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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by Harlock on April 18, 2005, at 14:19:52
I've tried just about every anti-depressant and anti-bipolar med out there. They either don't work at all, or poop out fast.
I've been diagnosed as bipolar II. I've been in a depressive state for 2 years, more or less. Used to be pretty manic, but that fizzled out over the last 2-3 years. I miss those days.. Mania was WAY better than severe depression.
Anyway, I may try Parnate or Nardil in the next few months. How bad are the OTC drug and food restrictions? Anyone want to warn me to stay away from MAOI's? Horror stories?
Should I try something else first? I've tried almost all of the ssri's out there. Only a couple of anti-psycotics though.
Taking the 50/12 dose of Symbyax and 450mg of Wellbutrin XL/XR (whichever it is).
Been on the symbax for a month or so and I don't feel better. WB just gives me energy, it has no anti-depressant effects for me. Never has.
Posted by mogger on April 18, 2005, at 14:59:07
In reply to TIme for MAOI's? They scare me., posted by Harlock on April 18, 2005, at 14:19:52
has your doctor heard of Selegiline? When used at higher doses it is like an MAOI but is said to have less chance of side effects and hypertensive crisis. When combined with Phenylalinine it has a stimulant effect. Check out the posts on Psycho-babble and do a little research. Here is an interesting link:
Posted by mogger on April 18, 2005, at 15:00:13
In reply to TIme for MAOI's? They scare me., posted by Harlock on April 18, 2005, at 14:19:52
always be careful though, make sure you talk to your doctor at length about this, I am only a patient so I am not an authority!
Posted by Greywolf on April 18, 2005, at 15:50:03
In reply to Re: TIme for MAOI's? They scare me., posted by mogger on April 18, 2005, at 15:00:13
Harlock:
Don't be afraid to give Nardil a shot. I did after having experienced a vast number of the ADs on the market over many years and finding them to be either ineffective or not worth the SEs. Nardil was more effective than any of them, with almost no significant SEs.
The dietary restrictions are no big deal. I was able to accomodate them almost without thinking after a couple weeks. It's worth the shot.
Posted by ixus on April 18, 2005, at 16:21:30
In reply to TIme for MAOI's? They scare me., posted by Harlock on April 18, 2005, at 14:19:52
> I've tried just about every anti-depressant and anti-bipolar med out there. They either don't work at all, or poop out fast.
>
> I've been diagnosed as bipolar II. I've been in a depressive state for 2 years, more or less. Used to be pretty manic, but that fizzled out over the last 2-3 years. I miss those days.. Mania was WAY better than severe depression.
>
> Anyway, I may try Parnate or Nardil in the next few months. How bad are the OTC drug and food restrictions? Anyone want to warn me to stay away from MAOI's? Horror stories?
>
> Should I try something else first? I've tried almost all of the ssri's out there. Only a couple of anti-psycotics though.
>
> Taking the 50/12 dose of Symbyax and 450mg of Wellbutrin XL/XR (whichever it is).
> Been on the symbax for a month or so and I don't feel better. WB just gives me energy, it has no anti-depressant effects for me. Never has.Hi,
If you have normal BP you shouldn't be afraid of HC while on MAOI. I react for red wine and beer only (Parnate 30 mg). I used to measure my BP after all meals at the beginning. Most of warnings are exaggerated (read the leaflet of celexa, probably the safest SSRI on the market).
/ixus
Posted by Phillipa on April 18, 2005, at 18:16:22
In reply to Re: TIme for MAOI's? They scare me. » Harlock, posted by ixus on April 18, 2005, at 16:21:30
This may be a stupid question but how depressed do you have to be to want to try an MAOI. I've given up on SSRI's and SNRI's, remeron, wellbutrin. I mean, how well are you functioning. Able to work, socialize, etc. Thanks Phillipa
Posted by Greywolf on April 18, 2005, at 20:44:08
In reply to Re: TIme for MAOI's? They scare me., posted by Phillipa on April 18, 2005, at 18:16:22
> This may be a stupid question but how depressed do you have to be to want to try an MAOI. I've given up on SSRI's and SNRI's, remeron, wellbutrin. I mean, how well are you functioning. Able to work, socialize, etc. Thanks Phillipa
I'm not sure that the question is how depressed you have to be in order to take an MAOI. Rather, I think the issue is probably effectiveness of the ADs that are out there vs. the SEs. Because of the dangers associated with MAOIs, it is probably better to treat them as somewhat of a last resort option if possible (and I'm sure some doctors want a fairly lengthy treatment experience with you before prescribing them to make sure that you'll comply with the dietary restrictions).
