Psycho-Babble Medication Thread 364763

Shown: posts 1 to 22 of 22. This is the beginning of the thread.

 

Anyone's doctors rx-ing for weight gain?

Posted by Racer on July 10, 2004, at 14:25:36

I have read a few articles about ways to mitigate weight gain from psychoactive drugs with other prescription drugs -- including glucophage when it's related to metabolic changes -- but I've never seen anyone here post anything about their doctors addressing that particular side effect with anything besides behavioral modification (and that seems to have been limited to advising patients to eat less and exercise more, without a real feeling that the doctor has really believed that the drugs were involved in the gain), so I wondered if anyone had had a doctor address the weight gain in a practical or even just a helpful way?

While I'm very interested in hearing about anything that was helpful to anyone, I'm especially interested in any stories involving a doctor addressing any side effect directly with an additional med, and in how the side effects of the second med added or subtracted from the side effects of the initial drug?

Thanks!

 

Re: Anyone's doctors rx-ing for weight gain? Racer

Posted by Sad Panda on July 11, 2004, at 2:19:00

In reply to Anyone's doctors rx-ing for weight gain?, posted by Racer on July 10, 2004, at 14:25:36

> I have read a few articles about ways to mitigate weight gain from psychoactive drugs with other prescription drugs -- including glucophage when it's related to metabolic changes -- but I've never seen anyone here post anything about their doctors addressing that particular side effect with anything besides behavioral modification (and that seems to have been limited to advising patients to eat less and exercise more, without a real feeling that the doctor has really believed that the drugs were involved in the gain), so I wondered if anyone had had a doctor address the weight gain in a practical or even just a helpful way?
>
> While I'm very interested in hearing about anything that was helpful to anyone, I'm especially interested in any stories involving a doctor addressing any side effect directly with an additional med, and in how the side effects of the second med added or subtracted from the side effects of the initial drug?
>
> Thanks!
>

Hi Racer,

I have just started metformin(glucophage) although I haven't really gained any weight from Effexor & Remeron. (I was fat to begin with) I also switched my Remeron to Nortriptyline as a preemtive measure because the main startup side effect of metformin is diarrhoea. It's very early days yet, but I'll keep you posted on metformin's effects. I have also been taking Thyroxine(T4) for the last two months & have lost a little weigth without actually doing anything.

Cheers,
Panda.


 

Re: Anyone's doctors rx-ing for weight gain? Racer

Posted by platinumbride on July 11, 2004, at 2:57:10

In reply to Anyone's doctors rx-ing for weight gain?, posted by Racer on July 10, 2004, at 14:25:36

last year my doc decided to try and kill tow birds with one stone by rxing topamax as a mood stablizer, with, as he said "weight loss properties". Didnt' cut it for me in either arena, but it does for many. Zonegran is another one. Are these possibilities for you>?

Diane

 

rx-ing for weight gain?SAD PANDA ?

Posted by crazychickuk on July 11, 2004, at 17:13:00

In reply to Re: Anyone's doctors rx-ing for weight gain? Racer, posted by Sad Panda on July 11, 2004, at 2:19:00

You of remeron? whats Nortriptyline for? i am overweight too, i tryed metformin yrs ago for my pcos but stopped it cus it made me to dizzy and fealt all ill...

 

Re: rx-ing for weight gain?SAD PANDA ? crazychickuk

Posted by Sad Panda on July 12, 2004, at 10:37:49

In reply to rx-ing for weight gain?SAD PANDA ?, posted by crazychickuk on July 11, 2004, at 17:13:00

> You of remeron? whats Nortriptyline for? i am overweight too, i tryed metformin yrs ago for my pcos but stopped it cus it made me to dizzy and fealt all ill...
>
>

Hi Donna,

Nortriptyline is a TCA that that you could try. It has much less dizziness than the others & I like it better than Remeron after only five days on it. If you want to know which AD is good for weight loss, then I would say the MAOIs Parnate & Selegiline are the only ones. Nearly all others cause weight gain, unless you are really thin & actually need the extra weight.

Cheers,
Panda.

