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Why MAOI's rarely prescribed » kittencat

Posted by harryp on May 11, 2004, at 2:57:41

In reply to Re: Please help me understand: harryp, posted by kittencat on May 10, 2004, at 21:09:54

The studies that exist seem to indicate that MAOI's are the most broadly effective AD's around, and they have a good side effect profile (esp. Parnate--which may have the best SE profile of any AD).

The "fly in the ointment" is the risk of hypertensive crisis. There have been only a few cases where an untreated crisis caused a stroke or death, but that's enough to make doctors terrified of prescibing them.

Psychiatrists loved the SSRI's because they could be prescribed like candy, with almost no liablity concerns. It's very hard to kill yourself with an SSRI!

Part of the problem with MAOI's is that psychiatrists tend not to trust their patients, and they are afraid that their pt. will not pay attention to diet, have a crisis and just take aspirin for it, and possibly get a stroke.

In practice, avoiding the problem foods and drugs is not hard, and if you get prompt treatment for a hypertensive crisis it will not do you any harm.

The main problem is that you have to be careful when traveling. Carrying a copy of your medical chart with instructions from your doctor wouldn't be a bad idea, because many ER staff haven't seen a MAOI-hypertensive crises before, and may have trouble figuring out what's going on.


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URL: http://www.dr-bob.org/babble/20040510/msgs/345625.html