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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 Hello123 on December 18, 2014, at 16:14:14
So, im wanting to try an MAOI and am currently taking Adderall. I know Adderall cant be taken with an MAOI, and im just wondering if a Withdrawal Period from Adderall, such as 2 weeks, is needed before I can start an MAOI? The MAOI im wanting to take is Emsam, but may have to try Selegiline instead because of the outrageous price if Emsam (over $1,000 at the pharmacys ive checked).
Ive already talked to my psychiatrist some about Emsam, who has been hesitant about trying an MAOI, and she says even the lowest dose of it requires the Dietary restrictions, which is the opposite of what ive read on sites like WebMD and even the Emsam Website. I also had a young Psychiatric Nurse tell me this when i was an inpatient for 3 days laat week, while a different Nurse, and the Psychiatrist there told me there is no need for the Diet Restrictions. im just getting tired of dealing with Healthcare "Professionals"...
Posted by Phillipa on December 18, 2014, at 17:05:34
In reply to Withdrawal period needed before starting an MAOI, posted by Hello123 on December 18, 2014, at 16:14:14
Isn't Ensam no restrictions at 6mg, maybe none at 9mg? Phillipa
Posted by Christ_empowered on December 18, 2014, at 17:45:09
In reply to Re: Withdrawal period needed before starting an MAOI » Hello123, posted by Phillipa on December 18, 2014, at 17:05:34
amphetamines are sometimes prescribed w/ maoi drugs.
Posted by Hello123 on December 18, 2014, at 17:54:44
In reply to Re: Withdrawal period needed before starting an MAOI » Hello123, posted by Phillipa on December 18, 2014, at 17:05:34
well i just found the answer to my question. youre supposed to wait 4 to 5 halflives after stopping a contraindicated med before starting Emsam. So i believe thats about 56 hours in all for Adderall.
And yes, on every site ive read about Emsam, it says there are no Diet Restrictions for the 6mg dose of Emsam. and ive read that the Diet Restrictions for the higher doses are just in case. that its basically to be cautious. It seems Some working in Psychiatry are being over cautious. i just dont like them telling me im wrong, when its them who are wrong. One of the Psych Nurses even told me i would have to take a 2 week class on the Diet Restrictions before i can be prescribed Emsam.
its just getting so irritating trying to find the help i need. i spent the past 2 months running back and forth to a hospital 200 miles away as part of the process of making sure im a candidate for Vagus Nerve Stimulation, and then on the day before i was to have the surgery, the surgeon called to let me know Medicare denied coverage.
its as if the closer i get to running out of treatment options, the less doctors are willing to help me with the options i do have.
Posted by rjlockhart37 on December 18, 2014, at 18:37:56
In reply to Re: Withdrawal period needed before starting an MAOI, posted by Hello123 on December 18, 2014, at 17:54:44
yea adderall actually can enhace the antidepressant effect on MAOI's, because it stimulates dopamine.... can't take like supplements, and the foods, yea i've seen here on babble people taking adderall with MAOI, paticularly Parnate, which it's effect is similar to adderall but not as speedy....does have alot side effects though.....
why don't you yea.....stop addearll, but really it's not ... i don't think it's harmful, i've been on bluelight.com it's a recreational experiment blog of drugs, at parties they have said that Nardil will increase the effect of exctacy and make it last longer.....and extacy is an amphetamine but it's diffrent and effect serotonin more than dopamine than classic amphetamine
Posted by baseball55 on December 18, 2014, at 19:40:53
In reply to Re: Withdrawal period needed before starting an MAOI, posted by Hello123 on December 18, 2014, at 17:54:44
Why ensam? It rarely works at the low dosages to avoid diet restrictions and is extremely expensive. Why not try parnate or nardil? These are cheap and often very effective. Yes, you have to monitor your diet, but people make way too big a deal about this. How hard is it, really, to stop eating cheese, salami, pepperoni, miso soup, marmite, fava beans and large amounts of soy sauce? It's not really a big deal. I was on parnate for four years and barely registered the dietary restrictions. I've never had salami, marmite or fava beans in my life. I missed feta on salad, parmesan on pasta, but it's not like some huge imposition to stop eating cheese. Cheese is probably bad for you anyway - lots of cholesterol.