 

Re: Anyone's doctors rx-ing for weight gain? Sad Panda

Posted by Racer on July 13, 2004, at 13:50:54

In reply to Re: Anyone's doctors rx-ing for weight gain? Racer, posted by Sad Panda on July 11, 2004, at 2:19:00

Thanks, Panda. Please do update me, because I'm hoping that my *next* doctor will be willing to discuss something of the sort with me. My experience in the past is that *every* anti-depressant I've ever taken has caused a significant amount of weight gain, and it's added to my distress a great deal. (Significant: about 60% of baseline body weight. On the other hand, that is from an underweight starting point. Still, it's left me overweight by any standard.) On all of them, I had no luck whatsoever either keeping the weight off or getting the weight back off while on the meds. If I've gotta be on something from this time forward, I'd like to be able to live with the effects, which means some form of mitigation. Since the Effexor, at least, certainly effected my blood sugar, glucophage is my first choice to discuss. (Although I will do a blood sugar diary before making a formal request from a doctor, since I'm hesitant about meds anyway.)

Best luck to you, and again -- do please let us know how it goes for you.

 

Re: Anyone's doctors rx-ing for weight gain? Racer

Posted by Sad Panda on July 14, 2004, at 8:34:00

In reply to Re: Anyone's doctors rx-ing for weight gain? Sad Panda, posted by Racer on July 13, 2004, at 13:50:54

> Thanks, Panda. Please do update me, because I'm hoping that my *next* doctor will be willing to discuss something of the sort with me. My experience in the past is that *every* anti-depressant I've ever taken has caused a significant amount of weight gain, and it's added to my distress a great deal. (Significant: about 60% of baseline body weight. On the other hand, that is from an underweight starting point. Still, it's left me overweight by any standard.) On all of them, I had no luck whatsoever either keeping the weight off or getting the weight back off while on the meds. If I've gotta be on something from this time forward, I'd like to be able to live with the effects, which means some form of mitigation. Since the Effexor, at least, certainly effected my blood sugar, glucophage is my first choice to discuss. (Although I will do a blood sugar diary before making a formal request from a doctor, since I'm hesitant about meds anyway.)
>
> Best luck to you, and again -- do please let us know how it goes for you.
>
>

Thanks for the luck injection! :)

So far metformin + nortriptyline = normal movements.

You say Effexor alters your sugar levels? That would probably make me give it up.

Cheers,
Panda.

 

Effexor and my blood sugar Sad Panda

Posted by Racer on July 14, 2004, at 13:31:10

In reply to Re: Anyone's doctors rx-ing for weight gain? Racer, posted by Sad Panda on July 14, 2004, at 8:34:00

That's one of those stories that proves I'm not a scientist: While I was on Effexor, my husband started testing my blood sugar pretty frequently, because he thought he recognized signs of variation from his own experience. I did notice a *lot* of variation -- off meds, I'm pretty consistently in the low to mid 70s, but on Effexor I was anywhere from high 30s to low 180s -- but only put it together with the Effexor much later, after reading something that said it was one of the effects of long term, high dosage Effexor use shown in a very small number of studies. Light bulb moment for me. Until then, I just thought that I was probably developing some new, weird health problem! Since stopping the Effexor, I'm back to low to mid 70s on the rare occassions my husband checks me.

But, scientist or not, I did figure out that checking things like that and *asking* my doctor about weird changes correlating to beginning a new drug were both good ideas.

(And, further proof that I'm not doing all that well with The Good Doctor EyeCandy, when I was on Strattera and my periods changed radically, I didn't think to mention it to him -- just assumed that I was heading into menopause a bit earlier than expected! Gotta remind myself sometimes...)

You can have all the wishes of luck I can send you, buddy -- you've been so helpful for so many people, you've certainly earned it all.

 

Re: Effexor and my blood sugar Racer

Posted by Sad Panda on July 15, 2004, at 17:55:49

In reply to Effexor and my blood sugar Sad Panda, posted by Racer on July 14, 2004, at 13:31:10

