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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 Girlnterrupted on May 3, 2007, at 0:52:04
I keep getting discouraged when I hear of people who had an MAOI work great, to only last a couple of weeks and poop-out.
So I'd like to ask all the people here who have been on any MAOI, how long did it last for you before it pooped-out?
Has it pooped-out for every single person reading this board?
Thanks in advance.
Posted by Malcolm64 on May 3, 2007, at 1:18:52
In reply to Poll: How long have MAOIs lasted b4 poop-out?, posted by Girlnterrupted on May 3, 2007, at 0:52:04
> I keep getting discouraged when I hear of people who had an MAOI work great, to only last a couple of weeks and poop-out.
>
> So I'd like to ask all the people here who have been on any MAOI, how long did it last for you before it pooped-out?
>
> Has it pooped-out for every single person reading this board?
>
> Thanks in advance.I was on Nardil about a year ago and after a superb initial reaction, it pooped out at around 4 weeks. But what a fantastic four weeks! They will forever be etched in my memory as the standard upon which all other drugs (including Parnate, which I'm on right now) will be judged.
Mine was definitely a classic hypomanic reaction; although, b/c I'm not a reckless person by nature, I didn't do anything that I would later regret. That's something that you defintely have to watch out for if you're so inclined.
But that doesn't mean that just b/c mine only lasted about 4 weeks, yours will be similarly short lived. Psch drugs are notorious for reacting differently depending on the person. Hopefully, yours wll last indefinitely, although I wouldn't count on it.
One thing that my doc didn't suggest was to augment the Nardil with a benzo once the Nardil's effectiveness waned, and that might have helped (at least from what I've been reading here).
So the bottom line is, don't give it up when you notice the poop-out; try augmenting it with other drugs. B/C when you think about it, no LEGAL drug can make you feel on cloud nine indefinitely. I have to keep reminding myself of that if I experience the hypomanic reaction that I'm hoping to achieve on Parnate.
I realize that I may be contracticting myself when I say not to expect an indefinite hypomanic rection while hoping that the Parnate produces exactly that in myself. But hopefully, there are other drugs which my doc hasn't tried which will at least extend the effect to a degree once the initial hypomania wears off.
Malcolm
Posted by Jedi on May 3, 2007, at 2:56:31
In reply to Re: Poll: How long have MAOIs lasted b4 poop-out?, posted by Malcolm64 on May 3, 2007, at 1:18:52
Hey guys,
Are you old enough to remember the scratched skipping record, well here I go again! Hypomania is a side effect. It can feel good after months or years of treatment resistant depression, but it is not the effect you are looking for. If you do get a hypomanic reaction, it can signal the med starting to work. But loss of that manic feeling does not mean the medication has lost it's efficacy. I've been on Nardil for most of the past ten years. the only times I've fallen back into the "black hole" of major depression is when I've stopped the med to try newer or different medications. MAOIs have been around since the late fifties. They are dirty meds with lots of side effects. For some of us, they are the only medication that works. Some people have posted that they have been on the drugs for thirty or forty years.
Jedi
Posted by UgottaHaveHope on May 3, 2007, at 5:37:28
In reply to Poll: How long have MAOIs lasted b4 poop-out?, posted by Girlnterrupted on May 3, 2007, at 0:52:04
And thats the truth.
Posted by Honore on May 3, 2007, at 9:54:23
In reply to I know two ppl on Nardil for 30+ years » Girlnterrupted, posted by UgottaHaveHope on May 3, 2007, at 5:37:28
Not only have Maois not stopped working for many people, it's a quite atypical reaction to have a good effect for several weeks and then have it disappear.
If you read around and search the archives, you;ll find lots of instances of people who used maois for years.
I used Parnate for four years without it's losing its effect. I did use a large dose, which eventually led to a rare side effect that caused me to stop usng it. But there's not any reason to fear that maois stop working for most people who use them.
Honore
Posted by Phillipa on May 3, 2007, at 11:23:30
In reply to Re: I know two ppl on Nardil for 30+ years, posted by Honore on May 3, 2007, at 9:54:23
That was a question of mine too if they poop out what then? Love Phillipa
Posted by Jedi on May 3, 2007, at 11:41:40
In reply to Re: I know two ppl on Nardil for 30+ years, posted by Phillipa on May 3, 2007, at 11:23:30
> That was a question of mine too if they poop out what then? Love Phillipa
Hi Phillipa,
I sure appreciate all you do for this forum. You are a very caring person. If the MAOIs fail me and I'm back in that fetal position with no hope, "Heaven Forbid". I'm counting on a couple of different things. 1st is VNS(Vagus Nerve Stimulation)or something similar that is devised to stimulate the spot in my brain that needs stimulating.
Last, I'm saving ECT as a last resort before the long dirt nap.
