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Re: MAOI characteristics

Posted by Adam on December 14, 1999, at 13:46:07

In reply to MAOI characteristics, posted by Mark on December 14, 1999, at 4:43:09

I assume (since you only referred to Parnate, Nardil, and Marplan) that you are primarily interested
in non-specific, irreversible monoamine oxidase inhibitors.

I can't comment extensively on a "collective personality" of MAOIs. I have personal experience with
only one, so I can comment in it's individual "personality". General things that I've heard about
MAOIs are that they kick in relatively rapidly, often are rather stimulating, and often cause mild
to moderate problems with orthostatic hypotension. Of course, there are the dietary restrictions
and adverse drug interactions that one must be mindful of (esp. the latter). From what I understand,
though, it's tough to make blanket statements because individual responses to the MAOIs can be so
different. I guess Parnate is the most activating of the three you mentioned, and the least likely to
cause weight gain and sexual dysfunction. Some find Nardil and Marplan sedating, one tends to gain
weight on these drugs, and sexual dysfuntion is a common complaint (though this can be true of Parnate
also). Nardil and Marplan are supposed to be particularly good for anxiety, and Nardil is often
referred to as the "gold standard" medication for social phobia.

Another MAOI I'll mention is selegiline (brand name Deprenyl), which is what I'm on. Selegiline at
high doses acts in many ways like the other MAOIs, though it has some interesting properties besides
its MAO-inhibitory effects. It acts especially potently on dopamine, one one of the nice things I've
found is that it has caused no sexual dysfunction at all. The flip side of this is that I have found
it very activating (some of its active metabolites are amphetamines), and this has caused everything
from jitters to really irritating insomnia (look at the times of some of my posts here for proof of
that). It's done a hell of a good job treating my depression, though, in a way that I honestly didn't
think a drug could do before I experienced such a remission myself.

That's one definite thing I've heard about the MAOIs: A robust response to this class of meds can
be very dramatic. Two very knowledgeable doctors I've spoken with recently feel that the antidpressant
response to MAOIs, when it is a fill response, is the best of any antidepressant class. Of course,
again, individual responses vary widely, and along with the benefits of MAOIs can come some difficultt
side-effects and definite risks.

> Every drug has its own "personality." For example, with the SSRIs, Prozac tends to be the most activating and Paxil the most sedating. In addition, certain collective categories of drugs, such as the SSRIs, can have their own personalities as well (SSRIs tend to increase assertiveness, self-confidence, etc. as explained by Peter Kramer). My question is what is the collective "personality" of the MAOI group as a whole, and what are the individual personalities of the drugs within the MAOI category (Nardil, Parnate, Marplan). I hope this doesn't sound too confusing to everyone.




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