> That's one of those stories that proves I'm not a scientist: While I was on Effexor, my husband started testing my blood sugar pretty frequently, because he thought he recognized signs of variation from his own experience. I did notice a *lot* of variation -- off meds, I'm pretty consistently in the low to mid 70s, but on Effexor I was anywhere from high 30s to low 180s -- but only put it together with the Effexor much later, after reading something that said it was one of the effects of long term, high dosage Effexor use shown in a very small number of studies. Light bulb moment for me. Until then, I just thought that I was probably developing some new, weird health problem! Since stopping the Effexor, I'm back to low to mid 70s on the rare occassions my husband checks me.
>
> But, scientist or not, I did figure out that checking things like that and *asking* my doctor about weird changes correlating to beginning a new drug were both good ideas.
>
> (And, further proof that I'm not doing all that well with The Good Doctor EyeCandy, when I was on Strattera and my periods changed radically, I didn't think to mention it to him -- just assumed that I was heading into menopause a bit earlier than expected! Gotta remind myself sometimes...)
>
> You can have all the wishes of luck I can send you, buddy -- you've been so helpful for so many people, you've certainly earned it all.
>
>

Effexor is definately not for you then! What are you taking at the moment?

Cheers,
Panda.

 

Re: Effexor and my blood sugar Sad Panda

Posted by Racer on July 16, 2004, at 13:43:49

In reply to Re: Effexor and my blood sugar Racer, posted by Sad Panda on July 15, 2004, at 17:55:49

Heheheh -- right now, I'm basically unmedicated. I do take 100mg of Provigil, which reduces my anxiety and agitation to a semi-bearable level, which makes the depression itself mostly bearable.

Long story short, it's got to do with my terror of going to the doctor, because of the nightmare that all dealings with the agency "treating" me has become. That's the problem with living in the States and being uninsured. (aren't you in Oz? My husband comes from there -- we've actually talked about moving there, although it's unlikely. Despite anything you may experience -- assuming you are -- bless your health care system daily for me, 'K? Beats the pants off being uninsured in this country.)

Ciao

 

Re: Effexor and my blood sugar Racer

Posted by Sad Panda on July 17, 2004, at 10:50:56

In reply to Re: Effexor and my blood sugar Sad Panda, posted by Racer on July 16, 2004, at 13:43:49

> Heheheh -- right now, I'm basically unmedicated. I do take 100mg of Provigil, which reduces my anxiety and agitation to a semi-bearable level, which makes the depression itself mostly bearable.
>
> Long story short, it's got to do with my terror of going to the doctor, because of the nightmare that all dealings with the agency "treating" me has become. That's the problem with living in the States and being uninsured. (aren't you in Oz? My husband comes from there -- we've actually talked about moving there, although it's unlikely. Despite anything you may experience -- assuming you are -- bless your health care system daily for me, 'K? Beats the pants off being uninsured in this country.)
>
> Ciao
>
>

I am in Oz & thankfull for our health system. It has a few minor problems, but it's mostly pretty good. :)

Tried any dirty old TCA's? They are good & cheap, I am up to 75mg of Nortriptyline & it doesn't seem to have any side effects. Much nicer than Effexor & Prozac.

Cheers,
Panda.

 

Dirty old TCAs and hypotension Sad Panda

Posted by Racer on July 17, 2004, at 14:07:20

In reply to Re: Effexor and my blood sugar Racer, posted by Sad Panda on July 17, 2004, at 10:50:56

My hubby is from near Sydney, which area are you in? (I spent some time in Melbourne while my ex was working on the Crown Casino, too.)

Yes, I've been on Nortriptyline, Sinequan (VERY briefly), and desiprimine. The Nort. was the only one I could stay on at all, but it only worked on the depression with the addition of a LARGE dose of L-trytophan also ordered by the doctor, and I gained 70# while on it. Oh, yeah -- it wasn't all that effective, partial remission at best, although that was enough at that time. (I was in my early 20s, my whole life before me, all sorts of other things to do to improve things, yaddida, yaddida -- this is a different situation: middle aged, several subsequent depressive episodes, major life troubles caused by a combination of circumstances and depression, etc. NOT the same sort of hopeful horizon before me, you know?)

