![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by dj on June 26, 2000, at 7:43:05
In reply to harry b. is sad distraught, posted by harry b. on June 25, 2000, at 22:10:39
> Now I'm crying, feeling so rejected & outcast, >and having serious thoughts of suicide again.
>
> I hate to even post this but I need to get it >out. I feel utterly lost.
>Hang in there, Harry!
Posted by Oddzilla on June 26, 2000, at 11:08:24
In reply to harry b. is sad distraught, posted by harry b. on June 25, 2000, at 22:10:39
harry I'm so sorry. I hope you made it through the night. I'm sending hope and good wishes your way. Please let everyone know how you are by now. I think you've shown tremendous courage through all this. Best wishes O.
Posted by kazoo on June 26, 2000, at 18:34:45
In reply to harry b. is sad distraught, posted by harry b. on June 25, 2000, at 22:10:39
Greetz to harry b.
Yes, the "uchicago.edu" servers have been quite CONSTIPATED lately ... they need a purge!
(Is there a doctor in DA house?)You, on the other hand, got DA BLUES and the best RX for that is humor,
so may I suggest that you visit my latest masterpiece on the web.It's DA BOMB!
http://www.geocities.com/edukayshun/
I remain,
DA kazoo
Posted by Kerry on June 26, 2000, at 18:39:02
In reply to harry b. is sad distraught, posted by harry b. on June 25, 2000, at 22:10:39
Well, it's good that you posted. All your faceless friends are rooting for you out here. Keep posting so we know how you're doing and even though you don't know me feel free to send email if the 'pooter is being a pain.
Posted by shar on June 26, 2000, at 21:51:39
In reply to harry b. is sad distraught, posted by harry b. on June 25, 2000, at 22:10:42
> Took forever to connect this evening. Very annoying &
> frustrating. If I wasn't so down I'd shut this machine
> off & throw it out the window.
>
> Don't need advice, don't want advice.
>
> One of my goals is to stop isolating and attempt to
> socialize.
>
> I tried today. Went to the airport & saw people & talked,
> and *everyone* asked me about my ex friend/father-figure/
> surrogate family. Wanted to know how they were, what
> they were doing, etc, etc.
>
> One person even handed me photos taken at his retirement
> party. I wanted to look at them but knew I should not.
> It was like passing a bad accident on the highway, you
> don't want to see the gore but you are compelled to
> look.
>
> The combination of everyone asking me how he is
> (they assume we are still close), and viewing the photos
> of the party that I did not attend (a self protection
> strategy because I did want to go) knocked me on my ass.
>
> Big time.
>
> All those years, memories and conversations are playing
> in an endless loop in my head, along with the constant
> questions of why the door was slammed in my face. I can't
> stop them.
>
> Now I'm crying, feeling so rejected & outcast, and having
> serious thoughts of suicide again.
>
> I hate to even post this but I need to get it out. I feel
> utterly lost.
>
> Sorry for the downer, folks, but I am one f*cked up
> loser tonight.
>
> Time to take some serious knock-me-out meds to get
> thru the night.
> hb
>
>
>
>I shake my fist at God for Harry B.
Shar
>
Posted by paul on June 26, 2000, at 22:57:05
In reply to Re: harry b. is sad distraught, posted by shar on June 26, 2000, at 21:51:39
harry-
a fd up loser wouldn't have the stones nor the self-awareness to post as you did. i hope you had a good sleep. is there someone you could talk to? let the tears do thier work. i extend an open hand only in hopes that you will see that it is there---
pcl
Posted by paul on June 26, 2000, at 23:24:41
In reply to harry b. is sad distraught, posted by harry b. on June 25, 2000, at 22:10:39
please harry go read kazoo's link. tears come from laughter too and there's PLENTY NUFF here to go round.
pcl
Posted by Janice on June 27, 2000, at 0:22:14
In reply to harry b. is sad distraught, posted by harry b. on June 25, 2000, at 22:10:39
hi harry b
don't you wish there was one straight line to getting better.
