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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Veronica on September 9, 2000, at 16:39:28
My husband has been treated for major depression & anxiety for several years. In February of this year, we finally got his pdoc to try something different...a MAOI, Nardil. Nothing he had tried previously had provided any real relief. Anyway, the Nardil seems to have conquered the depression for the most part. Anxiety isn't really an issue at this time either. The problem is that my husband has had a major negative personality change. His whole appearance has changed. He snaps at me without reason. It's gotten so bad that he says he's not going to my sister's wedding next month & now she doesn't even want him there because he's been treating her bad too.
My question is if this change is in any way possibily related to Nardil, and if so what to do about it. I am not willing to continue in this situation much longer at the rate it's going. I have been a supportive wife for 7 years, but I just don't deserve this current treatment.
Thanks for your comments.
Posted by Donna Lynn on September 9, 2000, at 18:33:09
In reply to MAOI personality change?, posted by Veronica on September 9, 2000, at 16:39:28
> My husband has been treated for major depression & anxiety for several years. In February of this year, we finally got his pdoc to try something different...a MAOI, Nardil. Nothing he had tried previously had provided any real relief. Anyway, the Nardil seems to have conquered the depression for the most part. Anxiety isn't really an issue at this time either. The problem is that my husband has had a major negative personality change. His whole appearance has changed. He snaps at me without reason. It's gotten so bad that he says he's not going to my sister's wedding next month & now she doesn't even want him there because he's been treating her bad too.
>
> My question is if this change is in any way possibily related to Nardil, and if so what to do about it. I am not willing to continue in this situation much longer at the rate it's going. I have been a supportive wife for 7 years, but I just don't deserve this current treatment.
>
> Thanks for your comments.Hi Veronica. I don't remember what the diet guidelines are for MAOi's but I was on Nardil and Xanax back in the 1980's for a short time, I was kind of naive about what the doctor warned me about- don't eat this or that. I know I just ate anything I wanted, which could have caused me great harm, but luckily it didn't. But your husband may be eating what he isn't supposed to be while he's at work, or on the sly. For instance, they say no red wine, no milk, I scoffed at that and I know I kept intaking what I wanted. Can you ask your husband if he's following the diet restrictions? What does his doctor say? Maybe the Nardil isn't working the way it used to, or maybe it lifted his depression at the cost of causing him to be more bold and opinionated. Maybe he needs a calmer added to his cocktail. One last thing, does he drink alot? The interaction with the Nardil could be setting him off. Hang in there, I think he needs you the most now.
Posted by SLS on September 10, 2000, at 16:44:27
In reply to MAOI personality change?, posted by Veronica on September 9, 2000, at 16:39:28
> My husband has been treated for major depression & anxiety for several years. In February of this year, we finally got his pdoc to try something different...a MAOI, Nardil. Nothing he had tried previously had provided any real relief. Anyway, the Nardil seems to have conquered the depression for the most part. Anxiety isn't really an issue at this time either. The problem is that my husband has had a major negative personality change. His whole appearance has changed. He snaps at me without reason. It's gotten so bad that he says he's not going to my sister's wedding next month & now she doesn't even want him there because he's been treating her bad too.
>
> My question is if this change is in any way possibily related to Nardil, and if so what to do about it. I am not willing to continue in this situation much longer at the rate it's going. I have been a supportive wife for 7 years, but I just don't deserve this current treatment.
>
> Thanks for your comments.
Hi Veronica.1. If there is any history of bipolar disorder (manic-depression) in his immediate family (siblings, parents, grandparents), it is possible that the Nardil has caused him to develop a type of mania (opposite side of depression) that is known for producing the sorts of personality changes you describe. Some of these features include irritability, talking a lot and very fast, not needing to sleep, and rage. Often, someone’s appearance will become disheveled as they are easily distracted, disorganized, and inordinately preoccupied doing other things.
2. In some cases of unipolar depression (regular depression), as the depression begins to improve with Nardil (or any other antidepressant), there is often an in-between state that occurs for a few weeks early in treatment that can include irritability.
My advice is to have a trained psychiatrist evaluate your husband to determine what exactly is going on. It is critical that frequent follow-up visits be conducted early in treatment with any medication.
I hope you can resolve the situation soon. In the meantime, you may want to give your husband the benefit of the doubt and consider his behaviors as being less “him” and more “drug-effects”. Perhaps the both of you should work together with the doctor.
Good luck.
