![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6 to 30 of 45. Go back in thread:
Posted by LostBoyinNC1 on July 28, 2002, at 21:44:23
In reply to MAOI Wowie!, posted by Jackd on July 28, 2002, at 17:13:52
> I've finally decided after getting a second opinion that Parnate is my next option. I just need a little support from any of you who have been or are on MAOI's.
>
> First of all, how long should I wash out for? No, let me refraise that: What is the shortest period that I can wash out for without sacrificing too much safety? I'm on Remeron 30mg, Lamictal 200mg, Concerta 18mg, Klonopin .5 mg, and Lithium 900mg. I only plan on stopping the Remeron (unless someone suggests I stop any others), and as of last night I have stopped it cold turkey. I know, I know... I am taking off from work for the next week or so in order to do this and thus I have a small window of time to suffer...You are askig for it possibly. Do what your doctor tells you to do, dont ask for advice about MAOIs here on psychobabble. Your doctor knows how to safely get you on an MAOI. Definitely the Remeron must go and probably the Concerta as you can have reactions with amphetamines very easily. I know you can take all the klonopin you want on an MAOI so you can keep taking that. Two weeks is the recommended washout. For the SSRI Prozac its a five week washout MANDATORY.
>
> Also, from the little I know, it seems the main culprit of drug interactions with MAOI's and AD's are SSRI's.
>Not true. You can have interactions with any antidepressant on an MAOI. Sometimes in rare cases tricyclics are combined with an MAOI but its not common. Rarely stimulants like Concerta are combined as well, but again thats rare. Combining MAOIs with lithium or lamictal is no problem generally.
> I have tried reading up as much as I can regarding the diet. I know I can't pick through trash and eat banana peels and rotting protein and dairy products, but what CAN I eat? I mean, what's a good, fast, easy food source that I can eat? Mind you, I'm 220lbs and a powerlifter. I eat 6 meals a day, and peanuts just won't cut it. Is pasta ok? Can I drink supermarket milk or do I need to drink it straight from the udder?
> What is out there that tastes good, is loaded with calories and protein, and practical?Just eat normal food, but go by the list your psychiatrist provides you with. The main rule is for EVERYTHING to be fresh. Dont eat leftover meats. Or leftover anything for that matter. I bring home my meat products from the grocery store and immediately store each hamburger or chicken breast or steak individually in plastic ziploc bags and stick them in the freezer. This way I maintain maximum freshness for all meat products.
Turn your temperature dial up to the max level in the summer if you live in the southern half of the USA, to keep all your foods cold and fresh. I drink skim milk and dont use it near its expiration date. Drink lots of water. I drink fresh orange juice, again not near its expiration date. Total cereal for breakfeast. I cut out coffee totally, caffeine is bad for people on MAOIs. Although I have had a couple mugs of decaff recently and that went fine.
If you are a powerlifter, eliminate all the OTC bodybuilding supplements crap. You dont need it, and its actually dangerous on MAOIs. NO EPHEDRA supplements!!!! Minimal use of caffeine. NOOOOOOOO ECA stacks!!!! No protein powders unless you get one that your doctor specifically says is OK. If you drink a soda, pick one that is caffeine free.
If you must take OTC vitamins, buy top quality ones at yuppie health food stores that dont have yeast in them and have no dairy products in them. Most cheap vitamins have yeast products in them and thats a major no no. And even then, clear the vitamins with your psychiatrist first. Just totally avoid all herbals on MAOIs. DANGEROUS.
I also dont eat cheese. They say you can eat cream cheese or cottage cheese but I havent tried that yet. I dont eat cottage cheese anyway, thats nasty. I decided basically to just kick out cheese on MAOIs.
The key rule is FRESH and no fermented or aged foods. When it gets near its expiration date, throw that shit out.
When you go on an MAOI, thats the time to eliminate most red meat for health reasons (you should do it anyway) and just go with chicken, eggs, milk, turkey and maybe fresh fish (real fresh) for protein sources. Red meat just clogs your arteries up, makes you fat. You can make hamburgers out of "turkeyburger" meat and instead of steaks or hamburgers eat grilled chicken breast. Lots of baked potatoes, I eat a couple carrots everyday with lunch. Bread is fine, pick whole wheat bread. Pasta is fine, use turkeyburger instead of hamburger for the spaghetti meat...much healthier. Just dont add any parmasagn cheese to it...or any kind of cheese or you will find yourself having an intracranial bleed and an ER visit, which wont be fun at all
I ate out once so far, in Chapel Hill. I was nervous as a cat. I ate a grilled turkey breast sandwich and for dessert I had key lime pie...one of my favorites. I did fine, no reactions. But you need to be careful when you eat out. Im still learning the diet. Its actually quite healthy.
