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Dr. Bob is Robert Hsiung, MD,
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Posted by jaby on May 24, 2002, at 11:46:56
I have big time problems with persistent GAD/dep 24 hrs./day It rules me!. I have been through the ringer with a ton of meds and want to know if people have had success with an MAOI for GAD w/ ruminating thoughts. It seems like the majority of the success stories here are with social anxiety, but this is much more than that. Thanks!
Posted by katekite on May 24, 2002, at 14:27:04
In reply to MAOI success for persistant GAD/dep?, posted by jaby on May 24, 2002, at 11:46:56
Maois are some of the most effective meds. Historically I believe it was those and the first antipsychotics that caused the huge de-institution-move.... allowed an awful lot of people to get out of hospitals.
So they can be extremely effective for all kinds of depression. They are much less used these days just because so many newer drugs with no food restrictions are available. But if you've tried those and are still depressed/anxious, not eating cheese etc isn't a huge deal if something will allow you to feel better.
If ssris and the norepinephrine drugs like effexor and wellbutrin didn't help, by all means don't let food interactions stop you from thinking of an maoi.
kate
Posted by Seamus2 on May 24, 2002, at 20:53:06
In reply to MAOI success for persistant GAD/dep?, posted by jaby on May 24, 2002, at 11:46:56
You ask an interesting question: can an MAOI tackle depression, GAD and rumination?
(I'm thinking back a few years here) Nardil gave me excellent AD activity and the gumption necessary to address psychological issues pertaining to what is now called social anxiety/phobia. Perhaps "GAD" falls under the same rubric.
I also used Xanax at the time; but were I to prescribe for myself in perfect 20/20 hindsight I would have used a long-acting beta blocker like timolol, with perhaps far less Xanax. The rationale is simple: block the physiological response to stressful situations and expose yourself to them by means of systematic desensitisation. The net result is your head no longer associates "that panicky feeling" w/ situations. Takes a while, but it worked for me.
In my case, the rumination/obsessive (self-deprecatory) thoughts persisted, but only as a function of the depression. Once the depression cleared, I was free from the internal harangues. Which isn't to say my brain doesn't have a tendency to get stuck on a thought or a song for a day or two or three -- it does! That's just how my brain is, I guess.
So yes, I would recommend a couple months on Nardil at a decent dosage (> 60 mg/day) to see where it gets you.
Clomipramine is used for OCD; if the rumination is a bigger concern you might want to try it. I never did.
Seamus
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