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Dr. Bob is Robert Hsiung, MD,
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Posted by mbailey on January 25, 2004, at 21:33:49
My husband has atypical depression and was treating it with the MAOI, Zyprexa (60 MG). It wasnt working and he started developing anxieties. The doc decided to take him off and is weaning him by going down 10 MG every 4 days. He is currently at 30. At the time he started going off it, he was put on Lithobid (300 Mg, 2 tablets per day). His anxieties have been steadily increasing so he was put on Xanax (1 mg) every day in the morning a few weeks back. His anxieties are continuing to mount to the point where its rare he doesnt have them.
1. Is worsening of anxiety a typical MAOI withdrawal symptom? If so, what are the characteristics of it (he was not anxious before the past few months)? Does it continue as his dose goes down or is that unpredictable?
2. Is Xanax the only safe way to treat anxieties for people coming off MAOIs?
3. What other non-MAOI drugs successfully treat atypical depression?
4. How long does it typically take to get the MAOIs out of your system once you reach 0?
THANKS!
Posted by gardenergirl on January 26, 2004, at 15:37:27
In reply to MAOI withdrawal, anxiety, Xanax, PLEASE HELP, posted by mbailey on January 25, 2004, at 21:33:49
I'm sorry your husband has to go through this. I have atypical depression and Nardil has been a godsend for me. How long was he on it? I assume he was on 60mg of Nardil. Some actually go to 90 mg to get the best effect. You might want to search the archives, as there is a lot of good stuff there about other meds, anxiety, and MAOI's. I am not an expert on this, but off the top of my head, here are my thoughts.
> 1. Is worsening of anxiety a typical MAOI withdrawal symptom? If so, what are the characteristics of it (he was not anxious before the past few months)? Does it continue as his dose goes down or is that unpredictable?
Since MAOI's are also used to treat Social Anxiety, it makes sense that if you discontinue it, you may feel more anxious. Your husband may have an unconscious anxiety underlying the depression. That is the case with my depression. It comes with the emotional reactivity and sensitivity.
>
> 2. Is Xanax the only safe way to treat anxieties for people coming off MAOIs?I believe I have seen others use Klonopin, but again, check the archives, or perhaps other posters will help with this.
>
> 3. What other non-MAOI drugs successfully treat atypical depression?There are all types of antidepressants. SSRI's, Tricyclics, MAOI's, and others. Has he tried all the usual meds? Perhaps Parnate instead of Nardil? From what I understand, MAOI's are still the gold standard, but of course everyone reacts differently. Perhaps a tricyclic in combo with the Nardil?
>
> 4. How long does it typically take to get the MAOIs out of your system once you reach 0?Dietary restrictions must be maintained for at least 4 weeks post, so I would guess it takes that long.
There are others who post who can answer this more scientifically, but this is to the best of my understanding.
You might also want to consider psychotherapy, if he is not already doing that. Atypical depression really stinks. I truly believe for me it is the combination of the Nardil and the psychodynamic psychotherapy which is working best for me. My friends are saying that the old me is back. It's been years since I have felt this good.
I hope your husband finds something that works for him. We all deserve to beat this.
Take care,
gg
>
> THANKS!
Posted by mbailey on January 26, 2004, at 20:09:58
In reply to Re: MAOI withdrawal, anxiety, Xanax, PLEASE HELP, posted by gardenergirl on January 26, 2004, at 15:37:27
gardengirl - Thanks for the info. He has not been on Nardil but on Zyprexa. Does it make a difference what MAOI?
He had a blood test done over the weekend and his sugar has come in at 254 - I guess 154 is normal. Tomorrow he is going for another. Do you or anyone else know if this itself could be a reason why its not working and anxiety etc
Posted by gardenergirl on January 26, 2004, at 21:28:04
In reply to Re: MAOI withdrawal, anxiety, Xanax, PLEASE HELP, posted by mbailey on January 26, 2004, at 20:09:58
Oops, just re-read your original post. Zyprexa is not an MAOI. It is an atypical antipsychotic. I don't know much about it, but I did see that it can cause high blood sugar, such as the results you reported. In fact, 154 is also not normal, and would be classified as borderline. Normal blood sugars need to be within 80-120. I'm guessing he is going off of the zyprexa because of the elevated blood sugar?
Antipsychotics tend to also reduce anxiety. I'm just guessing here, but his increased anxiety could be due to coming off of the zyprexa. Has he mentioned the symptoms to the doc. who prescribed the zyprexa and/or the one who's taken him off of it if not the same?
Sorry I can't help more. You might re-post with Zyprexa included in the subject line to get responses from those who have taken Zyprexa.
Good luck,
gg
Posted by missinglynx on January 27, 2004, at 3:56:02
In reply to Re: MAOI withdrawal, anxiety, Xanax, PLEASE HELP, posted by gardenergirl on January 26, 2004, at 21:28:04
Are you sure he was on 60 mgs. of Zyprexa? Thats a HUGE ammount! Good luck!
Posted by gardenergirl on January 27, 2004, at 6:44:26
In reply to Re: MAOI withdrawal, ---No Offense but » gardenergirl, posted by missinglynx on January 27, 2004, at 3:56:02
Yeah, I'm a little confused, too.
Posted by mbailey on January 27, 2004, at 8:41:27
In reply to Re: MAOI withdrawal, ---No Offense but » missinglynx, posted by gardenergirl on January 27, 2004, at 6:44:26
Sorry!
I took the bottles down and copied the info - he was in bed and mixed it up.He was on Parnate with Zyphrexa. Parnate was at 60. I dont know ZYphrexa dose.
When the doc started taking him off Parnate, he did it 10 mg every 4 days. He was down to 30 as of Sunday. He added lithium and xanax.
His blood tests came back and sugar is at 254. I guess this is due to Zyphrexa. So the doc now has told him to go off the Parnate and ZYphrexa completely. Double the lithium and xanax.
Again, I very much appreciate any info and am sorry for the mixup.
Posted by jerrympls on January 27, 2004, at 20:05:28
In reply to MAOI withdrawal, anxiety, Xanax, PLEASE HELP, posted by mbailey on January 25, 2004, at 21:33:49
> My husband has atypical depression and was treating it with the MAOI, Zyprexa (60 MG). It wasnt working and he started developing anxieties. The doc decided to take him off and is weaning him by going down 10 MG every 4 days. He is currently at 30. At the time he started going off it, he was put on Lithobid (300 Mg, 2 tablets per day). His anxieties have been steadily increasing so he was put on Xanax (1 mg) every day in the morning a few weeks back. His anxieties are continuing to mount to the point where its rare he doesnt have them.
>
> 1. Is worsening of anxiety a typical MAOI withdrawal symptom? If so, what are the characteristics of it (he was not anxious before the past few months)? Does it continue as his dose goes down or is that unpredictable?When I went of Nardil, my anxiety increased substantially. In my opionion, 1mg of Xanax/day is hardly enough to cover severe anxiety - Xanax is short acting. I was on 4mg of Klonopin/day - which did help with the anxiety.
>
> 2. Is Xanax the only safe way to treat anxieties for people coming off MAOIs?From what my psychiatrist told me - meds like Xanax are VERY safe in combination with MAOI's and are used for withdrawl.
>
> 3. What other non-MAOI drugs successfully treat atypical depression?
>MAOI's are usually the best. Many times an SSRI combined with an anti-psychotic is used.
> 4. How long does it typically take to get the MAOIs out of your system once you reach 0?
After you have taken your last dose of an MAOI, the usual waiting period is 2weeks.
>
> THANKS!Hope this helps
Jerry
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