Posted by LLL on July 28, 2002, at 22:33:31
In reply to Re: MAOI Wowie!, posted by LostBoyinNC1 on July 28, 2002, at 21:44:23
VERY good advice! I enjoyed your post. I also plan on sticking with the "cautious" side of this diet!
Posted by RonJohn on July 28, 2002, at 22:59:12
In reply to Re: MAOI Wowie!, posted by cybercafe on July 28, 2002, at 20:31:38
Posted by ross on July 28, 2002, at 23:22:53
In reply to MAOI Wowie!, posted by Jackd on July 28, 2002, at 17:13:52
first off the concerta goes and for full safety wait 10 days after stopping the remeron. MAO's get a very bad rap because of all the possible interactions and dietary restrictions.
you can eat cheese. just not aged. kfaft singles and those kind are perfectly safe. i am a bodybuilder also. it will take some time and i mean about a good month or more to adjust to the MAO. some people just do not get the side effects and some do. if you take Nardil your BP is going to drop in the beg of treatment. as for protein do not and i say do not use any WHEY isolates or ION exchange whey. dont use any protein powders or bars period. they contain alot of tyramine and will definatly send you into a hypertensive crisis. i know it sucks because its so needed to grow fast but protein powders are out.
the diet is very easy as long as you are careful.
everything is trial and error. there are not alot of dr.s who are very good in prescribing MAO's. you have to remember these drugs where bascially the first AD's out there next to Tofranil. the best thing to do is go to Medscape and do a search on the drug you want to go on. they are very up to date.
good luck and ask me any questions
ross
Posted by ayrity on July 28, 2002, at 23:52:27
In reply to Re: MAOI Wowie!, posted by cybercafe on July 28, 2002, at 20:31:38
> ... oh and btw i am a very very serious weightlifter and martial artist.. and at first i was somewhat frustrated that dizziness got in the way of my workouts.... but that soon went away 100% --- and even while it was a problem, i was able to workout by scheduling my dosing
>Hi cyber:
Cool, another MAOI martial artist! What do you study? I've been studying Shotokan karate for about nine months now. The karate is great- I feel wonderful and energized after a class; I just wish the feeling would last longer. It's definitely hard to drag myself to class some days, but I'm always glad afterwards.I feel a bit dizzy sometimes, and I think I have a bit less exercise tolerence on the Parnate, but this hasn't been too much of a problem. Like you, I try to plan my dose and take it after instead of before a class.
The diet has not been too much of a problem for me. I've already written ad nauseum about my blood pressure issues with Parnate (sse the above threads).
Posted by cybercafe on July 29, 2002, at 0:04:29
In reply to Re: MAOI Wowie!, posted by Jackd on July 28, 2002, at 21:00:31
> That's great to know. I was sort of guessing that it was over stated like everything else.
Yeah. Plus I thought it would take a lot of trouble or bother me to cut out those 4 or 5 foods. It didn't end up taking any trouble at all.
>It's also good to hear from another lifter, and a martial artist at that. Diet and dizziness aside, has anything about MAOI's interfered with your training? How do you feel about them in
Well my libido went super high. So I guess you could say women interfere with my training.
Diet doesn't effect my training at all.
And having a major stimulant+antidepressant effect allowed me to see an immediate 40% increase in weight (I plateaued at 100 pounds on the pec deck, but immediately jumped to 140, increasing 10 pounds a week after, and I'm 6'1" 150 pounds)>relation to other more conventional/mainstream meds? I have a diagnosis of anergic atypical
I was really afraid of taking an MAOI, but it turned out to be for nothing. It has the best side effect profile (more energy, increased libido) of any med I've taken. But most important is the fact it seems like it will actually work for my depression/anxiety.
>depression with comorbid ADD, anxiety, and mood instability (makes me sound f#cking nuts). Well
Parnate has been shown in studied to be possibly the best drug for anergic depression. Anecdotal evidence would seem to indicate this as well. I havn't heard many people talk about it's anti-anxiety effects, but even a year at the highest doses of Effexor and Paxil did nothing compared to even the first few weeks of the lowest parnate dose. If mood instability means >50% remission of symptoms from time to time, i.e. mood reactivity, that MAOIs would probably be the best choice. Though SSRIs can also work quite well for some. Tricyclics would not be recommended. I think I've heard that the stimulant effects of Parnate might help with ADD, but I can't remember for sure (may just be conjecture).
I wonder if I may be ADD, how can you separate lack of attention related to depression to ADD?
Posted by cybercafe on July 29, 2002, at 0:34:19
In reply to Re: MAOI Wowie!, posted by LostBoyinNC1 on July 28, 2002, at 21:44:23
> You are askig for it possibly. Do what your doctor tells you to do, dont ask for advice about MAOIs here on psychobabble. Your doctor knows how
Yeah I am totally with Lostboy on combining meds. Food can be dangerous, but I don't think the risk is anywhere near as great as the synergism you can get with an MAOI and other med.
