studies showing how the med works in many treatment resistant patients. In fact, I do this when I am asking for any different med and give them enough time to digest it before my appointment. This way I am sure to get all of my points in before my 10 minutes is up! Some doctors appreciate this effort and others are too arrogant to believe they can learn anything from a layperson. If you get one of those, you might as well cut your loses and move on. Just my opinion.
Good Luck,
Jedi
Posted by jealibeanz on July 2, 2006, at 14:03:15
In reply to Re: maois are the only meds that made non depressed .. » jealibeanz, posted by jedi on July 2, 2006, at 0:04:27
My doctor would trust my ability to understand the possible consequences of MAOI use and how to avoid them. I'm fairly certain of that. I don't consider diet a problem. I could easily memorize all the medications that are contraindicated. He realizes that I am mature and intelligent enough to do so. I just am unsure as to whether he'd consider such an antidepressant.
Posted by elanor roosevelt on July 2, 2006, at 21:40:44
In reply to Re: maois are the only meds that made non depressed .., posted by jealibeanz on July 2, 2006, at 14:03:15
my dr. attended a conference in the spring where there was much discussion concerning under-use of maoi's for patients who are srri treatment resistant. perhaps there will be a shift in attitude.
good luck.
Posted by jealibeanz on July 2, 2006, at 22:36:29
In reply to Re: maois are the only meds that made non depresse, posted by elanor roosevelt on July 2, 2006, at 21:40:44
Is he a pdoc? Glad to hear some discussion about pharmaceutical treatment for resistent patients, rather than shrugging us off and saying only therapy can help.
This is the end of the thread.
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