Psycho-Babble Medication Thread 617008

Shown: posts 1 to 12 of 12. This is the beginning of the thread.

 

Trying MAOI for first time

Posted by Gregor on March 7, 2006, at 11:13:52

Hi Everyone,

I have really bad anxiety and depression, although the anxiety has almost always been worse. I have tried about 10 different SSRIs etc, and none has really helped much. I have tapered off Luvox and expect to be put on a MAOI this Thursday when I see my doctor. We have talked mostly about Nardil. Two questions: How has a MAOI worked for you if you have had really bad anxiety that seemed treatment resistant, and what do you think of Nardil vs. another MAOI? Thanks

 

Re: Trying MAOI for first time » Gregor

Posted by Chairman_MAO on March 7, 2006, at 11:53:00

In reply to Trying MAOI for first time, posted by Gregor on March 7, 2006, at 11:13:52

Nardil works better than benzodiazepines for my social phobia and almost as well for generalized anxiety. I have tried Parnate (up to 200mg/day), which is certainly superior to all other antidepressants that I have tried, but unfortunately nowhere near as effective as Nardil can be for me at 75-90mg/day.

For treatment-resistant anxiety, Nardil or Marplan are IMHO first-line. Another option for severe anxiety would be Parnate or selegiline (Eldepryl, EmSam) + benzodiazepine/meprobamate/barbiturate/opioid.

 

Re: Trying MAOI for first time

Posted by Gregor on March 7, 2006, at 11:55:41

In reply to Re: Trying MAOI for first time » Gregor, posted by Chairman_MAO on March 7, 2006, at 11:53:00

Thanks for the response! Two follow-up questions: How long did it take to work, when did your anxiety start (mine started around the age of 12-13), and how restricted have you felt with your diet?

 

Re: Trying MAOI for first time » Gregor

Posted by Chairman_MAO on March 7, 2006, at 12:15:44

In reply to Re: Trying MAOI for first time, posted by Gregor on March 7, 2006, at 11:55:41

I went from Parnate immediately to Nardil, so I cannot say how quickly it starts working. However, I have felt some calming effects within the first 1-3 days. The antidepressant effect comes later.

My depression/anxiety issues got a lot worse starting in adolescence, and then intensifying again at age 19-20. Right on schedule!

I do not feel restricted in my diet at all. I just don't eat fermented soy products or really aged cheeses or meats. No fava beans either. It's really not that difficult, for me at least.
The benefits are well worth it. Note that not everyone is as lucky as I am.

I have never had a hypertensive crisis from any food or drug (thankfully!). The closest I came was from accidentally eating some soy-based sauce from a Chinese restaurant. Bad headache, but I've had worse from hangovers.

 

Re: Trying MAOI for first time » Gregor

Posted by TylerJ on March 7, 2006, at 12:45:52

In reply to Trying MAOI for first time, posted by Gregor on March 7, 2006, at 11:13:52

> Hi Everyone,
>
> I have really bad anxiety and depression, although the anxiety has almost always been worse. I have tried about 10 different SSRIs etc, and none has really helped much. I have tapered off Luvox and expect to be put on a MAOI this Thursday when I see my doctor. We have talked mostly about Nardil. Two questions: How has a MAOI worked for you if you have had really bad anxiety that seemed treatment resistant, and what do you think of Nardil vs. another MAOI? Thanks
>
>

I'm a big fan of the MAOI's...Parnate works great for me!
I started having anxiety problems at age 16. I'm 47 now. I've been diagnosed with atypical depression w/some major depression features. OCD, Panic attacks, GAD, and social phobia. I've tried all the ssri's, all the snri's many TCA's, Nardil and Parnate, plus tons of mood stabilizers,anticonvulsants,anxiolytics used as augmentation agents. For ME Parnate has worked by far the best. After only 1 wk ( I've been on it one month now) I have 0 depression, 0 anxiety, 0 ocd, 0 social phobia and 0 panic attacks...unbelievable for a guy who has had my crappy background! The only thing I'm taking is Parnate 80 mgs, and ativan (which i don't feel i need-I'm tapering off it) 3 mgs aday.
Please feel free to ask me anything. Good Luck, Nardil is a great drug! Good Luck.

Tyler

 

Re: Starting a MAOI

Posted by JaclinHyde on March 7, 2006, at 18:44:55

In reply to Starting a MAOI, posted by Gregor on March 7, 2006, at 11:40:00

The new nardil is not as good as the old nardil. Parnate is great if you don't mind a revved up feeling and Marplan is my favorite because it falls in the middle of the other two with minimal side effects. No matter which you pick you will get better with it :-)

Let us know how it goes!

JH

 

Re: Trying MAOI for first time

Posted by JaclinHyde on March 7, 2006, at 19:11:49

In reply to Re: Trying MAOI for first time » Gregor, posted by TylerJ on March 7, 2006, at 12:45:52

I have tried every damn drug out there and believe me NOTHING compares to the MAOI's. They're da bomb :-) The big guns. I love marplan first but had to stop it due to being bipolar. I am on Parnate now which is working equally as well. Nardil worked too but made me too groggy and I gained too much weight on it. Parnate worked the fastest, I felt relief in about a week. Nardil was my first and took me 6 weeks to feel better. But when I did....WOW! It was as sudden as a gut punch. :-)

Oh and the diet is no problem.

JH

 

Re: Starting a MAOI

Posted by Gregor on March 8, 2006, at 8:09:46

In reply to Re: Starting a MAOI, posted by JaclinHyde on March 7, 2006, at 18:44:55

Hi JH,

Thanks for the encouragement. I appreciate it! I am looking forward to trying it, I think it will be Nardil for me at first. One other question for everyone. I have bad allergies and usually take claritin or a derivative thereof in the spring - any problems taking these with Nardil?


