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Re: Dr. Hoffman - alternative approaches Daniel Hoffman, M.D.

Posted by KaraS on March 24, 2005, at 1:16:32

In reply to Re: Dr. Hoffman - alternative approaches, posted by Daniel Hoffman, M.D. on March 23, 2005, at 22:22:37

> > Dr. Hoffman,
> > Does the database include MAOI medications? So many physicians are reticent to prescribe them. Also, I have been afraid to try them but would be more inclined if a test showed that one of them would be a good match for me. Perhaps once this kind of testing becomes more mainstream, this would also encourage more physicians to prescribe MAOIs rather than just routinely handing out the latest SSRI.
> >
> > Thanks,
> > Kara
> Yes, the database includes MAOI's, but they don't fall under the "antidepressant" category. To the brain, they act similar to the "stimulants", which is often why only certain patients respond to them. rEEG had dramatically increased my use of MAOI's. American psychiatrists way under utilize these medications. Even a website by Harvard has chastised us for not using them the way European psychiatrists do. We're so afraid of litigation that we've scared ourselves and the public from considering these meds. None of my patients have had a problem with them, but it is initially scary to think about taking them. They are afraid of all the diet and medication restrictions. Several websites have reworked the foods you can eat categorizing them into high. medium and low risk. Newer MAOI's, which are reversible (but not available in the US) will not have the interactions that we see now. I think they are a definite viable option - but until rEEG I'd never used one. Shame on me!

Thanks again. That's surprising to me that the MAOIs are in the stimulant category, not so much for Parnate but for Nardil and Marplan. I had a feeling that rEEG would (and will) lead to more use of MAOIs. rEEG sounds like such a great improvement on the way things are currently done. I'm very encouraged by it. I wonder if I might ask you one more question about how success is measured here. An SSRI/SNRI might lift mood a lot and control anxiety but leave the patient feeling apathetic and without motivation. Would this be considered success according to this diagnostic system?





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