I would love to type more to you but I can't stay awake any longer. I did have a dream about you about a week ago. It wasn't a deep or meaningful dream, but you were the first cyberperson that ever made it into any of my dreams. That's a first for me. I'll tell you about it next time I come to psychobabble - my brain is so dead.It sounds like you try very hard. This must be what helps you beat your biology harry. no apologies expected or accepted, Janice
you know, I'm not so sure I like that guy.
Posted by harry b. on June 27, 2000, at 0:59:19
In reply to harry b. is sad distraught, posted by harry b. on June 25, 2000, at 22:10:39
Many heartfelt thanks to all of you for your concern.
I was desparate last night and needed to talk. You,
my friends at PB, have become my life line.
I made it thru the night & today, did not go to
work, used my favorite defense mechanism, sleep.I'm sure not over yesterday's trauma but I'm hanging
in there.I see my therapist Tues. and have my agenda planned.
It is so disconcerting to be in a quasi-normal depressed,
semi-functioning state and attempting to take a step
upward, only to lose my tenuious grasp because of
a trigger, or situation, that I can not resolve,
accept, or dismiss.When I am in this state, and it is quite often, my
thoughts are chaotic, jumbled, and sometimes frightening
when I am able to view them rationally.Hell, I don't know if I'm making any sense or not,
so I'll say thanks again and go to bed.
hb
Posted by NikkiT on June 27, 2000, at 7:37:37
In reply to Re: harry b. is sad distraught, posted by harry b. on June 27, 2000, at 0:59:19
Hey Harry (((hugs)))
Not so great here either, soI won't say too much (Ihave a whole anger / bitching / defense thing going on, so I always offend right now!!!!)
Just, you know we're al here for ya... and if sleep helps u get through today, sleep away.
You know we all love you in our little cyber way... Isn;'t it strange to care so much about people you know nothing really about, and will likely never meet!! ~smiling~
Take alot of care... and come to us when you need to.. (((more hugs)))
N xxx
Posted by dj on June 27, 2000, at 8:07:17
In reply to Re: harry b. is sad distraught, posted by harry b. on June 27, 2000, at 0:59:19
One step at a time, hb, and as they say at the Haven remember to, BREATH, as that is very grounding and something we often don't do very well when in a panic state and reverting to old,learned and deeply ingrained habits.
Posted by JudithC on June 27, 2000, at 10:45:12
In reply to harry b. is sad distraught, posted by harry b. on June 25, 2000, at 22:10:39
Hello,harry b,and I ask you how you are today?If that job is generating this much pressure for you then please find a way to walk away from it.
Posted by danf on June 27, 2000, at 11:28:26
In reply to Re: harry b. is sad distraught, posted by harry b. on June 27, 2000, at 0:59:19
Harry,
some advice which you did not ask for. If you cannot resolve, accept or dismiss, then avoid. Don't choose to play an old game that you know you will loose & you know will make you down.
Look for a new game ! As an aside, I can give this advice much easier Than do it myself. We all fall into that same trap. We have to break our old pattern that keeps us trapped.
One thing is to not hide & sleep today. That is an old pattern for you. It copes but does not fix anything. Think about getting out of the house.
If thoughts are chaotic & jumbled, then maybe a med change is indicated ? either as in, a different or new meds or a different dosage.
Keep on plugging away ! It has happened to all of us & still does. It will get better !
Posted by harry b. on June 27, 2000, at 17:28:42
In reply to Re: harry b. is sad distraught, posted by danf on June 27, 2000, at 11:28:26
Thanks again for the additional responses (and the
advice too, dan).I've tried so many meds, as have most of you. If
a pdoc tries to push another SSRI on me, you may
just read about it in the newspaper. I had a
glimmer of the effectiveness of Celexa, but it
lasted only a week or 2 then went kaput. I have
tried them all, except Prozac.I see my pdoc next week and am thinking of asking
for an MAOI. They terrify me, but maybe I have a
preconceived and unfounded negativity toward them.When I was in outpatient group therapy a young
woman in the group had just begun taking Parnate.