> Just eat normal food, but go by the list your psychiatrist provides you with. The main rule is for EVERYTHING to be fresh. Dont eat leftover meats. Or leftover anything for that matter. I
hmmm.... i've had lunch meats (turkey, chicken) that have been in the refrigerator for 1 or 2 weeks. Looking back, that was probably unneccessarily risky of me. But I was under the impression that fresh meant not left out in the heat.
>chicken breast or steak individually in plastic ziploc bags and stick them in the freezer. This way I maintain maximum freshness for all meat products.
Hmmm... I wouldn't worry about the freshness of frozen meat unless it's soy/veggiburgers.
In fact, the study done by Shulman (Sunnybrook) indicated a low tyramine content in a soy burger (much worse than real meat) stored in the fridge (4 degrees celsius, not the freezer)...
>date. Total cereal for breakfeast. I cut out coffee totally, caffeine is bad for people on MAOIs. Although I have had a couple mugs of decaff recently and that went fine.
... i have no problem with caffeine.. but i think it's bad to take any mood altering drug while you are trying to get your brain to up/down regulate different neurotransmitters to a set point...
... same thing with alcohol... i don't want to have to wait another week or month or whatever for my brain to fully adapt ...
>bodybuilding supplements crap. You dont need it, and its actually dangerous on MAOIs. NO EPHEDRA supplements!!!! Minimal use of caffeine.Yeah.. ephedra that's epenephrine right? Good chance of heart attack/stroke
>NOOOOOOOO ECA stacks!!!! No protein powders unless you get one that your doctor specifically says is OK. If you drink a soda, pick one that isi havn't heard of anyone having problems with a soda... but why bother? ... if you need a stimulant to get by, why not just have your doc perscribe something with less general effects and with a more predictable strength and duration? (and better studied, too)
> If you must take OTC vitamins, buy top quality ones at yuppie health food stores that dont have yeast in them and have no dairy products in them. Most cheap vitamins have yeast products in them and thats a major no no. And even then, clear the vitamins with your psychiatrist first. Just totally avoid all herbals on MAOIs. DANGEROUS.
Yeah... I was taking the "Greens" vegetable supplement which sounded innocent enough, .. but it turned out they were throwing ginseng and gingko biloba in it, which is not known to be safe
> I also dont eat cheese. They say you can eat cream cheese or cottage cheese but I havent tried that yet. I dont eat cottage cheese anyway, thats nasty. I decided basically to just kick out cheese on MAOIs.
... I have had pizza a number of different times... and "Refining the MAOI Diet: Tyramine content of pizza and soy products" seems to indicate that major brands (pizza pizza, pizza hut, domino's) are okay.
> When you go on an MAOI, thats the time to eliminate most red meat for health reasons (you should do it anyway) and just go with chicken, eggs, milk, turkey and maybe fresh fish (real fresh) for protein sources. Red meat just clogs
Agreed. I don't know about tyramine, I cut that stuff out cuz my cholesterol was high.
>turkeyburger instead of hamburger for the spaghetti meat...much healthier. Just dont add
tastes the same too :)
>cheese or you will find yourself having an intracranial bleed and an ER visit, which wont be fun at all
hmmm.. i think intracranial bleeding is rare from most food sources... but I know a major migraine is much more common..
but hey... you probably wouldn't want to risk your life based on what i say alone right?
So how is the parnate working for you now LostBoy?
Posted by LostBoyinNC1 on July 29, 2002, at 0:40:26
In reply to Re: MAOI Wowie!, posted by cybercafe on July 29, 2002, at 0:04:29
> I was really afraid of taking an MAOI
So was I. I wanted to take one, but honestly was terrified of the idea of a hypertensive crisis and a possible stroke. Ive wanted to take one for years, but my fears prevented me. Finally my psychiatrist basically just ordered me to go on Parnate back in late May. Well, he didnt really order me to go on it, but strongly suggested it to me and he told me he thought it was my best chance. I agreed and just got him to write me a script for klonopin along with the parnate. Basically I just stayed nice and sedated on klonopin for the two week Zoloft washout and the klonopin, kept me nice and relaxed during the washout, kept my worrying about MAOIs down. I continued taking klonopin the first couple days on the MAOI, but soon found out I no longer needed the klonopin, that the MAOI had a fine anti-anxiety effect as well as an anti-depressant effect.
I suggest anyone who wants to try an MAOI but is fearful of it (hey, that fear is well founded BTW) to just get a script of klonopin to take during those initial weeks of the MAOI. Take a benzo and stay nice and loose and relaxed until you get on the MAOI. Then its like riding a bicycle. Thats what worked for me.