Take care and be well,
Jedi
Posted by Phillipa on May 3, 2007, at 19:19:41
In reply to If MAOIs fail, what then? » Phillipa, posted by Jedi on May 3, 2007, at 11:41:40
Jedi don't forget that DBS is now being done. San Diego this summer. Love Phillipa
Posted by FredPotter on May 3, 2007, at 23:28:13
In reply to Re: If MAOIs fail, what then? » Jedi, posted by Phillipa on May 3, 2007, at 19:19:41
If Nardil (or Parnate) poop-out isn't it wise to increase the dose? However, I read that after 4 weeks of effective response one can drop the dose right down, as all the MAO has been destroyed and it takes a long time to be restored so a small dose is all that is needed to mop up the new MAO as it is created.
I'm disappointed to hear about MAOI poop-out as I didn't think it did. Also that once once on the right dose it always works
Fred
Posted by Jedi on May 4, 2007, at 1:12:31
In reply to Re: If MAOIs fail, what then? » Jedi, posted by Phillipa on May 3, 2007, at 19:19:41
> Jedi don't forget that DBS is now being done. San Diego this summer. Love Phillipa
Thanks Phillipa, I haven't researched DBS at all. Here is a Medscape interview with Helen S. Mayberg, MD,"about her groundbreaking research into the neurophysiologic loci of depression and the benefits of DBS for patients with intractable illness".
Take care,
JediLink: http://www.medscape.com/viewarticle/520659
From Medscape Psychiatry & Mental Health
Expert Interview:
Deep Brain Stimulation for Treatment-Resistant Depression: An Expert Interview With Helen S. Mayberg, MD
Posted 01/05/2006
Author Information: Helen S. Mayberg, MD, Professor, Departments of Psychiatry and Neurology, Emory University, Atlanta, GeorgiaDisclosure: Helen S. Mayberg, MD, has disclosed that she has served as an advisor or consultant to Cyberonics and Advanced Neuromodulation Systems and has a patent licensed from Advanced Neuromodulation Systems.
Editor's Note:
Despite numerous advances in our understanding of the neurophysiology of depression and the development of pharmacologic treatments, many treated individuals remain symptomatic. Electroconvulsive therapy is an effective approach for patients who do not respond to standard treatments, and recently, vagus nerve stimulation also was approved for treatment-resistant depression. Investigational strategies that directly target the brain are also proving to be successful, including transcranial magnetic stimulation, magnetic seizure therapy, and deep brain stimulation (DBS). On behalf of Medscape, Alisa R. Gutman interviewed Helen S. Mayberg, MD, Professor of Psychiatry and Neurology, Emory University, Atlanta, Georgia, about her groundbreaking research into the neurophysiologic loci of depression and the benefits of DBS for patients with intractable illness.
Posted by Jedi on May 4, 2007, at 2:30:05
In reply to Re: If MAOIs fail, what then?, posted by FredPotter on May 3, 2007, at 23:28:13
> If Nardil (or Parnate) poop-out isn't it wise to increase the dose? However, I read that after 4 weeks of effective response one can drop the dose right down, as all the MAO has been destroyed and it takes a long time to be restored so a small dose is all that is needed to mop up the new MAO as it is created.
>
> I'm disappointed to hear about MAOI poop-out as I didn't think it did. Also that once once on the right dose it always works
> FredHi Fred,
My strategies listed above are for if the meds quit working all together. Currently, I'm on 80mg of Parnate and doctor willing, I will take it up to 100mg or more if needed. I am already augmenting with clonazepam, but lithium and stimulants are other options I will pursue if necessary. If Parnate does not work for me, this is my 2nd trial-I'm going to push it a lot harder, then I would go back on Nardil. In ten years this medication has never failed me. I don't like some of the side effects, that is why I try other meds. Not saying it is the right thing to do, but I have a stash of Nardil to get me started again. I had a PDOC once who would have let me die before putting me back on Nardil. It took me several months of letter writing to find someone to prescribe it.I've read about the theory of being able to reduce your MAOI dosage after several weeks or months at an effective dosage. All I can say, it does not work for me(n=1). While on Nardil, I have to keep the dosage between 75 and 90mg or it's the "Black Hole". It sure would be nice to reduce it because of the side effects. This strategy may work for some people. I believe there are other things going on with MAOIs besides just Monoamine Oxidase Inhibition.
Good Luck,
Jedi
Posted by Phillipa on May 4, 2007, at 19:09:10
In reply to Re: If MAOIs fail, what then? » Phillipa, posted by Jedi on May 4, 2007, at 1:12:31
Jedi thanks I'm sending this link to a friend in San Diego being evaluated for the summmer studies. Love Phillipa
Posted by UgottaHaveHope on May 5, 2007, at 0:01:58
In reply to If MAOIs fail, what then? » Phillipa, posted by Jedi on May 3, 2007, at 11:41:40
No worries here, folks. Follow this regiment if your MAOI stops being as effective as it once was.
1. Most common and almost always works: INCREASE your dosage of your MAOI under your doctor's supervision.
2. Take MAOI with another drug. SLS and several others have found great success in mixing the MAOI with TCAs. Dr. Gillman says "The irony is that mixing a TCA (one which is not also an SRI) with an MAOI makes it safer!" Click here for more info:
http://www.psychotropical.com/maois_full.shtml3. Switch MAOIs (Nardil may not work for you, but Parnate does. Or Emsam. They are all different. Just because one doesn't work, doesn't mean all of them will not work).