The biggest problem I have with these drugs is hypotension. I think you've described something similar? (Maybe someone else, sorry if I'm confusing you with someone else here.) Even without meds, my blood pressure runs low, and certain types of stressors actually cause the lower number to drop even more. Since I'm normally about 90/60, the changes to things like 80/50, 100/50, etc are a pretty significant problem. On the des., for instance, I had a recurrent experience cooking breakfast every morning: I'd be walking around the kitchen, getting things out or checking the pots and pans on the stove, then walk back to the counter to, say, butter some toast -- and fall down in that grey veil. Or I'd be sitting in front of the TV in the evening, and find that I was losing consciousness as I sat there. Or walking around either the apartment or a store or down the street -- and grey veil as I hit the ground. (Mind you, for the most part there was enough warning for me to crouch down or even lie down with my legs in the air to try to stave it off -- although I somehow felt uncomfortable doing that in the vegetable section of the market...) Again, this is just a more pronounced version of a problem I already have: I can't stand in one place for any extended length of time, for instance, because my BP will drop -- and then I will drop... If I know that I have to stand for a while, I'll take little "breaks" by either marching in place, or doing a sort of isometric tensing of my leg muscles, or even going for a short, brisk walk every few minutes. And, again, when I'm tense, it's worse.

So, until I find a doctor who will address that issue -- or find a drug that works without such horrendous weight gain issues -- TCAs and MAOIs are pretty much out for me. (Too bad, too, because based on what I've learned from people like you and SLS and others here, I'm betting that I respond best to the NE and DA systems being tweaked, rather than serotonin.)

(Oh, yeah: weight gain is a HUGE issue for me, too, for a lot of reasons. I've said to Dr EyeCandy that I would "rather die than get that fat again" which he doesn't seem to have *quite* gotten, but in all honesty: I really don't think I could survive being that fat again. That also limits me, although I do think that a doctor who actually heard that concern and offered some sort of support or reassurance could help me past that. Too dang bad I don't have that luxury.)

(And I experienced the absolute best of your medical system in Melbourne, despite one of those "MD Ego" things: the doctor I went to when I developed an outbreak of shingles told me, "That's not shingles, that's Herpes Zoster!" Sure, and it's also Varicella Zoster, the chicken pox virus -- and commonly known as SHINGLES!!! I don't really care what you call it, just treat it, eh? And I really just laughed at him -- it felt as if he really wanted to do *something* to justify his fee. Having me lift the edge of my shorts a little to show him the lesions didn't seem like enough to him. He was very nice, was concerned about the cost of the drugs since I was self-pay, and tried so hard to make it easier for me. The pharmacist was the same way -- even reduced the price of the drugs for me, because he couldn't stand having to charge me full price. How I envy you there!)

 

Re: Dirty old TCAs and hypotension Racer

Posted by Sad Panda on July 18, 2004, at 11:22:59

In reply to Dirty old TCAs and hypotension Sad Panda, posted by Racer on July 17, 2004, at 14:07:20

Hi Racer,

I am in Brisbane. My blood pressure is high, so anything that lowers it is good for me. You can't exclude Parnate either as it might even raise your blood pressure. Do you take anything to increase pressure?

Cheers,
Panda.

 

Re: Dirty old TCAs and hypotension Sad Panda

Posted by Racer on July 19, 2004, at 17:00:28

In reply to Re: Dirty old TCAs and hypotension Racer, posted by Sad Panda on July 18, 2004, at 11:22:59

> Hi Racer,
>
> I am in Brisbane.

My hubby worked there for about six months, when the company he worked there assigned him the anti-cherry client site project. No one else in the office was willing to go, but he enjoyed it. (The only reason it wasn't a nice, red cherry was just that no one else wanted to head off for six months. He was excited, so it all worked great.)

>My blood pressure is high, so anything that lowers it is good for me. You can't exclude Parnate either as it might even raise your blood pressure.

Right now, because of my situation vis-a-vis Dr EyeCandy, I'm not willing to discuss MAOIs at all. Once I can see someone else, I'll be looking for a pdoc who will actually address my concerns, rather than just dismissing them as utterly outside his proper sphere of responsibility. Until then, I'm pretty much beyond hope of actually finding something helpful. (In fact, unless something changes radically at my next appointment, I'm basically planning to refuse further treatment. I just can't keep fighting this battle on top of the depression and its satellites. With a little luck, I'll have access to another doctor by the end of this year. Since this episode has gone on for over a year now, I guess I can manage another five months untreated, right?)

>Do you take anything to increase pressure?
>
Nope. When I can feel something coming on, I try to do something like go for a brisk walk, march in place, tighten my lower body muscles, or lie on the floor on my back with my legs in the air. (Sorta like a dead entomologist, right?) It is something I will be talking to my next doctor about, though, in hopes that it can be mitigated enough to allow me to try other anti-depressants. (I've read that upping salt intake can help, I just don't do it -- except for potato chips, I just don't like salty foods. My husband teases me about it all the time, since he salts most things.)