I was actually more afraid of the idea of taking an MAOI than I was of getting ECT. I wasnt afraid at all of ECT and still am not. In fact I KNOW if I was to get ECT, Id sleep fine the night before. I consider ECT safer than MAOIs actually. But MAOIs are safe as long as you go by the rules.
Posted by cybercafe on July 29, 2002, at 1:00:49
In reply to Re: MAOI-Martial arts, posted by ayrity on July 28, 2002, at 23:52:27
> Cool, another MAOI martial artist! What do you
Yes.... and you can really get into it when you are unemployed.
>study? I've been studying Shotokan karate for about nine months now. The karate is great- I feel wonderful and energized after a class; I just wish the feeling would last longer. It's definitely hard to drag myself to class some days, but I'm always glad afterwards.
Yeah I feel that same way exactly. I think that's "mood reactivity". But our class is very informal so at least I know that if I can't handle it I can just chill out.
then again, our classes are around 4 or 5 hours, so they'd better be laid-back :)I'm taking Brazilian Jiujitsu btw...
any other things you do to make yourself feel that good? i am kinda broke these days
> I feel a bit dizzy sometimes, and I think I have a bit less exercise tolerence on the Parnate, but this hasn't been too much of a problem. Like you, I try to plan my dose and take it after instead of before a class.... actually i try to take the dose in the morning and have class in the evening... i find that missing a dose often causes dizziness (in the beginning, anyways) ...
i took a week or two off of martial arts, then when i came back people commented that i was much more aggressive ...
.. how are you doing on parnate? ... how long have you been on it now? ...
> The diet has not been too much of a problem for me. I've already written ad nauseum about my blood pressure issues with Parnate (sse the above threads).... yeah ... that was a strange thing...
Posted by cybercafe on July 29, 2002, at 1:19:09
In reply to Re: MAOI Wowie!, posted by LostBoyinNC1 on July 29, 2002, at 0:40:26
> So was I. I wanted to take one, but honestly was terrified of the idea of a hypertensive crisis and a possible stroke. Ive wanted to take
Yeah... but it's good that you still encouraged others to take it.
>one for years, but my fears prevented me.
Man that is really unfortunate... and you were on it before too... but no use dwelling on the past
>Finally my psychiatrist basically just ordered me to go on Parnate back in late May. Well, he didnt really order me to go on it, but strongly suggested it to me and he told me he thought it
My psychiatrist DID order me! ... and i'm glad he did... okay it also helped that you thought it was a good idea as well. I remember asking to try moclobemide etc first, but he thought they just weren't powerful enough....
.. i also had no appreciation for how many of the cheddar cheeses out there were cheap and mild forms ...
>write me a script for klonopin along with the parnate. Basically I just stayed nice and sedated on klonopin for the two week Zoloft washout and....it's not just the sedation... klonopin has affinity for serotonin receptors... and that definately helps with withdrawal... (i got off 225 effexor in less than 2 weeks)
>the klonopin, kept me nice and relaxed during the washout, kept my worrying about MAOIs down. I continued taking klonopin the first couple days
... you didn't need the klonopin the first time you went on parnate right? ... was it that one h-crisis that really scared you? (i've never had one)
>on the MAOI, but soon found out I no longer needed the klonopin, that the MAOI had a fine anti-anxiety effect as well as an anti-depressant effect.
... yeah i don't have an inappropriate terror reaction anymore either.... but i thought it was just nardil that worked for anxiety? ... i don't think i ever remember them mentioning MAOIs on alt.support.anxiety-panic ... or perhaps i just never considered an MAOI
> I suggest anyone who wants to try an MAOI but is fearful of it (hey, that fear is well founded BTW) to just get a script of klonopin to take during those initial weeks of the MAOI. Take a benzo and stay nice and loose and relaxed until you get on the MAOI. Then its like riding a bicycle. Thats what worked for me..... yeah... it's really sad to go on suffering when it is totally needless ...
> I was actually more afraid of the idea of taking an MAOI than I was of getting ECT. I wasnt afraid at all of ECT and still am not. In fact I KNOW if I was to get ECT, Id sleep fine the night before. I consider ECT safer than MAOIs actually.
... what was it that finally convinced you ECT was safe? ... i can't help but be afraid of the risks associated with the unknown, especially since you rarely ever hear people talking about ECT on the boards...
.. can't ECT cause some minor cognitive problems?