Don't FEAR trying a MAOI. Fear NOT trying a MAOI.
Posted by Honore on May 5, 2007, at 11:52:37
In reply to There are PLENTY of options if your MAOI fail, posted by UgottaHaveHope on May 5, 2007, at 0:01:58
There's no particular reaon to think that Maois will stop working. That's certainly no reason not to try one. If it works, you can cross the bridge of what to do if it stops, when and IF it stops.
By then there may be options that we don't even know about now.
That fear just can't be an obstacle to using an AD if you need it.
Honore
Posted by Quintal on May 5, 2007, at 13:30:23
In reply to Re: If MAOIs fail, what then?, posted by FredPotter on May 3, 2007, at 23:28:13
>If Nardil (or Parnate) poop-out isn't it wise to increase the dose? However, I read that after 4 weeks of effective response one can drop the dose right down, as all the MAO has been destroyed and it takes a long time to be restored so a small dose is all that is needed to mop up the new MAO as it is created.
With Nardil you have active metabolites like phenylethylidenehydrazine that increase GABA and they very likely play an important part in the therapeutic response. Lowering the dose would lower the level of these metabolites so it might be unwise to assume it's okay to lower the dose once you've achieved a remission going purely by the MAO theory.
With Parnate you have those rumours of amphetamine metabolites which I think play an important role at high doses, yet my pdoc refused to raise the dose beyond 30mg and hoped to reduce it to 10mg as a maintenance dose. I'm sure that would not have worked.
Q
Posted by timidly on May 7, 2007, at 20:36:25
In reply to Poll: How long have MAOIs lasted b4 poop-out?, posted by Girlnterrupted on May 3, 2007, at 0:52:04
I have been on Nardil for 35 years and have experienced "poop out" every 9 to 12 years. Restarting it after 2+ months off it restored full effectivity for me.
Posted by FredPotter on May 7, 2007, at 21:21:06
In reply to Re: Poll: How long have MAOIs lasted b4 poop-out?, posted by timidly on May 7, 2007, at 20:36:25
Gosh! Take the pips outa that everybody!
Posted by rose45 on August 12, 2019, at 15:47:41
In reply to Re: Poll: How long have MAOIs lasted b4 poop-out?, posted by timidly on May 7, 2007, at 20:36:25
hi timidly,
I know this is an old post, but could you tell me a little bit more about restarting......was it very painful getting off the medication?
I thought once an maoi has pooped out, it would not work again for at least a while.....Both nardil and parnate have pooped out on me and I am very ill and desperate as I really dont know what to do.
Thanks
Posted by rose45 on August 12, 2019, at 15:57:47
In reply to Re: Poll: How long have MAOIs lasted b4 poop-out?, posted by rose45 on August 12, 2019, at 15:47:41
nardil lasted 22 years and parnate lasted 6 years.
Posted by Jedi on August 13, 2019, at 12:57:09
In reply to Re: Poll: How long have MAOIs lasted b4 poop-out?, posted by rose45 on August 12, 2019, at 15:47:41
Hi Guys,
I'm one of those people that have been on long-term Nardil. Sometimes augmented with clonazepam. Over 20 years at this point. I have had short times off for other drug trials. But Nardil has been my lifesaver.The only time that it has pooped out on me is when I'm taking low doses of 30 mg. When this happens I will up the dosage to 60 or 75 mg and usually start feeling better within a couple of weeks. I believe this shorter recovery time is because the MAOI is already partially built up in my system. So it takes less time for the full effect to kick in once I go to the higher dosage.
I take the minimal amount necessary to maintain remission. Most of the side effects have gone away over the years. But insomnia still has to be treated. And retarded ejaculation still happens at high dosage.
When I first started Nardil, over 20 years ago, I did have a major hypomanic episode. I can't tell you how good that felt after being depressed for so long. But that is not the antidepressant effect of the drug, it is a side effect. Don't misinterpret the loss of hypomania as poop out of the drug. Funny, after that initial hypomanic episode, I have never had another one. Even when off of Nardil for 9 months, when I started up again, the hypomania never came back.
For me Nardil has been the bomb. Honestly, the medication saved my life. Of course it won't be for everybody. And there are many other options. Never, never give up. We only get one shot at this life.
Be well,
Jedihi timidly,
>
> I know this is an old post, but could you tell me a little bit more about restarting......was it very painful getting off the medication?
> I thought once an maoi has pooped out, it would not work again for at least a while.....
>
> Both nardil and parnate have pooped out on me and I am very ill and desperate as I really dont know what to do.
>
> Thanks
Posted by chumbawumba on August 26, 2019, at 23:31:37
In reply to Poll: How long have MAOIs lasted b4 poop-out?, posted by Girlnterrupted on May 3, 2007, at 0:52:04
I've been on Parnate for years and it still works the same. But I take Lithium too.
This is the end of the thread.
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