Posted by Elizabeth on December 1, 2001, at 13:25:21
In reply to MAOIs » Elizabeth, posted by manowar on November 30, 2001, at 16:25:18
> > (You're right that while Paxil is a selective serotonin reuptake inhibitor, Effexor is a nonselective monoamine reuptake inhibitor, blocking the uptake of serotonin, norepinephrine, and (at very high doses) dopamine.)
>
> Effexor is a MAOI?I don't believe that anyone said that. (No, it's not. As I said in the above quote, it's a monoamine reuptake inhibitor.)
> I'm interested in the possibility in trying a MAOI. Last year I asked my pdoc and he said he would never consider it. He said that even if the "cheese effect" did not exist that his experience in the past (he's quite old) is that it didn't work often, and when it did-- only with women.
If I were in your situation, I would ask to see some numbers. I have a hunch that his prejudice against MAOIs (and yes, this prejudice is unfounded) is influencing his impression of how well they work. It also may be that his fears are preventing him from using effective doses of MAOIs. On the other hand, it seems that he's not very well educated about the risk of food interactions -- it sounds like he thinks it is something very common and unpredictable -- so maybe he doesn't feel qualified to prescribe MAOIs, and if so he might be right.
It may be that women are less likely to respond to tricyclics and so are more likely to end up being given MAOIs (since most pdocs still believe that TCAs should be tried before MAOIs). That doesn't mean that MAOIs work poorly for men, though.
> Should a MAOI be my next "drug of choice"?
I don't have an opinion about that...I know we spoke before, but I don't recall much about the specifics of your situation. If you're having trouble finding something that works for you among the newer ADs, and if your pdoc has this kind of attitude toward the older ones, it might be time to think about looking for a more informed pdoc. Don't take this as gospel, of course, it's just a thought based on what you have said here.
In general, I think it is worthwhile for people with a wide range of different types of depression and anxiety disorders to try MAOIs if the newer classes of ADs don't work. I don't think that TCAs should necessarily be tried before MAOIs.
-elizabeth
poster:Elizabeth
thread:85575
URL: http://www.dr-bob.org/babble/20011123/msgs/85742.html