> Cheers,
> Panda.
>

 

Re: Dirty old TCAs and hypotension Racer

Posted by Sad Panda on July 19, 2004, at 23:27:45

In reply to Re: Dirty old TCAs and hypotension Sad Panda, posted by Racer on July 19, 2004, at 17:00:28

> > Hi Racer,
> >
> > I am in Brisbane.
>
> My hubby worked there for about six months, when the company he worked there assigned him the anti-cherry client site project. No one else in the office was willing to go, but he enjoyed it. (The only reason it wasn't a nice, red cherry was just that no one else wanted to head off for six months. He was excited, so it all worked great.)
>
> >My blood pressure is high, so anything that lowers it is good for me. You can't exclude Parnate either as it might even raise your blood pressure.
>
> Right now, because of my situation vis-a-vis Dr EyeCandy, I'm not willing to discuss MAOIs at all. Once I can see someone else, I'll be looking for a pdoc who will actually address my concerns, rather than just dismissing them as utterly outside his proper sphere of responsibility. Until then, I'm pretty much beyond hope of actually finding something helpful. (In fact, unless something changes radically at my next appointment, I'm basically planning to refuse further treatment. I just can't keep fighting this battle on top of the depression and its satellites. With a little luck, I'll have access to another doctor by the end of this year. Since this episode has gone on for over a year now, I guess I can manage another five months untreated, right?)
>
> >Do you take anything to increase pressure?
> >
> Nope. When I can feel something coming on, I try to do something like go for a brisk walk, march in place, tighten my lower body muscles, or lie on the floor on my back with my legs in the air. (Sorta like a dead entomologist, right?) It is something I will be talking to my next doctor about, though, in hopes that it can be mitigated enough to allow me to try other anti-depressants. (I've read that upping salt intake can help, I just don't do it -- except for potato chips, I just don't like salty foods. My husband teases me about it all the time, since he salts most things.)
>
> > Cheers,
> > Panda.
> >
>
>

Hi Racer,

Brisbane has close to the best possible weather, it would be hard to find a better place to live. :)

Have you tried Effexor? That's a good one for lifting blood pressure. More salt & water is fairly obvuios too. What other meds have you tried?

Cheers,
Panda.

 

Re: Dirty old TCAs and hypotension Sad Panda

Posted by Racer on July 20, 2004, at 15:05:14

In reply to Re: Dirty old TCAs and hypotension Racer, posted by Sad Panda on July 19, 2004, at 23:27:45

LoL! What other antidepressants have I tried? That's a long list, my friend, and most of them are in the past year! I've kinda given up on finding an effective medication right now. Next time I see Dr EyeCandy, I'm going to ask to try Straterra again, though, because it seemed as if it helped before, it just came along with so many other problems. On the other hand, since I was also taking Prozac, Provigil, and Xanax, I'm more than willing to hope that the benefits were from the Straterra, and the side effects had more to do with the other drugs.

(Supporting my hypothesis, by the way, the other drugs in combination did cause a lot of the same problems that led to discontinuing the Straterra -- so far as I can tell, the only thing that I think probably was due to the Straterra was a major change in my {ahem} [feminine euphemism alert] 'cycle'. Otherwise, I'm pretty well convinced that the overwhelming agitation and "speedy" feeling was the combination of Prozac and Provigil -- because when I tried Prozac again at the end of May, that's what happened. The significant residual depression? Well, aside from the fact that I felt as if I looked like a speed-freak to everyone around me, I think the Xanax may have had a lot to do with that -- because when I took some a week or so ago for sleep, I was profoundly depressed for days afterwards. Maybe not scientifically verifiable, but I'm still inclined to believe it's worth trying... Let's hope Dr EyeCandy will agree...)

