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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Medline on November 4, 2008, at 3:13:06
I am 24 and had strong social phobia since I can remember, got suicidal depression at age of 14 but received treatment just when I was 18. I did recover a little bit from depression but began to selfmedicate my social-phobia with GHB (not the best idea). Got addicted to GHB and went through severe withdrawal needing treatment in an psychiatric ICU. Since then I have never touched GHB again, but started to drink (not daily, but when I drank then heavily). I am in psychiatric treatment since age of 20 (had several hospitalizations) and tried nearly every antidepressant imaginable (SSRIs/SNRIs/TCAs/Bupropion and also other psychotropic medication (Pregabaline/Topiramate/Olanzapine...) which never helped me. I have my (symptomatic) drinking better under control now but haven't been able to completely abstain from alcohol for long periods of time :-(. I still have what I would call atypical depression (overeating, oversleeping, rejection sensitivity), avoidant personality disorder and strong social phobia. I still live with my parents, I have NO social life at all, sitting at my Computer playing poker all time. I have read many stories about people who's live got changed by either Nardil or Parnate. Are these drugs really so different from SSRIs/SNRIs and other ADs? I could have Parnate from my Pdoc (It's called Jatrosom in my country 20mg tablets). I have very high hopes for this med and want to try it (in combination with Clonazepam). I'm scared by the diet restrictions. Would you try it if you were in my situation, are MAOIs really so special?
Posted by SLS on November 4, 2008, at 7:01:10
In reply to Are MAOIs 'miracle drugs'?, posted by Medline on November 4, 2008, at 3:13:06
Hi.
Being as trite as I can possibly be, I would say that any drug(s) that bring an individual to remission are miracle drugs for that person. These can come from just about every psychotropic group out there. There is nothing wholly magical about MAOIs except that they are sometimes effective where reuptake inhibitors are not. You will never know unless you try. If you experience an improvement after a single night total sleep deprivitation, my guess is that Parnate would be the better choice, especially if you responded partially to Wellbutrin.
- Scott
Posted by jnew12 on November 4, 2008, at 7:29:13
In reply to Re: Are MAOIs 'miracle drugs'? » Medline, posted by SLS on November 4, 2008, at 7:01:10
I don't know I have been on nardil for about a month or more, and I have found nothing "miracle" or "magical" I too tried alot of drugs (remeron, geodon, serequel, zoloft, paxil, effexor, ritalin, trazadone, anafranil, depakote, lexapro, and more I probally forgot)
I am pretty much a non-responder.
Since I have not had a response in a month and it is ruining my concentration does that mean I should jump off it. Some people say if it does not work for you in a month and it makes you miserable get off, and some people say stay on it and the side effects will get better and some time it takes up too 3 months!!
I don't know what to do..confused, sad, ambivalent.
Perhaps a washout, and try some parnate?
I was hoping nardil would work because I have severe depression, sensitivity to rejection, and all other stuff that comes with social anxiety.
Nardil + Benzo = waiste of time
Maybe Parnate + Benzo is better?
Posted by Nadezda on November 4, 2008, at 9:11:10
In reply to Re: Are MAOIs 'miracle drugs'?, posted by jnew12 on November 4, 2008, at 7:29:13
SLS summed it up. If maois work for you, they're miracle drugs-- if they partially work, they're still pretty good drugs.
By the way, imo, a "miracle drug" doesn't mean you pop one and never have a bad day again. If you have severe depression, it can mean that your depression remits significantly, and you have good and bad days, but you can live a more worthwhile life, and work productively toward an even better one. It also can mean that it takes time to get adjusted, to get a response, or even that you need some other drugs to boost the effect,, or to counteract some side-effects. A miracle is really a very complex and shifting thing in this domain, and while Maois haven't been the "answer" to all my problems, over time, they've (as part of a combination of medications) been part of great changes in how I live, and, I hope, greater changes in the future..
Response to these drugs (all drugs, really) is a very individual thing.
I definitely would try them-- but also be patient and not expect any miracles to be overnight ones, but rather ones that you notice one day, when you're thinking about how you differently you feel about things, and how much more you can do.
Nadezda
Posted by Nadezda on November 4, 2008, at 9:23:11
In reply to Are MAOIs 'miracle drugs'?, posted by Medline on November 4, 2008, at 3:13:06
The food restrictions, while you need to be careful and somewhat thoughtful, especially at the beginning, are by no means so scary.
They aren't as vague and diffuse as people think. The main problems, for most people, are aged cheeses, soy sauce, and, to some degree, certain red wines. You also have to be a little more aware of eating spoiled salads, especially from salad bars and so forth. That's it.
The salads, by the way, might be fine-- and probably are-- but it's just the sort of thing you might want to avoid. Over time, you'll come to understand how reactive you are to things-- although of course, care is always important.
At the beginning, you may be concerned, but as time goes on, you'll get quite used to the restrictions, and just build them in. After a long enough time, you'll hardly think about them, because they'll become second nature.
There are also drug interactions-- but they too aren't hard to tolerate.
If you start maois, buy a home BP monitor, though, so you can watch how your BP responds to various foods, and doses.
