Psycho-Babble Medication Thread 1111098

Shown: posts 1 to 11 of 11. This is the beginning of the thread.

 

MAOI frustrations

Posted by creepy on July 1, 2020, at 20:55:23

I had a doctor that was about to give me emsam, finally! but then just as we go around to finalizing what was left of my med regime, she says I wont go higher than 6mg. Not much good at 6mg!

No one on the forum 'MAOI doctors' list up where I live. This is all getting kinda old.
Anyone had luck doing these online pharmacy things and getting someone to give you a script for a fee?
I have insurance but if this is all I can get around here whats the point may as well pay for something that gets me functional again.
All the docs around here are OBSESSED with liability. Geez, ever heard of MAOI diet and nifedipine? These new docs have largely lost the art its horrible.
Its not like I have any pre-existing health issues other than depression. And if this continues.. I WILL get health issues due to inactivity and weight gain. but you cant sue them for that right? </snark>

 

Re: MAOI frustrations

Posted by PeterMartin on July 1, 2020, at 23:40:10

In reply to MAOI frustrations, posted by creepy on July 1, 2020, at 20:55:23

You might have some luck posting on a newish Reddit group.

https://old.reddit.com/r/MAOIs/

Sorry I don't have anything specific to suggest.

 

Re: MAOI frustrations PeterMartin

Posted by SLS on July 2, 2020, at 7:17:12

In reply to Re: MAOI frustrations, posted by PeterMartin on July 1, 2020, at 23:40:10

Emsam might be better for social anxiety than for depression. That was my doctor's observation early on. If you read the package label by the drug manufacturer, you will see that they state the dosage of Emsam necessary for an antidepressant response must be high enough to block a significant amount of MAO-A. Emsam is not *specific* for MAO-B. It is *selective* for MAO-B at lower dosages. My recommendation is not to view a failure to respond to Emsam to be generalized to all MAOIs. Not all people who respond to Parnate also respond to Nardil and vice versa.


- Scott

 

Re: MAOI frustrations creepy

Posted by beckett2 on July 2, 2020, at 13:36:03

In reply to MAOI frustrations, posted by creepy on July 1, 2020, at 20:55:23

> I had a doctor that was about to give me emsam, finally! but then just as we go around to finalizing what was left of my med regime, she says I wont go higher than 6mg. Not much good at 6mg!
>
> No one on the forum 'MAOI doctors' list up where I live. This is all getting kinda old.
> Anyone had luck doing these online pharmacy things and getting someone to give you a script for a fee?
> I have insurance but if this is all I can get around here whats the point may as well pay for something that gets me functional again.
> All the docs around here are OBSESSED with liability. Geez, ever heard of MAOI diet and nifedipine? These new docs have largely lost the art its horrible.
> Its not like I have any pre-existing health issues other than depression. And if this continues.. I WILL get health issues due to inactivity and weight gain. but you cant sue them for that right? </snark>
>

What are her reasons for not going higher? I didn't get much effect until 9 mg. At 12 mg I began to feel food reactions (coffee, chocolate).

I second https://www.reddit.com/r/MAOIs/

This is very hit-or-miss https://www.reddit.com/r/depressionregimens/

 

Re: MAOI frustrations

Posted by pontormo on July 2, 2020, at 14:25:39

In reply to Re: MAOI frustrations creepy, posted by beckett2 on July 2, 2020, at 13:36:03

Sounds really frustrating.

I use emsam at a much higher dose, >12 mg/day and only very rarely have any food reactions, and those only to things like really aged cheese and maybe the occasional spoiled food. But these reactions are really minor and all I've ever had to do is take off a patch and it subsides. Plus of course after a while, you know what and how much you can and can't eat.

I might be able to tolerate a higher dose than most (I don't know)-- but I would think 12 mg would be worth trying. I mean if it causes problems, you can stop. And she can give you nifedipine-- as stated. And then you at least will know that whatever dose you tried was too much, and go from there.

Maybe in this day of remote medical services, you can finally locate someone in another city, in whatever state you live in, who can supervise, or work in tandem with her, or take you on as a patient.


Your Pdoc could expand her horizons.

 

Re: MAOI frustrations

Posted by creepy on July 6, 2020, at 19:44:15

In reply to MAOI frustrations, posted by creepy on July 1, 2020, at 20:55:23

Well she is (like everyone else in this damn clinic) so fixated on liability that shes worried I will have a hypertensive episode on this medication and stroke out or something.
selegiline is selective for MAOB, right. And its not really much good for my MDD symptoms without that higher dose. Which means its utterly pointless to offer me 6mg and she totally knows this. Which makes me even more angry.
I mean, for example I have been on stims for ADD for years. in the last 6 years I havent had any becuase they suddenly decided they wanted to make everyone jump through hoops to get them. they want me to attend some 2 day 'study' and have an EKG. WTF, really?
I get so irritated just thinking about it that I cant even cope. its silly, but along with the apathy it keeps me from doing anything about it.
I get the feeling they just want you in there every month so they can get your insurance money, feed you crappy SSRIs that dont do anything except make you numb so you will shut up and pay them while you rot away at home with a life that amounts to an apathetic nothing.

 

Re: MAOI frustrations

Posted by rjlockhart37 on July 7, 2020, at 13:40:28

In reply to MAOI frustrations, posted by creepy on July 1, 2020, at 20:55:23

you shoud ask doctor about moclobemide - its a selective MAO-B, they use it both for parkinsons and severe depression

also Rasagiline, but its mainly for treatment of parkinsons, but still increases some dopamine. Not sure if those would qualify, there not popular MAOIS

 

Re: MAOI frustrations

Posted by SLS on July 7, 2020, at 20:58:57

In reply to Re: MAOI frustrations, posted by rjlockhart37 on July 7, 2020, at 13:40:28

Just a quick correction, RJ.

Moclobemide is a reversible inhibitor of MAO-A. It is my impression that MAO-A is more important for depression than MAO-B.

Moblobemide does not often produce a lasting improvement. Most people find themselves escalating the dosage quickly to retain any benefit until they reach the maximum dosage of 1200 mg/day, and then there's nowhere to go. The only theoretical advantage to moclobemide is that its reversibility doesn't require one to follow a low-tyramine diet. But it is its reversibility that probably makes it such a crappy antidepressant.


- Scott

 

Re: MAOI frustrations

Posted by Lamdage22 on July 8, 2020, at 14:46:12

In reply to Re: MAOI frustrations, posted by SLS on July 7, 2020, at 20:58:57

Small number of people will do well on it. I have met one.

 

Re: MAOI frustrations

Posted by adiaphora on July 9, 2020, at 14:27:41

In reply to Re: MAOI frustrations, posted by SLS on July 7, 2020, at 20:58:57

Apologies if I am being very dim, but moclobemide isn't available in the US, is it?

 

Re: MAOI frustrations

Posted by Lamdage22 on July 9, 2020, at 14:31:59

In reply to Re: MAOI frustrations, posted by adiaphora on July 9, 2020, at 14:27:41

No it isn't.


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