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Posted by eeyorena on January 25, 2005, at 12:06:19

In reply to RE: NEW THREAD - POSITIVE EFFEXOR EXPERIENCE eeyorena, posted by corafree on January 25, 2005, at 0:23:41

I have atypical depression, which is characterized by mood reactivity, sensitivity to rejection, excessive sleeping (versus insomnia), leaden paralysis, increased weight (vs. decrease), and chronic dysphoria (anxiety, depression and unease).

MAOIs have been around for absolutely ever. In the 1950's, little was known about the interaction between MAOI's, blood pressure and dosage. Dosages were too high (which caused liver damage). Patients' diets were not restricted. There is an early case study (from the 50's) of a patient in the UK on an MAOI who died after consuming three kinds of aged cheeses plus alcohol for dinner, then who had more aged cheese for breakfast.

Now, we know a LOT more about MAOI's.

There is a lot of misinformation about MAOI's still floating around out there which makes many doctors hesitant to suggest it to patients. They will try other meds first which require fewer lifestyle changes.

However, for people with atypical depression or treatment resistance who are not responding well to tricyclics, SSRI's, or newer classes of meds...MAOI's can be an excellent choice.

Doctor's will NOT prescribe Parnate (which is one kind of MAOI...the one I'm on) to patients with the following:

-cerebrovascular or cardiovascular disorders
-Parkinson's disease
-Diabetic patients
-liver disease or abnormal liver tests
-in combination with any of the following drugs...Marplan, Furoxone, Eutonyl, Mardil, Natulane, Elavil, Endep, Etrafon, Triavil, Anafranil, Norpramin, Petrofrane, Janimine, Tofranil, Aventyl, Pamelor, Vivactil, Adapin, Sinequan, Tegretol, Flexeril, Asendin, Surmontil, Wellbutrin, Redux, any SSRI, meperidine, dextromethorphan, Buspar, amphetamines, OTC weight-reducing meds, or OTC cold/hay fever meds.

How do MAOI's work?

A doctor will give you a more educated answer. An incomplete but easier to visualize answer might be this: Your body produces a chemical that keeps your blood pressure from getting too high. If you eat certain foods or take certain drugs and your blood pressure rises, your body will try to bring your blood pressure down by releasing this MAO...which acts as a kind of "safety valve." Parnate is an MAOInhibitor. It inhibits the production of MAO. That is why it is important, when on this drug, to take care of your blood pressure.

What about this "MAOI Diet" I hear about?

Patients on Parnate follow a special "diet" which elimates foods with high tyramine content. Tyramine occurs in foods which are required or have been allowed to age, but not all foods have to be aged to contain tyramine. Foods to avoid: Aged meats (sausage, salami, etc.), aged cheeses, beer/wine/sherry/liqueurs, yogurt, pickled herring, anchovies, caviar, sauerkraut, pods of broad beans, liver, canned figs, avocados, overripe fruit, sour cream, soy sauce, tofu and high quality chocolate.

There are many "MAOI diet" lists out there which have some misinformation on them. I've found that "faux chocolate" (most commercial American light chocolate) contains lower levels of tyramine. Some diet lists include bananas, when (actually) banana peels and overripe bananas are the culprits. Young cheeses (such as fresh mozzarella) or faux cheese (such as American cheese) have not created problems for me personally, but I am not a doctor or a dietician.

On Parnate, I eat better than I ever have. I eat a lot more fresh or frozen vegetables and meats, as well as less cheese and chocolate. I avoid foods with a lot of additives. I started to because I was nervous, but now I do because I've noticed an improvement in my overall health. Strangely, I don't have the cravings for carbs, caffeine, chocolate or cheese that I used to...which really makes me wonder about how I used to self-medicate with food. When I started Parnate, it was a little worrisome because I lost my appetite completely and dropped a LOT of weight. Eventually, I stabilized but still don't have the weight gain I had on other AD's.

I wear a Med Alert ID bracelet (a pretty one actually) with my other med names on it...I take Parnate, Allegra, Cytomel and Neurontin. This is really a good idea for anyone on meds anyway. I got one when my husband suggested it. He was nervous that he wouldn't remember all of my meds if something happened. With Parnate, it is a good idea because hospitals will want to be very careful about administering anethesia if you are on Parnate. Better that they know.

So, it's a bit more complex than Prozac or Zoloft. But, I've been on it for 2 years and it has worked wonders for me. So...I like it.




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