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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by shasling on September 20, 2005, at 16:19:21
Anhedonia, lethargic depression for years. I've taken truckloads of AD meds; SSRIs until I gag on them. Nothing works even a little. Can't take it anymore. Now they are talking about ECT. I've seen all the reasearch which says MAOIs are effective on this subtype of depression, but I can't get anyone to even try it. HOW does one find a Dr who will be serious about TREATING treatment-resistent depression? Imagine, they want to zap my brain before even TRYING the one class of meds known to work on this kind of preoblem. I am really, frighteningly desperate for relief. Who are these people getting to try MAOI's and how do you get them?
Thanks
Posted by Declan on September 20, 2005, at 16:32:34
In reply to how to get a Dr to rx MAOIs, posted by shasling on September 20, 2005, at 16:19:21
If you had tried them before and they worked it would be a powerful argument for trying them again. That's how I was Rxd Parnate. Plus you know all about them.
Declan
Posted by shasling on September 20, 2005, at 16:53:56
In reply to Re: how to get a Dr to rx MAOIs, posted by Declan on September 20, 2005, at 16:32:34
> If you had tried them before and they worked it would be a powerful argument for trying them again. That's how I was Rxd Parnate. Plus you know all about them.
> DeclanThanks. That was actually going to be my next/last shot at this. How did the Parnate work for you?
Posted by Tom Twilight on September 20, 2005, at 16:54:29
In reply to Re: how to get a Dr to rx MAOIs, posted by Declan on September 20, 2005, at 16:32:34
The idea of trying ECT before an MAOI seems obsurd!
(Is that how its spelt? Damn dyslexia!)Can I ask what country your living in mellymel?
If I were you I would email as many psychiatrists as possible, to see which ones are willing to prescribe and MAOI
Posted by shasling on September 20, 2005, at 17:01:59
In reply to Re: how to get a Dr to rx MAOIs, posted by Tom Twilight on September 20, 2005, at 16:54:29
Yeah, isn't that crazy? And it seems the more I want to try it the more resistant they become. Go figure...
Thanks for posting, its been feeling like I was way out here by myself for a long, long time and it's nice to know people are out there.
Posted by Declan on September 20, 2005, at 17:09:37
In reply to Re: how to get a Dr to rx MAOIs, posted by shasling on September 20, 2005, at 16:53:56
Well, it's like this. I don't sleep well anyway and Parnate makes that worse. But at least taking Parnate's not throwing insult at injury like a lot of (old) psych drugs. Parnate feels nice. But I don't need much. 10mg/d is enough for me. I don't always take it, but it's good to have it around. I've never taken Nardil, which might suit me better, except for the side effects.
30 years ago I got a script for Marplan after telling a doctor that I had been using amphetamine because I was depressed. He gave me the script, but on reflection it wasn't the best line.
Declan
Posted by UgottaHaveHOPE` on September 20, 2005, at 17:55:32
In reply to how to get a Dr to rx MAOIs, posted by shasling on September 20, 2005, at 16:19:21
then you can persaude your pdoc to let you try them. i would memorize what foods and drinks that the MAIOs have bad interactions with ....
knowledge is power. if the pdoc doesnt go for it and you feel strongly about trying this, then go to a new pdoc.
Posted by mworkman on September 20, 2005, at 18:51:57
In reply to Re: First thing to do is to research MAIOs, posted by UgottaHaveHOPE` on September 20, 2005, at 17:55:32
I just looked in the yellow pages and called every gp and pdoc that was listed. I asked the receptionist that I had tried everything else, and was looking for a doctor who would prescribe nardil. Then I asked them to ask the doctor(s) if they would. I got two yes answers out of about 30 calls.
Posted by Declan on September 20, 2005, at 19:19:01
In reply to Re: First thing to do is to research MAIOs, posted by mworkman on September 20, 2005, at 18:51:57
Posted by UgottaHaveHOPE` on September 21, 2005, at 2:11:28
In reply to Re: First thing to do is to research MAIOs, posted by mworkman on September 20, 2005, at 18:51:57
X
Posted by Jedi on September 21, 2005, at 2:20:04
In reply to how to get a Dr to rx MAOIs, posted by shasling on September 20, 2005, at 16:19:21
> Anhedonia, lethargic depression for years.
