Posted by Kirbyw on June 25, 2010, at 4:57:16
Rep;y Sent to F in response to his suggestions in a private letter about possible non traditional remedies for problems related to Parnate related difficulties in sexual functioning. These are some random observations about my MAO use that may be of interest to some people on this list.
Dear F.
Thanks for this information...everything is so very complex. I probably have information about at least 20 AD treatments and another dozen or more remedies for various MAO side effects. You can only try so many.Luckily at the present, i am going through a stage of being medication free. I feel good. Its strange. There are some factors that affect my depression and one is being involved in a relationship. I recently started dating an attractive guy (I am a gay man) and the ''crush" on this person I developed seemed to really improve my depressive symptoms very rapidly. Simultaneously since I was having some dental work done, I decided to cut down on MAO's as a mostly unnecessary precaution and dropped from 40 mg to nothing during the past two weeks. Two weeks is a very short time. Also interesting to notice that my sleep problems are a little worse in this good mood phase, and I am kind of hyper and have trouble sleeping. Sounds a little bit bi-polar. This is similar to one phase of MAO use, which is the MAO related insomnia. With MAO's I also go through contradictory phases-- either problems sleeping (more common) or when the depression is worse, hypersomnia meaning that even with 40 mg of I could easily sleep 18 hours a day with no problem. Again a kind of cyclical pattern.
Obviously, currently with no MAO, there is no issue about sexual functioning. i am much 'hornier" which I enjoy a lot even if I am not getting a lot of actual sex. But I can easily masturbate every two days if I wanted to ,nothing yet sexually with my new friend, for various reasons, but the focus is on emotional intimacy.
I may try to give lithium a good try (I have had short trials but probably never reached a therapeutic dose for more than a couple of days for various factors, and always abandoned the lithium, again because of various reasons).I would also be in a position to try a new class of ADs if and when my depression returns, without having to worry about the two week waiting period. I might consider effexor, I think sexual effects are fairly minimal on the lower doses, and it seems to be a pretty good drug.
I really don't understand my depression very well, even after 30 years, (of course I had 25 pretty good years between 1980 and last July, so it was much less of an issue) but the two best shrinks I have seen who are familiar with MAO's think that I do have some latent bi-polar stuff which they also refer to as atypical depression.
One of them, my main Psychiatrist in Chicago during my severe depression of 1980-82, (which was cured ONLY by Parnate) thinks that the cycles I go through are somewhat unrelated to real life events (such as meeting someone new who I can date) but is simply an 'inevitable change in neurochemistry.' that occurs cyclicly. But I believe that that life events do effect my mood, and perhaps rather profoundly. I could literally feel my mood changing from one day to the next after the first date with this person, which was my first real date in nearly a year.
Also the severest depression I have had in 20 years started last June when it became clear that another dating relationship was about to fail after near a year. Again I felt myself sinking rapidly once I realized that I was going to have to end the relationship, that this partner had serious issues that I had not been previously "aware" of, and that I was no longer enjoying our time together. (Not that I don't have issues myself, so I am not blaming him)
As I was sinking, I decided to give Remeron a try on the recommendation of a local Costa Rican shrink) and by the time I got onto it after the two weeks washout period , I was really down, and it seemed to have no impact at all, After a month of Remeron I switched back to Parnate as quickly as possible and the depression lessened again somewhat but not very much at all during the past 11 months.
Should also mention that I do take 3 mg of Clonazapam daily. And this is certainly mood enhancing. But I cannot attribute my current good mood to the clonazapam, as I have been taking it for months and with the 40 mg of Parnate and it helped me get out of bed in the morning, but not much more. It may have been a slight mood enhancer but I was still very depressed. I continue it for the moment. Its "addictive" but at 62 I am not going to worry too much about addiction, although I don't allow myself to go above the 3 mg daily.
Excuse the length and detail of this message. Don't know if its interesting to you at all, F. but I copy and paste it into my own notes so it also serves that purpose.
Recent exam with Cardiologist showed that I am ok for the moment. (Had by pass 2 years ago)
Exercising is so much easier without MAO's. The heaviness is gone. I can walk faster. Its an experience that is hard to describe, but has been mentioned frequently by other MAO users on this list.
Maybe thats the blood pressure issue, but I am also sure that something else is also involved in the relationship between MAO physiology and excercise. Sometimes I go to exercise with a normal blood pressure and still feel the MAO effect. Other times I am exercising (walking ismy exercise) with low pressure when on MAO's which can be pretty miserableBut I am in relatively poor condition in terms of stamina and physical conditioning (partially because of the difficulties of exercising on MAOs) and need to exercise more, so I hope to do this without the MAOs
I get some angina when I walk a lot but thats been happening ever since my bypass and I am not worried. Its seems to clear up with my beta blocker. However its interesting to note again that I don't get angina when on MAO's only when off of them Cardiologists pay no attention when I report this, which is too bad.Also, without MAO's my heart rate is up a little bit so I use a little more of the beta blocker lopressor to keep it below 75. Could be my semi hyperactive state, or physiological factors where Parnate actually helps to reduce heart rate and I am now off of it. I have no idea
Not counting any chickens before they hatch but I am hoping that current mood will stick around for a while.
Thanks for your letter. Getting back to your suggestion, I will keep it for future reference but there are so many recommendations for alternative AD drugs, as well as for remedies for side effects, and it can be quite overwhelming. I have confidence in Parnate, and really haven't found anything else in all in these years that I have been able to rely on. And trials of new remedies are always very anxiety provoking for me, which doesn't help either.
sincerely,
Rick in Costa Rica
poster:Kirbyw
thread:952117
URL: http://www.dr-bob.org/babble/20100615/msgs/952117.html