> The new nardil is not as good as the old nardil. Parnate is great if you don't mind a revved up feeling and Marplan is my favorite because it falls in the middle of the other two with minimal side effects. No matter which you pick you will get better with it :-)
>
> Let us know how it goes!
>
> JH

 

Re: Trying MAOI for first time

Posted by Gregor on March 8, 2006, at 8:11:17

In reply to Re: Trying MAOI for first time » Gregor, posted by Chairman_MAO on March 7, 2006, at 12:15:44

Thanks Chairman!

I appreciate your sharing your experience. I have never looked forward to taking a drug so much as I do for Nardil!


> I went from Parnate immediately to Nardil, so I cannot say how quickly it starts working. However, I have felt some calming effects within the first 1-3 days. The antidepressant effect comes later.
>
> My depression/anxiety issues got a lot worse starting in adolescence, and then intensifying again at age 19-20. Right on schedule!
>
> I do not feel restricted in my diet at all. I just don't eat fermented soy products or really aged cheeses or meats. No fava beans either. It's really not that difficult, for me at least.
> The benefits are well worth it. Note that not everyone is as lucky as I am.
>
> I have never had a hypertensive crisis from any food or drug (thankfully!). The closest I came was from accidentally eating some soy-based sauce from a Chinese restaurant. Bad headache, but I've had worse from hangovers.

 

Re: Trying MAOI for first time » Gregor

Posted by Chairman_MAO on March 8, 2006, at 11:32:26

In reply to Re: Trying MAOI for first time, posted by Gregor on March 8, 2006, at 8:11:17

Nardil is a very unique drug. It has, for better or for worse, an astounding array of varied effects. Keep in mind the following:

--For most people, the ideal therapeutic dose is 1mg per kilogram of bodyweight in divided doses (ideally three equal doses, perhaps four). I believe a lot of people's problems with this drug are a result of inadequate dosage and/or only once or twice daily administration.
--It will take many months for your body--brain and otherwise--and mind to adjust. Initially, I had a severe constellation of side effects (edema, orthostatic hypotension, constipation, urinary retention, the "Nardil nod" (especially in the afternoons), myoclonic jerks that interfered with sleep and scared my girlfriend, impotence, difficulty achieving orgasm, and marked insomnia. I gained some weight, but I went to the gym so I put it to good use. After four months, 3/4 or more of the side effects had waned. After seven months, the orgasm issue suddenly got markedly better. Side effects that went away completely were: constipation, urinary retention, "Nardil nod", orthostatic hypotension. The only one that never improved was insomnia, which I deal with using 10-15mg Ambien or 3-6mg Lunesta nightly.
--The monograph's assertion that there is a lower "maintenance dose" seems incorrect to me.
--A lot of what you think may be weight gain might instead be merely water retention. Hydrochlorothiazide 25-100mg every other day or every day works well for this. I believe I have retained up to 10+lbs of water at times (possibly 15).
--Testosterone plus a dopaminergic drug, with or without a PDE5 inhibitor (Viagra/Cialis/Levitra) is the best treatment I have found for the sexual dysfunction. Testosterone is very safe to use intermittently for BOTH MEN AND WOMEN (women use a lower dose obviously, as little as 1mg, whereas men use 5-10mg+). Androgel 1% testosterone gel comes in a dispenser that gives 1.25g per pump. Thus, even women can benefit from this treatment.
I have taken testosterone in very large doses via intramuscular injection as well. Again, if used INTERMITTENTLY, e.g. two to three times per week, it is virtually harmless in most people.
--D-amphetamine is a great agent to use for fatigue, sexual dysfunction, the "foggy" feeling that you may get (GABA-T inhibition probably), etc. 2.5-20mg two to three times daily.
--Get an updated MAOI diet; the food list included with the monograph is woefully incorrect and needlessly restrictive. The only things I make sure to eat as little as possible of are: fermented soy products, fava beans (l-dopa content), the brine in pickled herring (blech), spoiled bananas/meats/etc (yuck), banana peels (haha), heavily aged cheeses (processed cheeses are OK, so is goat cheese, mozz., any provolone I've had, and frankly most cheese, air-dried/cured sausages/meats. I have eaten all of these by accident or on purpose now and then, and only got "the headache" ONCE (it was not as bad as a hangover) while on Parnate after eating some soy-based sauce by mistake. I took some clonidine and it went away.

Best of luck!

 

Re: Starting a MAOI

Posted by JaclinHyde on March 8, 2006, at 12:24:38

In reply to Re: Starting a MAOI, posted by Gregor on March 8, 2006, at 8:09:46

No no problem with claritin et al, just watch for sudefed and its friends. The old time decongestents are what can do you harm.

JH

 

Re: Starting a MAOI » Gregor

Posted by jedi on March 9, 2006, at 1:43:42

In reply to Re: Starting a MAOI, posted by Gregor on March 8, 2006, at 8:09:46

Straight Claritin(loratadine) should not be a problem, though I did get some strange tinnitus combining it with Nardil one time. Be careful not to get Claritin-D. Pseudoephedrine hydrochloride is a definite no-no along with most over the counter cold meds. Benadryl(diphenhydramine hydrochloride) is also OK with Nardil, and can be valuable as an occasional sleep aid.
Take care,
Jedi

...
One other question for everyone. I have bad allergies and usually take claritin or a derivative thereof in the spring - any problems taking these with Nardil?


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