Psycho-Babble Medication Thread 579730

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Re: When the options are gone? » Bob

Posted by 4WD on November 18, 2005, at 22:29:26

In reply to Re: When the options are gone?, posted by Bob on November 18, 2005, at 17:35:39

Wouldn't it be worth giving an MAOI a try? I've always kind of held that in reserve for myself as a last resort. Sounds like you're at that point.

And I think you are probably right about the hospital. What does your pdoc say? Have you discussed opiate therapy with him/her?

Marsha

 

Re: When the options are gone? » 4WD

Posted by Bob on November 19, 2005, at 0:38:19

In reply to Re: When the options are gone? » Bob, posted by 4WD on November 18, 2005, at 22:29:26

> Wouldn't it be worth giving an MAOI a try? I've always kind of held that in reserve for myself as a last resort. Sounds like you're at that point.
>
> And I think you are probably right about the hospital. What does your pdoc say? Have you discussed opiate therapy with him/her?
>
> Marsha


I might give the MAOI a try. It's just that the washout period practically guarantees that I will have to endure weeks without meds. That's scary. Also, I haven't heard great things about them anyway, like Nardil causing massive weight gain and flawless chemical castration. I know I should n't be weighing these things against my life, but when you finally do get on a drug and pick up up 80lbs and go numb in your genital area, it just adds to the misery - especially if the drug doesn't work. I guess I'm just afraid of drugs anymore. They have led to much misery and I don't know how I can last a long time on any of them. When I look back, I didn't take any drug for more than a year before ultimately tapering off in a desperate attempt to reduce misery caused by side effects.

What exactly is opiate therapy? That causes me to imagine being stuck in a methadone-type clinic somewhere. Is there a website or something where I can check it out?


 

Re: When the options are gone? » linkadge

Posted by Bob on November 19, 2005, at 0:41:10

In reply to Re: When the options are gone?, posted by linkadge on November 18, 2005, at 19:18:50

> I saw a TV special on the SST stereotactic subcaudate tractononomy. It was supposedly very effective. The individuals followed were very satisfied, they said they felt like themselves but with extrordinarily less intensity to their emotions.
>
> Not like a lobotomy, differnt part of brain.
>
>
>
>
>
> Linkadge

I guess I'll have to do some research, but man it sounds scary. Is that something they perform for severe depression? My disease has progressed so far beyond just thought problems. It is a very physical disorder now - just as much so as mental.

 

Re: When the options are gone? » linkadge

Posted by Bob on November 19, 2005, at 0:41:48

In reply to Re: When the options are gone?, posted by linkadge on November 18, 2005, at 19:18:50

Thanks for the responses, everybody.

 

MAOIs and psycho-surgery » Bob

Posted by ed_uk on November 19, 2005, at 8:11:55

In reply to Re: When the options are gone? » linkadge, posted by Bob on November 19, 2005, at 0:41:48

Bob,

IMO, you really need to try an MAOI. Nardil and Parnate are really quite different - if one doesn't work the other can still work very well.

Since psychosurgery was mentioned, here is an interesting website which describes the various forms of surgery. I'm not recommending surgery, I just thought you might be interested.

http://www.dundee.ac.uk/psychiatry/research_mood_nmd.htm

Kind regards

Ed

 

Re: When the options are gone?

Posted by Sebastian on November 19, 2005, at 14:13:52

In reply to Re: When the options are gone?, posted by Bob on November 18, 2005, at 17:35:39

Have you tried anti psychotics, like zyprexa.

 

Re: MAOIs and psycho-surgery » ed_uk

Posted by Bob on November 19, 2005, at 15:58:11

In reply to MAOIs and psycho-surgery » Bob, posted by ed_uk on November 19, 2005, at 8:11:55

> Bob,
>
> IMO, you really need to try an MAOI. Nardil and Parnate are really quite different - if one doesn't work the other can still work very well.
>
> Since psychosurgery was mentioned, here is an interesting website which describes the various forms of surgery. I'm not recommending surgery, I just thought you might be interested.
>
> http://www.dundee.ac.uk/psychiatry/research_mood_nmd.htm
>
> Kind regards
>
> Ed
>
>
>
>
>
>


I haven't ruled them out. If my psychiatrist told me that's what I needed to try, then I guess I'd do it. He never forces anything on me though. I just can't imagine being on such a heavy duty medecine like that for the rest of my life. I mean, does anyone really take these things for decades, or does it always end up bad in the end? I also can't imagine being on a super-restrictive diet for a very long time. The last thing I need is a stroke. I wonder, if the MAOIs had remained a first line treatment if the drug companies would have found safe versions by now.