Posted by Hello123 on December 18, 2014, at 19:58:19
In reply to Re: Withdrawal period needed before starting an MAOI » Hello123, posted by baseball55 on December 18, 2014, at 19:40:53
> Why ensam? It rarely works at the low dosages to avoid diet restrictions and is extremely expensive. Why not try parnate or nardil? These are cheap and often very effective. Yes, you have to monitor your diet, but people make way too big a deal about this. How hard is it, really, to stop eating cheese, salami, pepperoni, miso soup, marmite, fava beans and large amounts of soy sauce? It's not really a big deal. I was on parnate for four years and barely registered the dietary restrictions. I've never had salami, marmite or fava beans in my life. I missed feta on salad, parmesan on pasta, but it's not like some huge imposition to stop eating cheese. Cheese is probably bad for you anyway - lots of cholesterol.
ive wanted an MAOI that mostly targeted MAO-B. and i would rather just take the pill form of it if a doc will prescribe it. but if i remember right, i believe i read that chocolate should also be avoided while on the MAOI Diet, and ive basically had an addiction to chocolate since i was about 10. but as the other user said, people make too big of a deal about the MAOI Diet. so maybe it wont be a problem?
Posted by Phillipa on December 18, 2014, at 20:39:13
In reply to Re: Withdrawal period needed before starting an MAOI, posted by Hello123 on December 18, 2014, at 19:58:19
I didn't know this about chocolate. As for Ensam some did extremely well on it. Check Robert David the very first in archives. Phillipa
Posted by europerep on December 20, 2014, at 16:27:14
In reply to Re: Withdrawal period needed before starting an MAOI, posted by Hello123 on December 18, 2014, at 19:58:19
> ive wanted an MAOI that mostly targeted MAO-B. and i would rather just take the pill form of it if a doc will prescribe it. but if i remember right, i believe i read that chocolate should also be avoided while on the MAOI Diet, and ive basically had an addiction to chocolate since i was about 10. but as the other user said, people make too big of a deal about the MAOI Diet. so maybe it wont be a problem?
Nah, chocolate is not a problem, unless something has fundamentally changed about the MAOI diet since two or three years ago. I mean, chocolatiers over here have started a while ago to make chocolates with the weirdest of ingredients, like tomatoes, porridge, chili, and whatever. So I wouldn't be surprised if some "innovative" chocolatier had come up with a chocolate that's 10% aged cheese, or that contains fava beans. But even then it's not the chocolate that is the problem. So yeah, chocolate is fine.As for the weird feedbacks you get from doctors, nurses, etc. Well, unfortunately many people in those circles really aren't too well-informed about MAOIs. Sometimes you just have to "play the game" and jump through their hoops. I mean, I certainly wouldn't do a two-week MAOI diet preparation course, and I actually even doubt that such a thing exists. But sometimes you just have to say what they want you to say to get where you want...
I agree with baseball55 though. Going for a "classic" MAOI like phenelzine or tranylcypromine seems to be the most straightforward option. They're powerful drugs. And I think that, at higher doses, selegiline (Emsam) loses its MAO-B selectivity anyway, though I would have to look that up to be certain.
That's mainly what I was gonna say...
Posted by baseball55 on December 22, 2014, at 21:13:57
In reply to Re: Withdrawal period needed before starting an MAOI » Hello123, posted by europerep on December 20, 2014, at 16:27:14
> I agree with baseball55 though. Going for a "classic" MAOI like phenelzine or tranylcypromine seems to be the most straightforward option. They're powerful drugs. And I think that, at higher doses, selegiline (Emsam) loses its MAO-B selectivity anyway, though I would have to look that up to be certain.
>
> That's mainly what I was gonna say...
>
Selegiline does lose MAO-B selectivity at higher dosages. I'm not sure what the dosing is for oral selegiline. I was told that 9mg and up of Ensam was no longer selective for MAO-B and required dietary restrictions.As far as a 2-week course. Please. It's just ridiculous. My p-doc, when I was hospitalized a few years back, was annoyed at how clueless most psychiatrists are about MAOI's today. He had me moved to McLean where the doctors know how to use these older drugs. At McLean, they gave me a one-page sheet listing the dietary restrictions. One page. That was all.
>
Posted by Christ_empowered on December 24, 2014, at 9:54:57
In reply to Re: Withdrawal period needed before starting an MAOI » europerep, posted by baseball55 on December 22, 2014, at 21:13:57
is it a liability issue?
Posted by Hello123 on December 24, 2014, at 22:27:40
In reply to Re: Withdrawal period needed before starting an MAOI, posted by Christ_empowered on December 24, 2014, at 9:54:57
well i was a psychiatric inpatient for 5 days and just got home a few hours ago. its has just gotten hard to be patient with psychiatrists. and yeah, ive been thinking the problem is that they dont want to be held responsible if something bad does happen to me if they prescribe an MAOI.
but, thanks for all the info you guys and Merry Christmas!
This is the end of the thread.
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