One thing I noticed with Nardil was how easy it was to tolerate. No fatigue/drowsiness, no sexual SEs, no fogginess, etc. And it was pretty effective even below max dose.
Posted by Harlock on April 19, 2005, at 9:43:48
In reply to Re: TIme for MAOI's? They scare me., posted by Phillipa on April 18, 2005, at 18:16:22
> This may be a stupid question but how depressed do you have to be to want to try an MAOI. I've given up on SSRI's and SNRI's, remeron, wellbutrin. I mean, how well are you functioning. Able to work, socialize, etc. Thanks Phillipa
Currently, I'm having a tough time just functioning normally. I'm on the brink of losing my job as I'm too depressed to work, etc.
I'm almost never in a good mood. It's a battle just to get out of bed. I don't even like to talk anymore - I'm like a zombie. There was a time when it was tough just to get me to shut up. A live one day at a time with no hope towards the future. I see the future as hopeless, bleak, dark, etc. I can't stand living like this anymore. So, I think I'm "ready" to try an maoi.
Posted by Mildred on April 19, 2005, at 21:37:24
In reply to Re: TIme for MAOI's? They scare me., posted by Harlock on April 19, 2005, at 9:43:48
> Currently, I'm having a tough time just functioning normally. I'm on the brink of losing my job as I'm too depressed to work, etc.
> I'm almost never in a good mood. It's a battle just to get out of bed. I don't even like to talk anymore - I'm like a zombie. There was a time when it was tough just to get me to shut up. A live one day at a time with no hope towards the future. I see the future as hopeless, bleak, dark, etc. I can't stand living like this anymore. So, I think I'm "ready" to try an maoi.It sounds to me like you are more than ready. I took Nardil for many years, and it was amazing. It gave me a life back. The contraindications for meds and food are not difficult at all. The only fear I had was the possibility that I might one day be given meds in an emergency situation that would be contraindicated by the maoi. So I wore a necklace - fortunately, the situation never arose.
Good luck!
Posted by alienatari on April 20, 2005, at 7:43:57
In reply to Re: TIme for MAOI's? They scare me., posted by Mildred on April 19, 2005, at 21:37:24
I couldnt stand the side effects on Parnate (it made me extremly tired. Id be in bed at 3pm every day, how can you work and study like this?) I know most people are suppose to find it stimulating but i didnt (and Ive talked to quite a few people on the yahoo MAOI forum that had the same thing happen to them).
One thing to keep in mind, EVERYONE reacts differently. I was not one of those people that could eat everything. In fact i would react to things you wouldnt even question, like cranberry juice!! (Maybe it was the preservative of this certain brand?) Anyway eating became a total hell for me. Im not trying to scare you off but Im just trying to warn you that even though some people seem to be able to eat whatever they like on an MAOI others (like myself) have to be extremely careful and it was really quite scary and a pain having so many reactions. I practically only ate at home because I was terrified of eating out after having some reactions with what seemed to be quite safe foods in cafes.
Just be well informed if you do go on them. I think if Anafranil doesnt work for me I will give an MAOI another shot but this time Nardil. But yea they can be quite dangerious meds.
Take care.
Posted by willyee on April 20, 2005, at 18:25:24
In reply to TIme for MAOI's? They scare me., posted by Harlock on April 18, 2005, at 14:19:52
I get a little frustrated when i see posts like these,and im not sure if its with the inudstry having executed a perfectly succesful scare tactic so many years ago,or if its us as a people.
The maois have interactions with drugs,and other chemicals,and that is about it.All one has to do are learn these,and learn the best antidote med to help,and become familiar with that.Now with that danger,thats enough to make it "last line".How much safe do we truly know ssris are,how much less severe damage to recpetors do we know are occuring.
Side effetc ?? What bigger sid effect in the entire world is there then living with a horrid clinical depression un treated.How much more of a side effect is the pain of watcging your family and friends enjoy life everyday,begging u too as well,how much more of a side effect is being bed ridden watchging from tv,your faimly,your jobs poeple enjoy life right in front of you,i know i good at my job,and personaly it hurt very bad to see people move up and know i wasnt because i was lucky enough to be there everyday.
If there is a med that you heard over and over has a very real POSSABILITY and track record of helping someone live there lifes,how can one compare the possable interaction side effect along side the ones i listed after,if your fighting some who plays dirty,the way depression gnores medication,then you have to play dirty too,and not be afriad to take a med might puncture through a wall of depression.We cant want the safest medicines and results too,life is never known in any aspect to be that easy.