- Scott
Posted by Veronica on September 10, 2000, at 19:46:38
In reply to Re: MAOI personality change?, posted by SLS on September 10, 2000, at 16:44:27
Thanks to both of you for your comments.
Yes, he does eat foods that he's not supposed to, but we were of the understanding that these may cause physical symptoms, not emotional ones? He was told it was ok to try small amounts of the foods that may cause problems and see how they affect him. He has not had any immediate reactions to various cheeses or beers. He has been having head pressure though, so the pdoc just this week gave him a blood pressure tester to borrow until he gets his own. So far the bp has been normal.
We did think his mother was manic, but were told that her mood swings were too quick to be mania. In other words, she'd be fine one minute & a monster the next.
I think his psychiatrist is a good doctor, but a lot of times you have to tell her what you want, what you think would work or what's wrong. She doesn't tell you what you need. We do have insurance but are only allowed so many visits per year. She tries to limit the visits by talking to him on the phone occasionally & he just calls for his refills. There's not a lot of in-office contact.
I'm not in a rush to condemn my husband as a bad person. I haven't stuck with him through all we've gone through these past years for nothing. I believe he has great potential to be a wonderful person. It never occurred to me until a couple days ago that the meds may be causing his recent change for the worse. I'll have to approach him about this and see what he thinks.
Thanks again
Posted by stjames on September 11, 2000, at 5:08:20
In reply to Re: MAOI personality change?, posted by Veronica on September 10, 2000, at 19:46:38
Has your husband ever been on poly drug, more that one
drug, thearpy ? If this doc cannot get him well after several years
then it is time for another doc. This med also does not seem to
help, given how much trouble you are having !james
Posted by Veronica on September 11, 2000, at 6:07:54
In reply to Re: MAOI personality change?, posted by stjames on September 11, 2000, at 5:08:20
> Has your husband ever been on poly drug, more that one
> drug, thearpy ? If this doc cannot get him well after several years
> then it is time for another doc. This med also does not seem to
> help, given how much trouble you are having !
>
> jamesWhen he was on the SSRI's, yes he did use more than one drug at a time. He has been seeing this current psychiatrist for the last couple of years. I'm not sure if she'd consider prescribing another med for him while he's on the MAOI, but it's worth checking into.
Thanks
Posted by stjames on September 11, 2000, at 18:47:24
In reply to Re: MAOI personality change?, posted by Veronica on September 11, 2000, at 6:07:54
> When he was on the SSRI's, yes he did use more than one drug at a time. He has been seeing this current psychiatrist for the last couple of years. I'm not sure if she'd consider prescribing another med for him while he's on the MAOI, but it's worth checking into.
>
> ThanksJames here....
I was not sugesting adding a drug to MAOI, just asking if a coktail
was tried, as this would be a next step, if not.
If all he has tried is the SSRI's, even in combination, this indicates
another class should be tried. I;m thinking TCA's, Wellbrutin, Remeron or Effexor.
Also, in general, if several meds don't work this begs the question
as to the Dx. Is the right condition being treated.The other thing that come to mind is thearpy. has this been tried ?
Do not expect a pdoc to do this, they are medical docs. When meds do not
work sometimes this indicates psychological issues
need to be addressed.james
james
Posted by anita on September 12, 2000, at 0:28:34
In reply to MAOI personality change?, posted by Veronica on September 9, 2000, at 16:39:28
Hi,
Increases in noradrenaline and dopamine (which occur with MAOIs) can result in irritablity or agression. Every noradrenergic or dopaminergic med I've tried eventually made me very irritable. Three possible ways to go: add on a mood stabilizer like lithium; add high dose propananol; add a low dose of zyprexa or risperidone (atypical antipsychotics). These have all been proven to reduce irritability and agression, and would also help if the MAOI has switched him into a hypomanic mixed state.
good luck,
anita
> My husband has been treated for major depression & anxiety for several years. In February of this year, we finally got his pdoc to try something different...a MAOI, Nardil. Nothing he had tried previously had provided any real relief. Anyway, the Nardil seems to have conquered the depression for the most part. Anxiety isn't really an issue at this time either. The problem is that my husband has had a major negative personality change. His whole appearance has changed. He snaps at me without reason. It's gotten so bad that he says he's not going to my sister's wedding next month & now she doesn't even want him there because he's been treating her bad too.
>
> My question is if this change is in any way possibily related to Nardil, and if so what to do about it. I am not willing to continue in this situation much longer at the rate it's going. I have been a supportive wife for 7 years, but I just don't deserve this current treatment.
>
> Thanks for your comments.
This is the end of the thread.
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