We ate lunches together a few times, and I noticed
that she would just 'space out' in the middle of
a sentence or while eating. She told me she was not
capable of driving her car. She blamed these effects
on the Parnate.Can anyone who has used or is familiar with MAOIs
educate me on them?Have they helped you, and how? Would you recommend
trying them? Are they fast acting or does it take
weeks/months for the levels to build and to see if
the trial is effective or not?What are the side effects? Sedation, cognative
dulling, confusion, sexual dysfunction, insomnia, hypersomnia,
tremors, GI distress, weight gain/loss? any info
you can give me will be appreciated.I realize I ask a lot. Many thanks to anyone
who can help out.
hb
Posted by janeS on June 27, 2000, at 20:31:22
In reply to harry b. needs New Meds.........MAOIs??? , posted by harry b. on June 27, 2000, at 17:28:42
> that she would just 'space out' in the middle of
> a sentence or while eating. She told me she was not
> capable of driving her car. She blamed these effects
> on the Parnate.
>
> Can anyone who has used or is familiar with MAOIs
> educate me on them?
>
> Have they helped you, and how? Would you recommend
> trying them? Are they fast acting or does it take
> weeks/months for the levels to build and to see if
> the trial is effective or not?
>
> What are the side effects? Sedation, cognative
> dulling, confusion, sexual dysfunction, insomnia, hypersomnia,
> tremors, GI distress, weight gain/loss? any info
> you can give me will be appreciated.
>
> I realize I ask a lot. Many thanks to anyone
> who can help out.
> hbHB:
Hello, I'm fairly new here but I have had a good experience with an MAOI, specifically, Nardil. Initially, due in large part to my high anxiety level, I was completely terrified. I just knew that I would eat the wrong thing and die. As it turns out, I remained on Nardil and Xanax for well over 4 years. Sorry, I don't remember the mg's of Nardil...but they were orange and I took one 2x per day and 1mg of Xanax.
Since I am one of those types that ANY med will make sleepy, we switched from morning dosage to evening. Also, I was about 50 pounds overweight and, overtime, I realized I was losing weight...slowly, but without any effort of my own. I had no GI upsets, which I am most prone to do. I experienced no cognitive dulling, in fact, I had never felt sharper; no sexual dysfunction(!); and no tremors. (I think I've addressed everything.) Anyway, after being on Nardil for about a month I felt like a new person. I was productive, energetic and creative-- quite a switch from the slug I had become prior.
As you may know, before you go on ANY MAOI, you have to come off any AD you may be on...and once you've come off you can't take the MAOI for two full weeks...supposedly to lessen the chances for negative interactions.
I kept in mind what my p-doc told me: if it 'bleeds or grows out of the ground' I could eat it. Well, after memorizing the MAOI diet list, I found it was much easier than I would have thought...though I did have to give up some of my favorite foods...some pizza, pickles, pepperoni, some cheeses, etc.
When you go to the supermarket you realize how very little you have to give up. When cooking I did not use MSG but I did not hesitate to order in Chinese...so some of the warning may be similar to the results of the studies in mice...you know...are we EVER going to consume that amount?!
I was on Nardil for about 4 years and I felt so much better, because it has a a good anti-anxiety agent, I felt it was worth the extra effort to remember/question my special diet...and if you really want to get healthy, staying off these kinds of foods is better for you anyway.
The downside here, for me, was that it pooped-out on me after about 4 years...and now I am in that trial and error mode again...but I wish you lots of luck!
Jane
Posted by kazoo on June 28, 2000, at 1:08:28
In reply to Re: harry b. needs New Meds.........MAOIs??? , posted by janeS on June 27, 2000, at 20:31:22
harry:
This genre of drug is safe just as long as you follow the basic
dietary caveats, and avoid certain other drugs. These drugs are
useful for atypical depression and dysthymia.I've been on all three, NARDIL, PARNATE and MARPLAN, and found that
PARNATE had a more stimulating effect, and was helpful in my general
apathy and malaise.If you do decide to go with NARDIL, one of the things you must
be particularly conscious of is this drug's FATAL interaction
with DEMEROL (meperidine). Demerol is a heavy-duty pain killer
that's still used extensively in hospitals and by some dentists.