Thank you for the website.

 

Re: When the options are gone? » Sebastian

Posted by Bob on November 19, 2005, at 16:02:24

In reply to Re: When the options are gone?, posted by Sebastian on November 19, 2005, at 14:13:52

> Have you tried anti psychotics, like zyprexa.

I took Geodon once, and literally hours after one dose, I got extremely agitated and panicky, at which point I promptly called my psychiatrist's emergency number for advice/scrips. I have not tried any of the other anti-psychotics. Is Abilify one of these?

Hasn't Zyprexa run into problems for causing extreme weight gain and diabetes? I see ambulance-chaser lawyer ads on TV now and then, and one of them talks about Zyprexa of all things. I mean, there's a lot of dangerous drugs out there, why would they mention Zyprexa?

 

Re: MAOIs and psycho-surgery » Bob

Posted by ed_uk on November 19, 2005, at 16:11:43

In reply to Re: MAOIs and psycho-surgery » ed_uk, posted by Bob on November 19, 2005, at 15:58:11

Hi Bob

>I just can't imagine being on such a heavy duty medecine like that for the rest of my life. I mean, does anyone really take these things for decades.......

Yes, there are people here who've taken them for many years. They're not necessarily heavy duty - some people have few side effects. Other people have lots of side effects, you'll have to try them and see for yourself.

>I also can't imagine being on a super-restrictive diet for a very long time.

The modern MAOI diet isn't super-restrictive. Here is some more information........

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8617704&dopt=Abstract

Regards

Ed

 

Re: MAOIs and psycho-surgery » Bob

Posted by Jedi on November 19, 2005, at 17:02:45

In reply to Re: MAOIs and psycho-surgery » ed_uk, posted by Bob on November 19, 2005, at 15:58:11

>I just can't imagine being on such a heavy duty medecine like that for the rest of my life. I mean, does anyone really take these things for decades, or does it always end up bad in the end? I also can't imagine being on a super-restrictive diet for a very long time. The last thing I need is a stroke. I wonder, if the MAOIs had remained a first line treatment if the drug companies would have found safe versions by now.

Thank you for the website.



Bob,
As a person that has been on Nardil plus augmentation for the good part of the last decade, I am having a hard time with your thinking on MAOIs. There is a school of thought that a person can not even be considered treatment resistant without a couple of five week trials on Nardil and Parnate. Without Nardil I would not be living right now. I do not know the history of your depression, but if it is atypical with social anxiety, an MAOI should have been the 2nd tier medication trial. It is not a last resort, it is the gold standard that other medications are compared to. The side effects and diet restrictions are way overblown. I plan on being on Nardil with various augmentations the rest of my life.
Wishing you Well,
Jedi

 

Re: MAOIs and psycho-surgery » Jedi

Posted by Bob on November 19, 2005, at 18:02:08

In reply to Re: MAOIs and psycho-surgery » Bob, posted by Jedi on November 19, 2005, at 17:02:45

> >I just can't imagine being on such a heavy duty medecine like that for the rest of my life. I mean, does anyone really take these things for decades, or does it always end up bad in the end? I also can't imagine being on a super-restrictive diet for a very long time. The last thing I need is a stroke. I wonder, if the MAOIs had remained a first line treatment if the drug companies would have found safe versions by now.
>
> Thank you for the website.
>
>
>
> Bob,
> As a person that has been on Nardil plus augmentation for the good part of the last decade, I am having a hard time with your thinking on MAOIs. There is a school of thought that a person can not even be considered treatment resistant without a couple of five week trials on Nardil and Parnate. Without Nardil I would not be living right now. I do not know the history of your depression, but if it is atypical with social anxiety, an MAOI should have been the 2nd tier medication trial. It is not a last resort, it is the gold standard that other medications are compared to. The side effects and diet restrictions are way overblown. I plan on being on Nardil with various augmentations the rest of my life.
> Wishing you Well,
> Jedi
>
>

Jedi

Your info is heartening. I assume you are not getting extreme side effects, or otherwise you'd be off of it? If you don't mind me asking, what types of things did you augment Nardil with, assuming that none of the SSRIs are available?