I did take Effexor from 1999 until the end of 2002, although it really stopped working for me by the end of 2000. It wasn't ever effective on its own, but with the addition of 10mg of Prozac, it did well enough for over a year. I'm not willing to try again, though, because of the withdrawal. The taper schedule from my doctor left me a basket case, so we slowed it down pretty radically: 37.5mg reduction taking place only when the withdrawal symptoms from the last reduction were past. Since I was on 225mg, that taper lasted from February until late November -- and aside from the distress from the withdrawal itself, my depression was back full force by about halfway through the process. The withdrawal, by the way, is only part of the reason I'm unwilling to try it again: the fact that it never worked very well and then stopped working entirely is probably a bigger issue for me.

Salt? You must be HIGH! (Sorry, like I said, hubby teases me about it a lot...) I'm pretty sure I get enough salt for health, just not a lot extra. I do eat store-bought bread, for example, and have a liverwurst sandwich most days for lunch. (Boring? Maybe, but I do *adore* liverwurst.) And, thanks to my husband and tendency to eat certain things compulsively, I eat a bowl of potato chips most nights after dinner. (Upsets me, since I tend to eat them even if I'm not hungry -- feels so uncontrollable, and compulsive.) I have thought of getting some salt tablets, though, and will probably bring it up with the next doctor I see.

Really, except when the meds make it so much worse, the hypotension is something I've gotten used to. I try not to jump up from my chair and race into action, there's usually enough warning that I can get my head down when I need to, etc.

Always great to 'chat' with you, Panda. And tell me, are you a Great Panda, a Lesser Panda, or a Red Panda?

 

Re: Dirty old TCAs and hypotension Racer

Posted by Sad Panda on July 21, 2004, at 4:40:06

In reply to Re: Dirty old TCAs and hypotension Sad Panda, posted by Racer on July 20, 2004, at 15:05:14

> And tell me, are you a Great Panda, a Lesser Panda, or a Red Panda?
>
>

A Great Panda last time I looked :)


 

Re: Dirty old TCAs and hypotension

Posted by Ilene on July 21, 2004, at 20:18:26

In reply to Dirty old TCAs and hypotension Sad Panda, posted by Racer on July 17, 2004, at 14:07:20

My normal BP is also about 90/60, and I've had problems with low blood pressure, esp. with a TCA and an MAOI. I am actually doing better w/ the BP with the MAOI than I did on the TCA. Lithium brought the diastolic pressure way down.

I self-diagnosed neurally mediated hypotension as a trigger for my chronic fatigue syndrome. It hasn't been formally diagnosed (requires something unpleasant called a tilt table test) but my previous internist, who sees a lot of CFS patients, treated it with Florinef (fludrocortisone), based on my symptoms. What I noticed with the Florinef is that I can take a hot shower without getting light-headed for hours. He also recommended an electrolyte solution called E-lyte. It has no sugar and quite a bit of magnesium.

I've avoided exerting myself since I figured out what was going on. It means I'm out of shape but I spend much less time in bed. Another thing that helped was moving to a cooler climate. Hot humid weather used to do me in. Other tricks--not eating too fast or too much. Coffee sometimes helps and sometimes hurts.

Neither drinking lots of plain water nor increasing my salt intake helped.

I.

 

{{{SMACK!!!}}} Ilene

Posted by Racer on July 21, 2004, at 21:11:01

In reply to Re: Dirty old TCAs and hypotension, posted by Ilene on July 21, 2004, at 20:18:26

(That's a big kiss for you! You'll see why at the bottom!)


> I've avoided exerting myself since I figured out what was going on.


Heheheh, see, if I ever get back to functioning again, my life actually involves a fair amount of physical exertion, so that's not necessarily an option for me. I have found, though, that I have fewer problems with hypotension when I'm getting more exercise, so I hope that it won't be a problem.
>
> Neither drinking lots of plain water nor increasing my salt intake helped.

*THAT* is the best news I've ever heard about this! Thank you!

My husband likes to tease me about salt, since I almost never salt anything I eat, and usually omit salt when cooking -- although not baking -- because I like to taste the flavors of my food. He says -- over and over -- "salt is a flavor *enhancer* so you'll taste everything *more* if you use it!" May work for him, but... Anyway, I figure most of us get as much salt as we need from processed foods, anyway, so we probably don't really need the extra. (I could be wrong about that, but it works for me and I enjoy my food just fine, so why change it?)