In the event of an emergency, and you're unable to warn people
treating you that you're on NARDIL, I would carry some sort of
a medic-alert card, or let family and friends know that you're on
this drug so that they may intervene.Another "nice" thing about the MAOIs is that you don't have to wait
weeks or months to see the results. With all three, you should see/feel something
within the first 12 hours. With Parnate, there was no weight gain, but
at times it did interfere with my sleep. I was given a mild benzo for that
and it worked out fine.I agree with you about the SSRIs: they didn't work for me either. Miserable failures!
Lastly, harry, is that you should be aware that most "conventional wisdom" doctors
will not give you these drugs for a variety of reasons, the chief one being with the
introduction of newer classes of drugs. MAOIs have been around since the 1950s
and despite the success stories, and they still got a bad rap. So don't be surprised
if your doctor poo-poos the idea of starting you on them ... stick to your convictions,
and if that don't work, find one that will prescribe them. Personally, I think doctors
are still afraid of them, which brings me to another point. It seems to me that older,
more EXPERIENCED doctors, have a better handle on the MAOIs than the younger up-starts.There's an interesting history as to how the MAOIs surreptitiously came into being,
and if anyone is interested in knowing this, let me know.In any event, harry, the best of luck to you.
I remain,
kazoo
Posted by harry b. on June 28, 2000, at 7:32:48
In reply to Re: harry b. needs New Meds.........MAOIs??? , posted by kazoo on June 28, 2000, at 1:08:28
jane & kazoo, thanks for your info, much appreciated.
kazoo- Yes, I'd be interested to hear how the MAOIs
came into being.Did the MAOIs help with chaotic, troubling, obsessive
thoughts, assuming you had them? If you did not,
can someone with experience with this advise me?Why did you stop the MAOI's?
--------------------------------------------------
Now the beer. I'm not a drinker but I do enjoy a
beer or 2 with a good crabcake, etc. I've read
several lists of dietary restrictions and beer is
listed. I'd estimate that I drink maybe 4 beers
per month. Not a lot to give up, but I really do
enjoy them.And, unfortunately, I like imported beers (Becks).
My domestic choice is Rolling Rock.MAOI users: Have you done any experimenting with
beer? I know, YMMV, but would one or 2 beers (max)
cause a mild/moderate/severe/fatal reaction?Caffeine is also listed. Would my usual morning
20oz cup from the convenience store be too much?I'd also like to hear about any reactions MAOI users
have experienced. Causes, severity, etc.Thanks
hb
Posted by Diane E. on June 28, 2000, at 9:11:19
In reply to Re: MAOIs??? Beer? Other Questions, posted by harry b. on June 28, 2000, at 7:32:48
Hi Harry,
I asked similar questions about beer and MAOIs about two weeks ago and got some good responses
(including a very specific lists of beers that Adam has tried). You might want to search old posts. My
husband is going to try an MAOI for the first time starting this week (I'm not sure which one the
psychiatrist is going to prescribe yet). His psychiatrist told him that all types of beer are fine (and he
specifically asked speciality and imported types) as long as he doesn't have more than one or two. I
am certain others here will disagree with that advice. He intends to proceed very cautiously.Good luck. I am really hoping MAOI work for you and my husband. Your histories with other
meds. and symptoms sound very similar.-Diane
Posted by janeS on June 28, 2000, at 12:56:26
In reply to Re: MAOIs??? Beer? Other Questions, posted by harry b. on June 28, 2000, at 7:32:48
> jane & kazoo, thanks for your info, much appreciated.
>
> kazoo- Yes, I'd be interested to hear how the MAOIs
> came into being.
>
> Did the MAOIs help with chaotic, troubling, obsessive
> thoughts, assuming you had them? If you did not,
> can someone with experience with this advise me?
>
> Why did you stop the MAOI's?
> --------------------------------------------------
> Now the beer. I'm not a drinker but I do enjoy a
> beer or 2 with a good crabcake, etc. I've read
> several lists of dietary restrictions and beer is
> listed. I'd estimate that I drink maybe 4 beers
> per month. Not a lot to give up, but I really do
> enjoy them.
>
> And, unfortunately, I like imported beers (Becks).
> My domestic choice is Rolling Rock.