Posted by Jackd on July 29, 2002, at 1:27:30
In reply to Re: MAOI Wowie!, posted by cybercafe on July 29, 2002, at 0:04:29
> And having a major stimulant+antidepressant effect allowed me to see an immediate 40% increase in weight (I plateaued at 100 pounds on the pec deck, but immediately jumped to 140, increasing 10 pounds a week after, and I'm 6'1" 150 pounds)
Impressive... I had a breakthrough with Remeron for a while and I gained 20 lbs of muscle. People said it was because of the Remeron but I think it was more from the renewed fervor and determination.
> Parnate has been shown in studied to be possibly the best drug for anergic depression. Anecdotal evidence would seem to indicate this as well.
That's the notion I've gotten.
If mood instability means >50% remission of symptoms from time to time, i.e. mood reactivity, that MAOIs would probably be the best choice.
Yup.
Though SSRIs can also work quite well for some. Tricyclics would not be recommended. I think I've heard that the stimulant effects of Parnate might help with ADD, but I can't remember for sure (may just be conjecture).
I've read a few case studies, but they weren't very in depth or conclusive.
> I wonder if I may be ADD, how can you separate lack of attention related to depression to ADD?
Well.... mind you this is the way I look at it... ADD attention problems are more like sensory input overload and general processing the data correctly. For example, if you're talking to a few friends and they're having side conversations with others and there's background noise, it's really hard to know what's going on. Also, there's the hyperfocus thing. You can get such bad tunnel vision it's almost like you're in a trance. Basically you're in your own little world, always dazed and confused, as opposed to on point and perky.
It's unfortunate that ADD has become such a broad and misused label. I have had friends of mine claim they have ADD and even get prescribed stimulants with little more effect than getting a boost of energy. Turns out they were just lazy and undisciplined and looking for a shortcut, but I could've told anyone that all along.
Posted by Jackd on July 29, 2002, at 1:31:02
In reply to Re: MAOI-Martial arts, posted by cybercafe on July 29, 2002, at 1:00:49
Are you guys hijacking my thread? Watch out I got a mean axe kick...
Posted by cybercafe on July 29, 2002, at 2:09:56
In reply to Re: MAOI Wowie!, posted by Jackd on July 29, 2002, at 1:27:30
> Impressive... I had a breakthrough with Remeron for a while and I gained 20 lbs of muscle. People said it was because of the Remeron but I think it was more from the renewed fervor and determination.
Either way... it's a nice benefit :)
>sensory input overload and general processing the data correctly. For example, if you're
hmmm.. what does sensory input overload feel like?
>talking to a few friends and they're having side conversations with others and there's background noise, it's really hard to know what's going on.
yeah? ... when i was in school i used to have my hearing checked every year -- and it always came out great -- because the teachers thought i couldn't hear them...
... i also find that when i go to bars with loud music i just can't concentrate on the cute girls right in front of me...
>Also, there's the hyperfocus thing. You can get such bad tunnel vision it's almost like you're in a trance. Basically you're in your own little world, always dazed and confused, as opposed to on point and perky.
... yeah i definately don't like to be interrupted when i do something... some activities will temporarily give me a burst of pleasure and fascination ... whereas i usually am just bored out of my skull ... actually i used to think that might be rapid cycling, but i guess not...
>mine claim they have ADD and even get prescribed stimulants with little more effect than getting a boost of energy. Turns out they were just lazy and undisciplined and looking for a shortcut, but
hmmm... i thought that if non-understimulated people took ritalin they would just feel agitated and anxious (get the bad side effects) no?
otherwise how do you know if you are taking enough?
... thanks for answering my questions dude...
btw... do the effects of ritalin wear off, do you have to keep increasing the dose?
cheers
Posted by Phil on July 29, 2002, at 6:48:49
In reply to what the heck is a MAOI? (nm), posted by RonJohn on July 28, 2002, at 22:59:12
One of the oldest AD's. Still one, if not the most effective. Does have diet restrictions and a lot of docs don't prescribe them much. They should.
Monoamine oxidase inhibitor.
Go to RXlist.com if you want info on drugs. Very handy.
Posted by Jackd on July 29, 2002, at 10:30:01
In reply to Re: MAOI Wowie!, posted by cybercafe on July 29, 2002, at 2:09:56
> hmmm.. what does sensory input overload feel like?
Confusion, being overwhelmed.
> yeah? ... when i was in school i used to have my hearing checked every year -- and it always came out great -- because the teachers thought i couldn't hear them...
Funny you mention that. I had major audial comprehension problems until I started treating my ADD.
> hmmm... i thought that if non-understimulated people took ritalin they would just feel agitated and anxious (get the bad side effects) no?
>
> otherwise how do you know if you are taking enough?
>Well, yeh, you're right, they do feel agitated and anxious. But often a bit euphoric and aroused too.
> ... thanks for answering my questions dude...Likewise man.