While this may sounds like a whole rigamarole, it really isn't hard in practice. It's well worth it.
Of course, if your insurance will cover it, you can also get Emsam, which, at the lower doses, has no dietary restrictions.
Nadezda
Posted by Phillipa on November 4, 2008, at 10:14:48
In reply to Re: PS: Food Restrictions, posted by Nadezda on November 4, 2008, at 9:23:11
I agree with the some good days and some bad days as nothing is perfect. Phillipa
Posted by JadeKelly on November 4, 2008, at 10:47:14
In reply to Are MAOIs 'miracle drugs'?, posted by Medline on November 4, 2008, at 3:13:06
I agree with Nadezda, for most people just learning what to watch for with foods and drugs is the real issue. I don't feel I'm missing out on anything (except cheddar cheese!) I find its when I'm out, or at someone's house, I'm a little leery about whats in sauces, dressings, etc.
As for miracle drug, it was for me. I have atyp/tr Depression, frustrating. I was about to give up on the whole mess when I tried Emsam. Great response in 5-6 days. Then switched to Parnate (cheaper) and same thing about 5-6 day excellent resonse. Felt like a new person. Its not exactly euphoria, Its enjoing everyday things, like going from black and white to color. I had to take a break from Parnate but aside from some tolerable side effects, low BP, high BP, Insomnia, it worked within a week and the insomnia was gone in a few days. I'm back on it now at 30mg, waiting for effects to kick in. I know they will. Have no idea for how long.
Maoi's are ONLY AD thats ever touched my depression. As was said, miracle drug for many, def worth trying. I'd suggest buying a BP cuff and get the antidote for hypertention with your script. Having never had experience with low/high BP, its nice to know whats going on if I have symptoms.
Btw- as for the difference in Emsam/Parnate: Didn't feel the BP effects on Emsam, Parnate feels a little more powerful to me, but again, watch BP.
Hope that helps-
Jade
Posted by JadeKelly on November 4, 2008, at 11:03:17
In reply to Re: PS: Food Restrictions, posted by Nadezda on November 4, 2008, at 9:23:11
Hello Nadezda, we don't know each other, I've been a poster just for a few days. I've been reading posts for a long time though.
You sound like you know alot about maoi's which makes me think you have had success on one or more? I had to add a med for high blood pressure (nifedpine) daily until next PDoc appt. Seems the fatigue it causes is delaying my response. Not sure.
Of course the big fear (for me) is that Parnate will stop working. Probably a fear many share when they finally find their "miracle A/d".
So my question(s): How long have you been on MAOI. Which one(s), and how long til your initial response? Did it last? If not, did you augment with anything that helped? If not, how long would you say you got a full response? Anything that causes lack of response i.e. other meds, alcohol, etc.?
Would be great to hear from you. Thanks if you have the time!
Jade
Posted by Medline on November 4, 2008, at 11:06:28
In reply to Re: PS: Food Restrictions, posted by Nadezda on November 4, 2008, at 9:23:11
Thanks for all the info. As I speak German I was able to read alot from the company's website that sells Tranylcypromine in Germany (www.jatrosom.de). To get access to the literature for healthcare professionals only a DocCheck-Password is needed, but I found out the username:jatrosom and the password:jatrosom works too ;-). So I read about 150 sites of recent MAOI literature and a very long FAQ about Jatrosom.
I now know which antidepressants can safely be combined with this MAOI (eg. noradrenergic TCAs like Amitriptyline, Doxepine, Trimipramine, Nortriptyline; Reboxetine, Trazodone, Mianserin, Mirtazapin). But the right sequence is very important and strong serotonergic drugs are a big NO-NO!!. The FAQ also tells that combining noradrenergic drugs with MAOIS (in the right order!!) has a protective effect against the cheese effect, Reboxetine the strongest. Nevertheless one should follow the special diet while on such a combo.
Also very other interesting stuff, I think I will read it again, have an appointment with my (great) Pdoc tommorow and want to know what I talk about.
"If you start maois, buy a home BP monitor, though, so you can watch how your BP responds to various foods, and doses."
I already have one, thanks.
Posted by Medline on November 4, 2008, at 11:10:56
In reply to Tranylcypromine, posted by Medline on November 4, 2008, at 11:06:28
"get the antidote for hypertention"
My Pdoc said he gives his patients on Jatrsom some nasal spray that works within 2 minutes. I don't know if it's Nifidipine.
Posted by linkadge on November 4, 2008, at 19:56:41
In reply to Re: Tranylcypromine, posted by Medline on November 4, 2008, at 11:10:56
Posted by JadeKelly on November 4, 2008, at 21:13:45
In reply to Re: Tranylcypromine, posted by Medline on November 4, 2008, at 11:10:56
> "get the antidote for hypertention"
>
> My Pdoc said he gives his patients on Jatrsom some nasal spray that works within 2 minutes. I don't know if it's Nifidipine.Sounds like you have a good PDoc and all the bases covered Medline. Hope it turns out to be your "miracle" but if not, there's plenty more to try! Let us know how you respond!
Cheers! Jade
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