>
> MAOI users: Have you done any experimenting with
> beer? I know, YMMV, but would one or 2 beers (max)
> cause a mild/moderate/severe/fatal reaction?
>
> Caffeine is also listed. Would my usual morning
> 20oz cup from the convenience store be too much?
>
> I'd also like to hear about any reactions MAOI users
> have experienced. Causes, severity, etc.
>
> Thanks
> hb
>
>Harry:
RE: The BEER thing: In my adult career, I have always been pretty sensitive to alchohol(boy that spelling doesn't look right...one those days)meaning 2 beers and I'm practically dancing on the table. However, that didn't stop me while on Nardil. I would drink 2-3 Bud Lites with no unusual side effects. Wine was a little different...I only consumed White Zin but usually woke up with a typical 'hangover' headache...but nothing worse than that. I did not, however, explore white wines nor red ones as they are guaranteed to give me migraines. (The Nardil helped tremendously with those.)
I've never really had troubling obsessive thoughts so I can't comment there but I do suffer from incredible, life altering anxiety and Nardil combined with Xanax helped basically wiped that out. The reason I stopped Nardil was that it just pooped out after 4 years and so I've been on that trial and error roller coaster now for almost 2 years.
Hope this info helps. Bottom-line: 4 years of MAOI and I did not have one MAOI crisis...so anything's possible.
Sincerely,
JanePS: I drank coffee heavily during that time period as well...no side effects for me...not even tremors.
Posted by noa on June 28, 2000, at 18:26:22
In reply to Re: harry b. is sad distraught, posted by harry b. on June 27, 2000, at 0:59:19
Hope you are feeling better today.
Posted by harry b. on June 28, 2000, at 18:53:56
In reply to Re: harry b. is sad distraught, posted by noa on June 28, 2000, at 18:26:22
> Hope you are feeling better today.
Thanks Noa-
Yes, better. My appt w/my therapist yesterday
helped.
hb
Posted by shellie on June 29, 2000, at 7:19:22
In reply to Re: harry b. needs New Meds.........MAOIs??? , posted by kazoo on June 28, 2000, at 1:08:28
> Another "nice" thing about the MAOIs is that you don't have to wait
> weeks or months to see the results. With all three, you should see/feel something
> within the first 12 hours.Sorry Kazoo, but I'm going to have to strongly disagree with your above statement. When I first started Nardil, all the information said that it should kick in after about three weeks. For me, after three weeks, still nothing. I had a paperback called FROM SAD TO GLAD, I think by Nathan Brandan?; anyway he said that it could take up to six weeks for an MAOI. I was horribly depressed and read that page everyday from week3 to week5, and sure enough my breakthrough was at five weeks. At that time the only two choices were tricyclics (which I couldn't take) and MAOIs, so I was feeling pretty desperate. I think that book saved my life. shellie
Posted by MA on June 29, 2000, at 8:11:49
In reply to Re: MAOIs--positive effect not immediate , posted by shellie on June 29, 2000, at 7:19:22
My experience with MAO's...
After taking Elavil and having horrible dry mouth, dilated pupils, an out of it feeling, my doctor tried Nardil. This was probably about 1987.
Nardil worked pretty quickly. I remember not having to wait and wait so I think it worked within the first week. I felt normal for the first time.
At that time, doctors didn't want you to stay on these meds for very long and since the doctor that had originally prescribed the Nrdil had left the area, I was now seeing a young, inexperienced, but Yale trained psychiatrist.
She kept trying to wean me off the med and I kept telling her I was feeling worse again, so I eventually found another doctor who told me that I should not have been taken off it.
Well, by that point, Nardil stopped working, so we tried Marplan with great success. I was on it for about two years and then the manufacturor, Hoffman-Roche, discontinued it and I was left in limbo.
Parnate never worked for me, and I eventually went the whole gamut of SSRIs, etc and I never believe i ever felt as good as I did on Nardil/Marplan.
As far as side effect, I believe that I had few, if any, and the food restrictions were not difficult to handle. I would have a cup of coffee or a glass of wine, might have pushed this on occasion, but always understood the danger of doing this.
Believe me, when you feel better, you will not risk your health to have an extra glass of wine, or a second slice of pizza.