> btw... do the effects of ritalin wear off, do you have to keep increasing the dose?I think most peope with serious understimulation are very sensitive to stimulants. And that's a big defining factor. My friends can pop like five of my 5 mg ritalins and feel like they did some weak coke, but I think I would have a seizure. Anyway no, I have never had to up the dose or lose any effect, and it does increase any underlying anxiety a lot.
> cheers
>
Posted by LostBoyinNC1 on July 29, 2002, at 11:12:30
In reply to Re: MAOI Wowie!, posted by cybercafe on July 29, 2002, at 1:19:09
> My psychiatrist DID order me! ... and i'm glad he did... okay it also helped that you thought it was a good idea as well. I remember asking to try moclobemide etc first, but he thought they just weren't powerful enough....
Psychiatrists in the USA cant "order" patients to take any drug. Thats illegal here. In Canada, I suppose it might be different. If so, thats sad.> ....it's not just the sedation... klonopin has affinity for serotonin receptors... and that definately helps with withdrawal... (i got off 225 effexor in less than 2 weeks)
Klonopin has affinity for serotonin receptors? HUH? Where did you hear that? I always understood Klonopin, like all benzos worked more on GABA. Klonopin is a depressant drug and therefore would be more likely to decrease serotonin levels than increase serotonin levels.
>
> ... you didn't need the klonopin the first time you went on parnate right? ... was it that one h-crisis that really scared you? (i've never had one)
LOL I could have used some klonopin the first time I tried Parnate. But didnt think about asking for it.>
>
> ... what was it that finally convinced you ECT was safe? ... i can't help but be afraid of the risks associated with the unknown, especially since you rarely ever hear people talking about ECT on the boards...
> .. can't ECT cause some minor cognitive problems?What convinced me it was safe was talking to others offline who have actually had ECT. And talking to my psychiatrists about it. And even my family doctor strongly recommended it. My family doctor raves about ECT and thinks its the best thing for severe depression since sliced bread. And he has absolutely nothing to financially gain from ECT and is not in the mental health field. Also, I read stuff on the Internet (credible stuff, not crap anti-ECT websites) and realized there are some very basic differences between "old" style ECT and the modern, current version of it.
IN the old version of ECT, when it developed its evil reputation, patients were not artificially oxygenated and tended to hold their breath for minutes at a time during the seizure. Many of them their face would turn blue from oxygen deprivation. Anyone who has had Red Cross first aid and CPR training or has taken an EMT course knows that brain damage begins to occur after youve stopped breathing for two minutes or more. Four minutes without breathing and you die. Well with ECT, many patients didnt breath during the seizure for two minutes or more. No wonder so many of them complained of severe memory problems and claimed they were "never the same." I dont dispute their claims.
However with the modern form of ECT, all of your bodily functions are closely monitored via machines and you are artificially oxygenated. Unlike the old form of ECT. The anesthesiologist makes sure your blood oxygen levels do not drop too low, thus ensuring there is a constant supply of oxygen to your brain even during the grand mal seizure. This prevents the oxygen deprivation induced brain damage which occurred in the primitive forms of ECT used in the forties, fifties and sixties and prevents excessively severe memory loss.
Reading about ECT convinced me the modern form of it, providing it is done correctly and you are properly oxygenated is safe. Definitely safer than MAOIs. Even though Im on Parnate, I still view ECT as medically safer than MAOI therapy.
Posted by cybercafe on July 29, 2002, at 13:02:21
In reply to Re: MAOI Wowie!, posted by Jackd on July 29, 2002, at 10:30:01
> Funny you mention that. I had major audial comprehension problems until I started treating my ADD.
Yeah! people would always comment on how awesome my language skills (french for example) were when it came to reading/writing ... my speaking skills were mediocre ....
but i totally could not follow when people would
speak....> I think most peope with serious understimulation are very sensitive to stimulants. And that's a big defining factor.
that really clears things up for me --- when i have some caffeine i definately get a noticable effect... whereas other people just don't seem effected at all
Posted by cybercafe on July 29, 2002, at 13:11:58
In reply to Re: MAOI Wowie!, posted by Jackd on July 29, 2002, at 10:30:01
hey dude i'm curious... what is it like trying to hold down a job with and without ADD medication?... cuz unlike my friends i totally found school 100 times easier than work.... as i could always skip classes or socialize when i wanted... but at work i felt like i couldn't sit still... or the work just wasn't interesting etc etc
cheers -- you have your thread back, i hope you're happy :)
Posted by RonJohn on July 29, 2002, at 19:27:53
In reply to Re: what the heck is a MAOI? » RonJohn, posted by Phil on July 29, 2002, at 6:48:49
Thanks for the info Phil on MAOI's
RonJohn
Posted by ross on July 29, 2002, at 22:11:33
In reply to Re: MAOI Wowie!, posted by LostBoyinNC1 on July 29, 2002, at 11:12:30
klonopin has no affinty for any serotonin recepters. where did you hear that one???
it works on gaba and is a depressant. klonopin is one of the only benzo's that cause depression.