As for last line,thousands of dollers,as well as pounds and pounds of ssris,mood stablizers,different docters,different offices,suicideal ideation,withdrawals and the list goes on were my result of letting PARNATE be my last line of choice,a last line of choice that responded in 48 hrs.I look at the meds i used,how i allowed them to be given over and over and in cocktails again and again while parnate or nardil i med i knew nothing of was never even told.That last line is a crock,its CROCK OF S-,last line of medication my a- how many docters while trying to help a patieint inform them of these meds saying well ill tell you we do have a last line of treatment.......no theyll tell u last line of treatment after they fail is hispilatlazion,i can bet the majority of maoi users CAME to their doc asking what they were,i am doubtful last line or not they are not being offered or made known they even exist,and ur begining patient not a group memeber or net surfere will not know this from simple info,we do cause we share,hell i learned of parnate through remedyfind,15 docs thousands in bills and not one of the 15 docs ever made me aware of what a MOAI even was.
MY BELIEF is they listen to the reps,they prescribe what the sales reps provide them in sampled and up to date market revues and trials etc,they have no intention on using a very old mecication that they themselves had to blow the dust off their damn pdr book and read a paragrahp.
IM SORR but with every visit,and every sufferer i see here,i begin to loath the mental inudstry more and more,i sat recently across a sales woman,in here brand new hundred doller shoes,gold watch,brand new palm pilot,she looked like a million bucks,it all just makes me sick.
Please never forget your the most important player on your team,your doc is there,friends are there,groups,boards atricles,health store workers everyone is there to help provide info,but remember you need to become the leader of it all.i wish this was not the case and a doc should play the role,but the truth is we have come almost nowhere in progress,and letting a doc do that can sometimes be very dangerous .
Posted by Phillipa on April 20, 2005, at 18:43:04
In reply to Re: TIme for MAOI's? They scare me., posted by willyee on April 20, 2005, at 18:25:24
A wonderful post! So why am I stupid enough to not be able to work, live in constant anxiety, and not be able to enjoy life? I guess it's because of what you say. I had so many bad experiences with SSRI's TCA's, etc, or not having them do anything, that I'm ontent to be able to sleep and take valium. Right now I'm swallowing 25mg of zoloft and don't feel a thing. Why not a higher dose? I'm afraid of failure again. Fondly, Phillipa
Posted by alienatari on April 21, 2005, at 4:55:26
In reply to Re: TIme for MAOI's? They scare me., posted by willyee on April 20, 2005, at 18:25:24
Seriously though, the MAOI's are not as safe as other antidepressants and do require a lot of food and medication restrictions. That being said, I do think they are under-used and its ashame because they are so effective.
Ok, now your making me want to take Parnate again! lol
> I get a little frustrated when i see posts like these,and im not sure if its with the inudstry having executed a perfectly succesful scare tactic so many years ago,or if its us as a people.
>
>
> The maois have interactions with drugs,and other chemicals,and that is about it.All one has to do are learn these,and learn the best antidote med to help,and become familiar with that.
>
> Now with that danger,thats enough to make it "last line".How much safe do we truly know ssris are,how much less severe damage to recpetors do we know are occuring.
>
> Side effetc ?? What bigger sid effect in the entire world is there then living with a horrid clinical depression un treated.How much more of a side effect is the pain of watcging your family and friends enjoy life everyday,begging u too as well,how much more of a side effect is being bed ridden watchging from tv,your faimly,your jobs poeple enjoy life right in front of you,i know i good at my job,and personaly it hurt very bad to see people move up and know i wasnt because i was lucky enough to be there everyday.
>
>
> If there is a med that you heard over and over has a very real POSSABILITY and track record of helping someone live there lifes,how can one compare the possable interaction side effect along side the ones i listed after,if your fighting some who plays dirty,the way depression gnores medication,then you have to play dirty too,and not be afriad to take a med might puncture through a wall of depression.We cant want the safest medicines and results too,life is never known in any aspect to be that easy.
>
>
> As for last line,thousands of dollers,as well as pounds and pounds of ssris,mood stablizers,different docters,different offices,suicideal ideation,withdrawals and the list goes on were my result of letting PARNATE be my last line of choice,a last line of choice that responded in 48 hrs.I look at the meds i used,how i allowed them to be given over and over and in cocktails again and again while parnate or nardil i med i knew nothing of was never even told.
>
> That last line is a crock,its CROCK OF S-,last line of medication my a- how many docters while trying to help a patieint inform them of these meds saying well ill tell you we do have a last line of treatment.......no theyll tell u last line of treatment after they fail is hispilatlazion,i can bet the majority of maoi users CAME to their doc asking what they were,i am doubtful last line or not they are not being offered or made known they even exist,and ur begining patient not a group memeber or net surfere will not know this from simple info,we do cause we share,hell i learned of parnate through remedyfind,15 docs thousands in bills and not one of the 15 docs ever made me aware of what a MOAI even was.