So, all and all, I would highly recommend MAO's. Good luck!
Posted by Adam on June 29, 2000, at 11:22:36
In reply to Re: MAOIs??? Beer? Other Questions, posted by harry b. on June 28, 2000, at 7:32:48
Harry,
Beer: I've consumed moderate amounts (1-2 bottles over the course of an entire evening) and had no problems. I'd say stick to moderate amounts of bottled beer if you are going to drink at all, and avoid tap beers, since, for a variety of reasons, they may have more tyramine in them. The first few times you consume a bottle of beer, check your blood pressure a few hours later, and always have someone around who is familiar with your condition and can help you get to an ER if there is a negative reaction.
Caffeine: I have the occasional Coke, but that's it. Two Cokes in a row leave me feeling transiently hyper and then ill, but it's not a b.p. effect. I seem to have a particularly low tolerance for caffeine on selegiline, and that may have more to do with the stimulat properties of this drug (I'm not sure, to be honest). If you wind up on selegiline (Eldepryl) or tranylcypromine (Parnate), you might want to avoid caffeine altogether, as those drugs tend to be "activating" and can cause a lot of insomnia. The last thing you will want in your system, especially at first, is a lot of caffeine. Caffeine, in large amounts, could be dangerous because of catacholamine release (namely norepinepherine). I think moderate consumption is likely to be safe.
Origins: The first MAOI, iproniazid, was developed in an attempt to improve the action of ioniazid, a drug used to treat tuberculosis. In a trail of iproniazid in a VA hospital, using elderly TB patients as subjects, physicians observed marked mood elevating effects, and thus serendipetously discovered the first class of antidepressants. Later the MAO-inhibitory properties were elucidated, as well as a couple other potentially beneficial effects. They appeared at first to be a great improvement over the opiates and amphetamines currently employed (as in fact they were), but hepatotoxic and harmful catecholamine-elevating effects (leading to hypertensive crisis, among other things) were soon observed, and later focus shifted to the antihistamine-derived tricylics, which were also serendipetously discovered. MAOIs never fell completely out of use, and their speceficity and tolerability was improved. The have, in the past ten years or so, seen greater employment than one might have expected, given the wealth of safer alternatives currently available. My feeling is that MAOIs, due to their multiple mechanisms of action (primarily either monoamine elevation+psychostimulant effects or monoamine elevation+GABA potentiation), may have the most robust mood-elevating properties of any single molecule available, and have proven to be, as they have in the past, the only good solution for many who have not responded well to other drugs. They are not a panacea by any means, and many either do not respond or cannot tolerate them. However, for some, they are by far the best alternative, and are certainly worth a trial, IMO.
> jane & kazoo, thanks for your info, much appreciated.
>
> kazoo- Yes, I'd be interested to hear how the MAOIs
> came into being.
>
> Did the MAOIs help with chaotic, troubling, obsessive
> thoughts, assuming you had them? If you did not,
> can someone with experience with this advise me?
>
> Why did you stop the MAOI's?
> --------------------------------------------------
> Now the beer. I'm not a drinker but I do enjoy a
> beer or 2 with a good crabcake, etc. I've read
> several lists of dietary restrictions and beer is
> listed. I'd estimate that I drink maybe 4 beers
> per month. Not a lot to give up, but I really do
> enjoy them.
>
> And, unfortunately, I like imported beers (Becks).
> My domestic choice is Rolling Rock.
>
> MAOI users: Have you done any experimenting with
> beer? I know, YMMV, but would one or 2 beers (max)
> cause a mild/moderate/severe/fatal reaction?
>
> Caffeine is also listed. Would my usual morning
> 20oz cup from the convenience store be too much?
>
> I'd also like to hear about any reactions MAOI users
> have experienced. Causes, severity, etc.
>
> Thanks
> hb
>
>
Posted by harry b. on June 29, 2000, at 22:09:02
In reply to Re: MAOIs??? Beer? Other Questions, posted by Adam on June 29, 2000, at 11:22:36
Thank you everyone for your replies, anecdotes, and
advice. And thanks, Adam, for providing some history.I'll welcome more responses too.
hb
This is the end of the thread.
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