Can you tell me which MAOI you're on? Or were on? You said that it wasn't as bad as the TCAs, so I'm guessing Parnate? If so, what were your experiences with it? (No, I'm nowhere near ready to say to Dr EyeCandy, "Gee, what I'd really like most is to give up holiday dinners with my family, liverwurst sandwiches for lunch, pepperoni pizzas on weekends, Guinness Extra Stout, and my little glass of Chartreuse on special occasions -- so why don't we try an MAOI now?" But I am starting to think about maybe being a little more open to the idea of an MAOI -- once I can go play with a "real" doctor. Oh, and once I really think we've exhausted the alternatives. Right now, I can see a half dozen alternatives to going that route, so I'm not exactly eager to restrict my eating even more, you know?)

Thanks for your input.

 

Re: {{{SMACK!!!}}} Racer

Posted by Ilene on July 21, 2004, at 22:28:58

In reply to {{{SMACK!!!}}} Ilene, posted by Racer on July 21, 2004, at 21:11:01

> Can you tell me which MAOI you're on? Or were on? You said that it wasn't as bad as the TCAs, so I'm guessing Parnate? If so, what were your experiences with it? (No, I'm nowhere near ready to say to Dr EyeCandy, "Gee, what I'd really like most is to give up holiday dinners with my family, liverwurst sandwiches for lunch, pepperoni pizzas on weekends, Guinness Extra Stout, and my little glass of Chartreuse on special occasions -- so why don't we try an MAOI now?"

I'm taking Marplan. On the SE spectrum it falls between Nardil and Parnate. I haven't gained weight from it--I know that's a concern of yours--but I had to go from 50 mg to 40 mg because I was having dizzy spells. I don't get postural hypotension at this dosage, either.

Most of the published info. on the MAOI diet is *wrong*. You can have all the things you mention, except maybe the Guiness. What you absolutely can't have is aged cheese. The toppings on chain-restaurant pizzas are not real. I've eaten a couple of pieces of pizza from one of the chains, but I'm not a real pizza fan. I'm also not a real drinker. I'm not much for aged sausage, either. Liverwurst should be okay as long as it's fresh. I've eaten soy sauce and tofu, which some sources cite as absolute no-nos. I tried increasingly larger amounts of soy sauce, and I stuck to one brand (Kikkoman), to be on the safe side. I don't have miso soup anymore, but that's no big deal.

Note that people taking Parnate tend to have more food reactions than those on other MAOIs. Sometimes they even have spontaneous episodes of hypertension. Also, food reactions seem to be idiosyncratic, meaning that we could both be taking the same dosage of the same drug and eat the same amount of the same food, and one of us would react while the other wouldn't.

I can't take Ultracet, which is the only painkiller that helps when my CFS flares up. No OTC allergy, cold, or cough meds, either, but I never take them anyway.

On the downside, I'm not sure if 40 mg is really enough, as I've been depressed lately. I see a new pdoc on Monday and I'll bring up increasing the dosage. Or maybe I'll do it anyway. I think my script is still being written for 50 mg.

(I get to see a resident. Yuck.)

Good luck. I think MAOIs are worth trying because they affect all three of the neurotransmitters implicated in depression.

I.

 

Re:MAOI and neurotransmitters

Posted by Cairo on July 23, 2004, at 8:26:36

In reply to Re: {{{SMACK!!!}}} Racer, posted by Ilene on July 21, 2004, at 22:28:58

Anyone know of a table that lists the effects on the various transmitters of the different MAOIs? Perhaps some MAOIs have more of a pressor effect than others and you can make an educated guess as to which one to try first according to your individual symptoms. Just a thought.

Cairo

 

Sounds like a good thought Cairo

Posted by Racer on July 23, 2004, at 9:55:04

In reply to Re:MAOI and neurotransmitters, posted by Cairo on July 23, 2004, at 8:26:36

If you find such a chart, do please post it here. It sounds like a useful starting point.

For me, though, the first issue is side effects -- the hypotension is just the other side of safety for me, so I'd have to make my choice based first on whether the drug is likely to lower my BP. My choices with other drugs, though, are usually based on the neurotransmitters that have been targeted by drugs that helped in the past, so such a chart for MAOIs specifically would be a very good tool.

The closest I know of is SLS's chart covering all the drugs. It's here:
http://sl.schofield3.home.att.net/medicine/psychiatric_drugs_chart.html

Thanks for the thought.


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