Posted by willyee on March 2, 2005, at 0:02:40
In reply to Something Scary, posted by ed_uk on February 27, 2005, at 9:28:45
> Hi,
>
> I was just thinking, how can we ensure the continued availability of Nardil and Parnate? They have already been discontinued in many parts of the world.
>
> While pharmaceutical companies are pushing their latest money-spiners, how can we educate doctors that MAOIs are still useful?
>
> Ed.I dont think its directly the p-docs.I believe (and im sure not everyone agrees) that the pharm companys are the spine of the industry,the core.
Like the other poster mentioned,you see pads,pens,etc and most of all samples!!! In docters office as a result of who runs the industry,the pharm companys!
If your a p-doc you have a new medication presented to you,a consistent visit from a rep of the medication,who keeps you informed of the medication,encourges you to use it,provides free samples,then what are you likly to use? This medication or a much older one where you more than likly will have to read up on and learn yourself,one which no one but the patient is encourgaging,...it doesent give Maois a fair chance.
Maybe its not so much they feel we are uninformed,maybe a good number of p-docs themselves arent too informed on them,since they are not mainstream,and not a part of their everyday experieances,maybe the lack of expereiance and knowledge the docs themselves have discourage them from using them.I know i have come across docs who were not up to par on them.
Maybe the folks who do get them prescribed without asking are the ones who have older docs,who remember when they were mainstream and are themselves familiar and comfortable with it.
Like any profession,you will be most familiar with what you interact with daily,they see so many patients on these meds they prob know very well the course the med generaly takes,and feel comfortable with it.
Slap on a little discouragment from the industry, along with time consuming work re-amping their knowledge,it is easy to see why an unfamiliar docter would not see it in his interest at all to prescribe them.This once again spins back to the pharm company.
Also think what would happen if a doc began prescribing them,and his records show a decline in prescriptions of the newer "encouraged meds" im sure a doc with low numbers will not make visiting reps too pleased.
I think it might be more complex than the docter simply fearing the paitent on them.I mean even now you have meds adapting dangerous reputations,such as paxil addiction etc,i doubt this makes a doc relcutctant,or luvox and the big columbine scare,once again i doubt if most docs are reluctant with this newer med,i just dont think in general it comes down to a docs concern of use by the patient more so than a load of other hush hush factors.
Either way the thought of either parnate or nardil being obsolete is more than scary,its horrid,a crime.I have spoken to the country and i dont believe parnate anyway is in any consideration for that to happen.At least not here in the U.S
Lastly once again i dont think people should not value their docs,i do HOWEVER think we need to tone down the who "dont do anything without talking to your doc" this was adapted when we dident have the internet with a zillion resources,this was adapted when the docs had accsess to more than a paitent could get.With the internet now this is not the case.So if youre a responsable adult,and you feel comptent,then why rest your emotional state soly on a two week wait basis,where you get 5-10 mintues of treatment time.
Your docter is not gonna read a million dociments,or follow a speicifc drug,or seek out individuals to gather experainces for you,this is a 24 hr job,and who better for that job then yourself!
As long as we dont question the docters,or make it clear to them we want to play a role in our treatment,then i doubt things will change,and a patients request of a maoi will continue to be patrionized away only to instead aggressivly recomend a ssri.
I know i had to go through 2 docters,one flat out refused,and put me back on buspar and lithium,two drugs i totaly failed on rather than prescribe parnate,i was still timid then and agreed.
Of course i got worse,and decedid i would not take another med but parnate,and when i did get it i had a remission in 48 hrs,something every cocktail of ssris failed to do in over 4 years.Sorry for the long post its just such a close touchy topic for me since i lived it and seen how hard it can be to get a medication u feel can help,and how hopless it can feel when no matter how hard you try,you are made to feel guilty for continuing to seek it,and go home with more pocket emptying repeat unsuccessful medications.
poster:willyee
thread:464006
URL: http://www.dr-bob.org/babble/20050227/msgs/465268.html