>
> MY BELIEF is they listen to the reps,they prescribe what the sales reps provide them in sampled and up to date market revues and trials etc,they have no intention on using a very old mecication that they themselves had to blow the dust off their damn pdr book and read a paragrahp.
>
> IM SORR but with every visit,and every sufferer i see here,i begin to loath the mental inudstry more and more,i sat recently across a sales woman,in here brand new hundred doller shoes,gold watch,brand new palm pilot,she looked like a million bucks,it all just makes me sick.
>
>
> Please never forget your the most important player on your team,your doc is there,friends are there,groups,boards atricles,health store workers everyone is there to help provide info,but remember you need to become the leader of it all.i wish this was not the case and a doc should play the role,but the truth is we have come almost nowhere in progress,and letting a doc do that can sometimes be very dangerous .
Posted by Harlock on April 21, 2005, at 9:37:12
In reply to Re: TIme for MAOI's? They scare me., posted by willyee on April 20, 2005, at 18:25:24
From what I hear from people here, MAOI's are underutilized. I'm waiting on them to see how I do with my current cocktail of symbyax and wellbutrin first. Their definately working to some degree anyway so at this point, I don't need to move over an MAOI just yet.
I also agree completely about docs just pushing the meds on patients that are pushed on them by "drug dealers".
I met a group of people who did this for a living, pushing and selling their line of drugs to docs and hospitals and the like. What was funny to see was how they ragged on their competitors drugs, saying theirs were much better, etc.
They make crazy money. One guy was making so much that he bought an $800 watch, and whole bunch of other really overpriced junk he didn't need. It kinda made me sick to see him living so well off other people's misery. That's just the way it is though, what are you gonna do?
Posted by Harlock on April 21, 2005, at 11:35:11
In reply to Re: TIme for MAOI's? They scare me., posted by alienatari on April 20, 2005, at 7:43:57
Thanks for the warnings. Just so I'm clear, what kinds of things can happen to you if you eat foods that are on the 'do not eat' list.
I like to drink alcohol too.. is that prohibited on an maoi?
> I couldnt stand the side effects on Parnate (it made me extremly tired. Id be in bed at 3pm every day, how can you work and study like this?) I know most people are suppose to find it stimulating but i didnt (and Ive talked to quite a few people on the yahoo MAOI forum that had the same thing happen to them).
>
> One thing to keep in mind, EVERYONE reacts differently. I was not one of those people that could eat everything. In fact i would react to things you wouldnt even question, like cranberry juice!! (Maybe it was the preservative of this certain brand?) Anyway eating became a total hell for me. Im not trying to scare you off but Im just trying to warn you that even though some people seem to be able to eat whatever they like on an MAOI others (like myself) have to be extremely careful and it was really quite scary and a pain having so many reactions. I practically only ate at home because I was terrified of eating out after having some reactions with what seemed to be quite safe foods in cafes.
>
> Just be well informed if you do go on them. I think if Anafranil doesnt work for me I will give an MAOI another shot but this time Nardil. But yea they can be quite dangerious meds.
>
> Take care.
Posted by Mildred on April 21, 2005, at 11:44:03
In reply to Re: TIme for MAOI's? They scare me., posted by Harlock on April 21, 2005, at 11:35:11
> Thanks for the warnings. Just so I'm clear, what kinds of things can happen to you if you eat foods that are on the 'do not eat' list.
You can have a hypertensive crisis.
> I like to drink alcohol too.. is that prohibited on an maoi?
Yep. No alcohol.
Check out some tips by Dr. Bob -
http://www.dr-bob.org/tips/maoi.html
Posted by willyee on April 22, 2005, at 11:27:54
In reply to Re: TIme for MAOI's? They scare me., posted by Harlock on April 21, 2005, at 11:35:11
I would not get my NO NO list from here and there questions.Maois are a medication a serious one,find a good source for a through date sheet thats up to date.
And yess,if youre a drinker,even occasionaly than an Maoi is not for you,but you will see aclholol is right up there on the list of NO NOS.
Alcholol with any med is not a great idea,if you taker benzos for anxiety,or a sedating anti-deprassant,or even a regualr one alchlolol is not going to play nice,but MAOIS put that on a whole different scale,it comes down to again,reviewing the information out there,and deceding if you are able to do it.
Maois work well,by they require more scarfices on the paitent,scarfices that for myself are a breeze to trade for the relief it provides as opposed to most other meds,which for me again is zilch,dont take em if cant cut out drinking.
