Posted by Racer on August 26, 2007, at 13:41:23
In reply to Re: Benzos do not have any effect on me. . ., posted by DiscoPuppy on August 26, 2007, at 13:10:53
> I find this very sad and disappointing. If a drug is known to work for a specific indication, doctors should not feel encumbered to prescribe something appropriate to treat their patient.
I assume this is in response to Quintal's comments about Nardil.
Here's the thing about anti-depressants in general: mostly, they all work for roughly the same percentage of people who take them. Doctors do tend to exhaust the SSRIs and other newer drugs before going for MAOIs, and even before going for TCAs. That's because the newer drugs tend to have fewer, milder side effects and be much safer in overdose.
Additionally, MAOIs require that one follow a diet which restricts certain types of food -- basically, anything aged or fermented. If the diet is not followed, the result can be life threatening. While those here who take the drugs have learned to accommodate the diet, most of the world would not find that so easy.
Always remember that those of us who come here tend to be outliers -- many of us have tried and failed many drug trials, we tend to be treatment resistant, and we've found this place to learn more so that we can be more involved in our own treatment. That's great, of course, but it's also not necessarily true of the average consumer of mental health care. The average person who goes to a doctor for an anti-depressant probably wants a simple, easy fix -- take a pill every day, no more depression. Since that's the average patient, a lot of psychiatrists don't have a lot of experience with MAOIs. That being the case, I don't think we can fault them for being resistant to prescribing them.
What's more, while MAOIs do work well for a lot of people, they won't necessarily be the answer for everyone. And they're not the first drugs I'd recommend for anyone to try -- it makes sense to try the "easier" drugs before going to the big guns. MAOIs will always be there if the other drugs don't work out. Why not try those drugs which won't require giving up Japanese food, pepperoni pizza, etc, before going on to MAOIs? The more benign alternatives may just work for you -- they do work for hundreds of thousands of people, after all.
In terms of anxiety such as you describe, I'd say start with an SSRI -- they do tend to reduce anxiety, although some people find them to cause apathy. In fact, that apathy is a benefit for some people. Otherwise, I loved BuSpar, although it increased my depression too much to continue it. Seroquel might be a good option, as well.
Personally, I'd recommend psychotherapy to learn some self-soothing techniques, and explore what causes your reactions to these situations. I suspect you'd get more long lasting benefit than the meds can provide. That's my bias, though.