Hi Shasling,
I'm from a small town about 150 miles from any major city. When I was seriously depressed the first time, I was lucky enough to find a PDOC that knew enough about atypical depression and social anxiety that he used Nardil on about the fourth trial. Thank God. When I came out of the depression, it was like night and day. Then this doctor left town and after a year or two I wanted to try Parnate, in hopes of maintaining the antidepressant effect and losing the sexual and weight gain side effects. After trials with several of the newer antidepressants and Parnate, nothing worked and I found myself back in major depression. At least this PDOC put me back on Nardil before he retired from practice, so I could recover to a somewhat normal level of dysthymia. I then traveled to see a PDOC that was suppossed to be one of the best in the country. At the time I was taking Nardil and Wellbutrin SR. He said this combination could kill me, and recommended ECT. I said I was saving that one for the last resort. I then saw one more PDOC who put me through nine months of different trials and refused to go back to what had worked in the past, Nardil. His reasoning for this was my tendency to adjust my own medications. I'm sure he would have rather seen me dead on a nice safe SSRI than try a MAOI. Finally I switched GPs and did about fifty pages of research to convince him that the Nardil was the only thing that would work for me. Since then, about three years ago, I have tried augmenting with different meds, but I will never go off Nardil until a med comes out that is proven to be as effective with less side effects. Good luck, the search for a knowledgeable MD with guts can be very difficult.
Take care,
Jedi
Posted by shasling on September 21, 2005, at 17:42:59
In reply to Re: how to get a Dr to rx MAOIs » shasling, posted by Jedi on September 21, 2005, at 2:20:04
>
>
> Hi Shasling,
> I'm from a small town about 150 miles from any major city.Hi Jedi (and all who wrote),
Thanks so much for sharing. What a nightmare dysthymia/atypical/treatment resistant depression can be. I've been chasing treatment for like 20 years. When a series of New Wonder SSRI's don't work, docs give up - "you might have to get used to it.." (?!!) - and so I go away, telling myself someone will help me figure it out in the future; put quality of life on the back burner and fight through the deadness I feel, one foot in front of the other over and over just to make it through the day/week/month/year.. So after 20 years and several docs I am now 45, with the realization that 1) I've run out of future to postpone acheiving successful treatment to, and 2) 45 years have been wasted suffering. And the idea that we haven't ever been willing to try - TRY - something that might work infuriates and defeats me at the same time. I'm so beat down by this that I can barely put myself through going to see a new doc, only to be blindly run through their favorite SSRI paradigm, while I pay them not to do their job and still all the while continue to suffer; yet always knowing that I have done lots of research and chances are they just might have the key in their hand but they simply won't bring it out and try use it. It makes me feel so helpless and angry at the same time.
I've been seriously out of hope; weekends lately I lay in bed with my eyes closed day and night and let the days go by until its time to go to work again, cause thats the only time I know what to do with myself. I want you all to know what your responses have meant a lot to me. Really. I feel a little less lost. You may have given me the motivation to get up and try again.Sorry I ran on like that. Upon reading, I wonder whether I ought to post this, but it somehow feels better if I do. I know we all have our own issues, but letting me just communicate my experience made me feel a little better.
Thanks again for sharing and helping.
Posted by Chairman_MAO on September 21, 2005, at 19:40:27
In reply to Re: how to get a Dr to rx MAOIs, posted by shasling on September 21, 2005, at 17:42:59
If you absolutely cannot find a doctor to Rx an MAOI, order it from xxx or a chemical supply house and self-medicate. Then, when you are [hopefully] feeling better, you will be in a state of mind to convince a pdoc to Rx one for you.
If I had to bet on which MAOI would be most likely to work, I'd go with 1mg/kg phenelzine hands down.
the response to high-dose tranylcypromine is often robust, but it is prohibitively expensive mail-order (12-20 tabs/day!)
Posted by UgottaHaveHOPE` on September 21, 2005, at 22:33:04
In reply to Re: how to get a Dr to rx MAOIs » shasling, posted by Chairman_MAO on September 21, 2005, at 19:40:27
Thanks for sharing your story. Please continue to do so. That is what this board is for, to exchange experiences and support.
Posted by shasling on September 22, 2005, at 9:13:56
In reply to Re: how to get a Dr to rx MAOIs » shasling, posted by Chairman_MAO on September 21, 2005, at 19:40:27
A-ha! I have scoured the internet, cause I don't even care what it might cost, but was unable to find anything. You are a saint. Thanks.
Posted by shasling on September 22, 2005, at 9:17:16
In reply to Re: Urgent for Shasling, posted by UgottaHaveHOPE` on September 21, 2005, at 22:33:04
Thanks for sharing your story. Please continue to do so. That is what this board is for, to exchange experiences and support.
Thank you. You know, you all make me cry when I read these, just thinking people are out there who care. But its a good cry : ) Thanks again.
Posted by SFY on September 22, 2005, at 13:50:18
In reply to Re: how to get a Dr to rx MAOIs, posted by shasling on September 21, 2005, at 17:42:59
Go to this site to find pdocs experienced in treating treatment-resistant depression: http://www.psycom.net/depression.central.psychiatrists.html
You may be able to find a pdoc nearby. If not you can always see if any of them can provide a local referral. You can also email Dr. Ivan Goldberg, who runs the site, to see if he can offer a referral. It couldn't hurt and Dr. Ivan is usually pretty helpful with a quick email.