Posted by bill.e on April 23, 2005, at 9:53:01
In reply to Re: TIme for MAOI's? They scare me., posted by willyee on April 20, 2005, at 18:25:24
I've been taking MAOI's for years (Nardil for over a decade). Never had a hypertensive crisis. You just learn what foods to avoid. After a while it becomes automatic.
The MAOI's were developed 40 years ago, the patents are long gone. They don't have the high profit margins of the newer drugs.
The scare tactics are important to get new patients to be careful. My positive results outweigh the few dietary restrictions.
Hope this helps, Bill
Posted by Benzini on April 24, 2005, at 13:00:24
In reply to TIme for MAOI's? They scare me., posted by Harlock on April 18, 2005, at 14:19:52
It seems that for a small number of people including myself Nardil is bit too powerful a medication. Within two weeks of starting, early last fall, I became very paranoid to the point of having a paranoid panic attack on the plane. I went up from 15mg to 45mg and stopped abruptly once I realized I was having paranoid delusions. Afterwards, I had to endure a long-course of treatment with anti-psychotics which was very unpleasant and led to a pretty bad depression. But Nardil seems to work just fine for most people.
Posted by KaraS on April 24, 2005, at 18:00:59
In reply to Horror story - Nardil made me psychotic, posted by Benzini on April 24, 2005, at 13:00:24
> It seems that for a small number of people including myself Nardil is bit too powerful a medication. Within two weeks of starting, early last fall, I became very paranoid to the point of having a paranoid panic attack on the plane. I went up from 15mg to 45mg and stopped abruptly once I realized I was having paranoid delusions. Afterwards, I had to endure a long-course of treatment with anti-psychotics which was very unpleasant and led to a pretty bad depression. But Nardil seems to work just fine for most people.
That's awful. I'm so sorry to hear that. Had you ever experienced psychosis before?
Posted by Benzini on April 25, 2005, at 11:41:57
In reply to Re: Horror story - Nardil made me psychotic » Benzini, posted by KaraS on April 24, 2005, at 18:00:59
No, I've never been psychotic before. But I've heard stories of some people reacting this way to Nardil.
Posted by KaraS on April 25, 2005, at 16:20:00
In reply to Re: Horror story - Nardil made me psychotic, posted by Benzini on April 25, 2005, at 11:41:57
> No, I've never been psychotic before. But I've heard stories of some people reacting this way to Nardil.
How scary! I guess you never know what you're going to experience with these meds. Hope you're doing well now.K
Posted by Chairman_MAO on April 26, 2005, at 12:24:21
In reply to Re: TIme for MAOI's? They scare me., posted by willyee on April 22, 2005, at 11:27:54
I take 120mg tranylcypromine per day. I have taken as much as 200mg/day when I was on tranylcypromine alone, and have been taking it since August 2004. I have never had a hypertensive reaction to anything.
The only alcohol I avoid is tap beer, although I absentmindedly had one last weekend to no ill effect. The only foods I have to cut out are these:
--fava beans
--REAL aged cheeses, such as cheddar and feta. Proecssed cheddar, etc. like you find in almost everything in the US is just fine. I had a cheddar cheese burrito with a tap beer in a restaurant and was fine.
--Fermented soy products
--air-dried sausagesThat's it. Statistics show only 8% of MAOI users ever have hypertensive crises, whether they follow the diet or not.
Posted by Harlock on April 26, 2005, at 13:02:34
In reply to Re: TIme for MAOI's? They scare me., posted by Chairman_MAO on April 26, 2005, at 12:24:21
> I take 120mg tranylcypromine per day. I have taken as much as 200mg/day when I was on tranylcypromine alone, and have been taking it since August 2004. I have never had a hypertensive reaction to anything.
>
> The only alcohol I avoid is tap beer, although I absentmindedly had one last weekend to no ill effect. The only foods I have to cut out are these:
>
> --fava beans
> --REAL aged cheeses, such as cheddar and feta. Proecssed cheddar, etc. like you find in almost everything in the US is just fine. I had a cheddar cheese burrito with a tap beer in a restaurant and was fine.
> --Fermented soy products
> --air-dried sausages
>
> That's it. Statistics show only 8% of MAOI users ever have hypertensive crises, whether they follow the diet or not.I'm not familiar with that drug. I'm assuming it's an maoi.
How has it worked for you and what do you suffer from?
Avoiding certain foods will be real easy for me, except for pizza and beer. I never use OTC drugs, so there's no issue there.
What exactly is a hypertensive crisis. What happens to you, and how to do remedy it?
This is the end of the thread.
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