Posted by cybercafe on July 29, 2002, at 22:25:44
In reply to Re: MAOI Wowie!, posted by LostBoyinNC1 on July 29, 2002, at 11:12:30
> Psychiatrists in the USA cant "order" patients to take any drug. Thats illegal here. In Canada, I suppose it might be different. If so, thats sad.
Okay there was no court order or anything. I just didn't get the feeling I was going to get any other med out of him. And for a person with "Real Depression", taking no med is much worse than a fatal heart attack.
> Klonopin has affinity for serotonin receptors? HUH? Where did you hear that? I always understood Klonopin, like all benzos worked more on GABA. Klonopin is a depressant drug and therefore would be more likely to decrease serotonin levels than increase serotonin levels.
You are totally right -- klonopin does work more on GABA. But it also works on serotonin receptors, to a lesser degree. This is why it helps with migraine, SSRI withdrawal, etc etc..
It definately causes sedation, but is it purely depressant? I know it is supposed to be more of a mood stabilizer, whereas other benzos are considered pure depressants...because of it's sedation, i would not consider it an antidepressant i would be willing to take for anything other than a washout period ...
> LOL I could have used some klonopin the first time I tried Parnate. But didnt think about asking for it.really i thought you were cool with parnate the first time you took it... i mean you were so relaxed you went right for the macaroni and cheese! ... whereas now, the more concerned lostboy, i'm sure, would never think about touching the stuff
> What convinced me it was safe was talking to others offline who have actually had ECT. And
where did you meet other patients in Real Life (tm) .... i find most non-internet savy patients to be lacking self-awareness and aggressiveness...
> IN the old version of ECT, when it developed its evil reputation, patients were not artificially oxygenated and tended to hold their breath for minutes at a time during the seizure.
... yeah my father is very seriously fucked up... i mean ultraradian type I bipolar (cycles several times a day) ... narcissistic aggressive intermittant explosive rage several times a day... but he would never consider getting help because when he had ECT they didn't bother to wait for the anaesthetic to take effect... and apparently being awake and not being able to breathe for 2 min is quite horrible... i'm like "dude, why don't you take lamictal or valporate instead of your 1960s antipsychotic, which doesn't work well and has major side effects" but he is terrified of letting his doc have even the slightest hint their might be a problem in case he ends up getting ECT again....
> However with the modern form of ECT, all of your bodily functions are closely monitored via machines and you are artificially oxygenated.
didn't they have that technology in the 60s?
>of oxygen to your brain even during the grand mal seizure. This prevents the oxygen deprivation induced brain damage which occurred in the primitive forms of ECT used in the forties,
hmmmmm... do epileptics stop breathing when they have seizures too?
> Reading about ECT convinced me the modern form of it, providing it is done correctly and you are properly oxygenated is safe. Definitely safer than MAOIs. Even though Im on Parnate, I still view ECT as medically safer than MAOI therapy.
hey if other people go without oxygen for minutes and still come out alright i'm sure we'd do alright...
Posted by cybercafe on July 29, 2002, at 22:27:45
In reply to Re: MAOI Wowie! klonopin!!!, posted by ross on July 29, 2002, at 22:11:33
> klonopin has no affinty for any serotonin recepters. where did you hear that one???
> it works on gaba and is a depressant. klonopin is one of the only benzo's that cause depression..... my doc is one of the best around and he is quite certain it has some affinity for serotonin receptors...
... he recommended i take it for effexor withdrawal, and i can assure you that the benefits i received where neither from sedation nor from placebo :)
Posted by Bob on July 29, 2002, at 22:39:02
In reply to Re: MAOI Wowie!, posted by LostBoyinNC1 on July 29, 2002, at 11:12:30
>
> Reading about ECT convinced me the modern form of it, providing it is done correctly and you are properly oxygenated is safe. Definitely safer than MAOIs. Even though Im on Parnate, I still view ECT as medically safer than MAOI therapy.
>If ECT is so safe, then why is the medical establishment not advocating ECT right of the bat for many patients and forgoing drugs altogether. Why can't people just get ECT treatments at regular intervals for the rest of their lives and forget about drugs? Seems like that would be a viable option if the treatment was that safe, but I just don't hear about it being done.
Why are you taking an MAOI, if you believe ECT is a better option?