Posted by shasling on September 22, 2005, at 17:40:07
In reply to Re: how to get a Dr to rx MAOIs » shasling, posted by SFY on September 22, 2005, at 13:50:18
> Go to this site to find pdocs experienced in treating treatment-resistant depression: http://www.psycom.net/depression.central.psychiatrists.html
>
> You may be able to find a pdoc nearby. If not you can always see if any of them can provide a local referral. You can also email Dr. Ivan Goldberg, who runs the site, to see if he can offer a referral. It couldn't hurt and Dr. Ivan is usually pretty helpful with a quick email.Thanks for the link - there are three of them in Dallas. You all have been so great. Good karma all around! It blows me away that perfect strangers will try more to help than anyone esle... very grateful.
Posted by laurenjb on September 22, 2005, at 18:19:32
In reply to Re: how to get a Dr to rx MAOIs » SFY, posted by shasling on September 22, 2005, at 17:40:07
Shasling: Best of luck finding a pdoc to prescribe. After having tried 30 or so meds AND ect (which was AWFUL for me but has worked wonders for some), my doctor actually suggested Parnate. I was the one who was somewhat resistant to trying it, but after researching it, here especially, I realized there is a much better understanding by some MDs re: the food issues and that the benefits far outweighed the sacrifices. I am doing ok on 60mg Parnate right now but desperately need something to augment it and will be seeing a top psychopharmacologist on Oct. 7. When I hear stories like yours about having so much difficulty participating in your own treatment, I feel very fortunate to have the doctor I have. For those who live in Orange County, California or somewhere accessible, send me an e-mail and I'll refer you. One last thought, when you go to the doctor, it helps to go in armed to the hilt with medical information (unfortunately, psycho-babble posts tend not to be persuasive!) about your choice. I truly, truly hope you get what you need and that it works! Take care, Lauren
Posted by shasling on September 22, 2005, at 21:08:10
In reply to Re: how to get a Dr to rx MAOIs, posted by laurenjb on September 22, 2005, at 18:19:32
> Shasling: Best of luck finding a pdoc to prescribe. After having tried 30 or so meds AND ect (which was AWFUL for me but has worked wonders for some), my doctor actually suggested Parnate. I was the one who was somewhat resistant to trying it, but after researching it, here especially, I realized there is a much better understanding by some MDs re: the food issues and that the benefits far outweighed the sacrifices. I am doing ok on 60mg Parnate right now but desperately need something to augment it and will be seeing a top psychopharmacologist on Oct. 7. When I hear stories like yours about having so much difficulty participating in your own treatment, I feel very fortunate to have the doctor I have. For those who live in Orange County, California or somewhere accessible, send me an e-mail and I'll refer you. One last thought, when you go to the doctor, it helps to go in armed to the hilt with medical information (unfortunately, psycho-babble posts tend not to be persuasive!) about your choice. I truly, truly hope you get what you need and that it works! Take care, Lauren
Lauren and all:
Thanks for the input. I do have lots of research, but a funny thing happens: The more I lobby for something, the more they resist. I don't know, maybe my delivery sucks. Admittedly, I'm intensly frustrated and nearly in a panic by now, so maybe they sense that and don't want any part of it. Who knows? I mean, she'll give me ANYTHING else I ask for. And its clear to both of us that I'm nearing suicidal opt-out, but there's no way in hell we're trying that damn class of drugs. Go figure. I'd be interested in what your new phara guy comes up with. We tried Abilify, because we do pretty much both agree that my problem is in all likelihood dopamine-related, and the thing is is worked really well, I felt like a brand-new, whole person, and I dared to get my hopes up, but then but then it, like, turned on me and made me crazy. Crazy crazy. Jumping out of my skin, waiting to hear voices crazy. And this is no matter how small the dose. So, anyway, It would be of interest to hear what your pharmacologist comes up with. The good news is that I now know where to get ahold of what I'm looking for, and will probably go that route, do it without her. Just knowing that's an option and my life is back under my own control has made me much less agitated.I'm gonna say it until you gag on it: You people have saved me, and don't ever underestimate the power of showing a little interest. You all have done more good just spending five minutes posting a response to a stranger than all the doctors I've ver seen put together.
Posted by gardenergirl on September 23, 2005, at 22:26:39
In reply to Re: how to get a Dr to rx MAOIs » shasling, posted by Chairman_MAO on September 21, 2005, at 19:40:27
> If you absolutely cannot find a doctor to Rx an MAOI, order it from xxx or a chemical supply house and self-medicate.
GG here, acting as deputy for Dr. Bob...
Please don't use this site to exchange information that could be used to obtain prescription medication without a prescription.
It's fine to discuss here the pros and cons of the medications, just not how to obtain them in those ways.For further information, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#illegalFollow-ups regarding these issues should be directed to the admin. board.
Thanks,
gg
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