Posted by LostBoyinNC1 on July 29, 2002, at 23:25:15
In reply to Re: MAOI Wowie!, posted by cybercafe on July 29, 2002, at 22:25:44
>
> > What convinced me it was safe was talking to others offline who have actually had ECT. And
>
> where did you meet other patients in Real Life (tm) .... i find most non-internet savy patients to be lacking self-awareness and aggressiveness...Different places. An offline real world support group I go to sometimes. Met a few people there who had ECT. I know a woman here in NC who had it three times and recently met her offline and she didnt seem fucked up at all. Not one bit. She seemed very together mentally and like I said, she had ECT three times. And she had it back in the sixties, even though she did admit to me she has huge memory blocks from the sixties era ECT's. She also saw people getting insulin shock treatment in the sixties when she was getting ECT. Scary.
Finally, I met some people at Duke psychiatry who had it. Some of them return once a month to get shocked outpatient for maintence and swear by it. Of course Duke has one of the best ECT units in North America.
>
> > IN the old version of ECT, when it developed its evil reputation, patients were not artificially oxygenated and tended to hold their breath for minutes at a time during the seizure.
>
> ... yeah my father is very seriously fucked up... i mean ultraradian type I bipolar (cycles several times a day) ... narcissistic aggressive intermittant explosive rage several times a day... but he would never consider getting help because when he had ECT they didn't bother to wait for the anaesthetic to take effect... and apparently being awake and not being able to breathe for 2 min is quite horrible... i'm like "dude, why don't you take lamictal or valporate instead of your 1960s antipsychotic, which doesn't work well and has major side effects" but he is terrified of letting his doc have even the slightest hint their might be a problem in case he ends up getting ECT again....
>
> > However with the modern form of ECT, all of your bodily functions are closely monitored via machines and you are artificially oxygenated.
>
> didn't they have that technology in the 60s?nah, they didnt have shit in the sixties. They didnt know MAOIs could cause hypertensive crisises back then. They didnt even have an MAOI diet back then. They were still doing lobotomies and insulin shock in the sixties and still believed in Freud. Back then if you got depression or schizophrenia they thought it was cause you were raised shitty and blamed it on you and your family...Freud crap. Back then nobody gave a flying fuck about the mentally ill. They were still using ECT back in the sixties for "behavioral control" and didnt restrict its use for just severe mood disorders like they do now.
Torrey Fuller was the guy who came up with the idea that schizophrenia is a brain disease in the early seventies. And that was the beginning of the end of the Freudians, thank God.
>
> >of oxygen to your brain even during the grand mal seizure. This prevents the oxygen deprivation induced brain damage which occurred in the primitive forms of ECT used in the forties,
>
> hmmmmm... do epileptics stop breathing when they have seizures too?I dont know the answer to that question.
>
> > Reading about ECT convinced me the modern form of it, providing it is done correctly and you are properly oxygenated is safe. Definitely safer than MAOIs. Even though Im on Parnate, I still view ECT as medically safer than MAOI therapy.
>
> hey if other people go without oxygen for minutes and still come out alright i'm sure we'd do alright...
>yeah, but you dont want to hold your breath more than a minute. I feel uncomfortable as hell holding my breath thirty seconds. Two minutes and you get brain damage. Trust me, one of the most important things in safe, successful ECT is being properly oxygenated the entire time.
Posted by LostBoyinNC1 on July 29, 2002, at 23:32:23
In reply to Re: MAOI Wowie! » LostBoyinNC1, posted by Bob on July 29, 2002, at 22:39:02
>
> >
> > Reading about ECT convinced me the modern form of it, providing it is done correctly and you are properly oxygenated is safe. Definitely safer than MAOIs. Even though Im on Parnate, I still view ECT as medically safer than MAOI therapy.
> >
>
> If ECT is so safe, then why is the medical establishment not advocating ECT right of the bat for many patients and forgoing drugs altogether. Why can't people just get ECT treatments at regular intervals for the rest of their lives and forget about drugs? Seems like that would be a viable option if the treatment was that safe, but I just don't hear about it being done.Well, honestly a lot of the medical establishment is terrified of ECT just like the general public is. Just like you are terrified of it. I have known psychiatrits who acted scared of it. Most psychiatrists dont do ECT, probably some of that is cause they are chickenshit. Its probably too medical, too involved for a lot of psychiatists. And actually, my family doctor...totally nonconnected in anyway to the mental health field or ECT, he raves about ECT. He told me the reason its not used as a first or second line treatment for depression is mainly stigma. Basically you cant talk people into it cause they are scared of it. They watched One Flew Over the Cuckoos Nest and thats it...no ECT for them ever.
>
> Why are you taking an MAOI, if you believe ECT is a better option?Well I actually wanted ECT two months ago but my Pdoc specifically said he thought I had a better chance of responding to an MAOI cause he says I have an "atypical depression." Whatever that is. But trust me, if the Parnate does not pan out I will be getting ECT done.
>
>
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