Again, it's not that I am somehow against the MAOIs, just that I've had a bad time with so many meds for so long that I'm real skittish now.

I basically have major depression, major anxiety, and some obsessional/rumination problems. Most of the meds I've taken have affected me greatly in one way or another - it's not like I'm some sort of inert rock and completely insensitive to all meds. I've just never been able to find a med that helped with my mental (and now physical problems) while at the same time actually allowing me to function in life. My standards were much higher in the beginning. Now I just want to be able to get out of the house on a daily basis.

 

psychosurgery, etc.

Posted by med_empowered on November 19, 2005, at 18:03:37

In reply to Re: MAOIs and psycho-surgery » Bob, posted by Jedi on November 19, 2005, at 17:02:45

hey! The reason I don't think psychosurgery i susch a great idea is b/c its irreversible and there haven't been any really *good* double-blind studies. I also have problems with destroying healthy brain tissue to alter personality and mood...the idea of brain damage as therapy repulses me. MAOIs aren't too bad, but I can understand people wanting to avoid them. Aurorix (moclobedmide, others) is a reversible MAOI w/ fewer problems. The dose has to be pretty high to get effects--apparently a bunch of studies made it seem ineffective b/c they used low doses. Plus, it can be used with tricyclics and I think SSRIs. Its available in canada, europe, asia...pretty much everywhere except the US. If you're in the US, your doc might go for finding a way to get it to you and then monitoring your progress. Its available in generic, so even if your insurance won't cover that the costs shouldn't be too bad (I would think..I dont really know, though). The most hardcore Antidepressant regimine I can think of would be an MAOI+Tricyclic+low-dose stimulant; with moclobemide, you could probably do this w/ minimal side effects (and if you can use provigil as the stimulant, that will also reduce side effects). Good luck!

 

opioids for depression » Bob

Posted by pseudoname on November 19, 2005, at 20:59:44

In reply to Re: When the options are gone? » 4WD, posted by Bob on November 19, 2005, at 0:38:19

I think we're in similar positions. I go days without leaving the house. I've tried ECT and about 3 dozen med regimes plus lots of therapy etc. Almost nothing did any good. Right now I'm just starting opioid therapy with buprenorphine.

> What exactly is opiate therapy? ... Is there a website or something where I can check it out?

See Stoll's 1999 case studies reprinted here: http://www.dr-bob.org/babble/20010522/msgs/64652.html

The buprenorphine I'm trying is a weaker & more complex opioid. See "Buprenorphine Treatment of Refractory Depression" by Bodkin et al, Journal of Clinical Psychopharmacology, Feb 1995, vol 15, p 49-57: http://balder.prohosting.com/~adhpage/bupe.html

One huge Babble opioids-for-depression thread starts here: http://www.dr-bob.org/babble/20011015/msgs/81414.html.

Adding naltrexone (which acts on opioid receptors) to an SSRI may be a better bet if you've had at least *some* response to the SSRI already (e.g., weak or pooped-out).

It sounds like you're thinking now of an MAOI? If you also become interested in opioid therapy ("opioid" is a more inclusive term than "opiate"), I'd suggest going ahead with MAOI trials while you gather info and talk to your docs about opioids. They may initially be reluctant or unaware of the literature or even misinformed about the law. And if an MAOI works, well, it'd easier to get, anyway.

 

Re: MAOIs » Bob

Posted by Jedi on November 20, 2005, at 1:50:44

In reply to Re: MAOIs and psycho-surgery » Jedi, posted by Bob on November 19, 2005, at 18:02:08

> Your info is heartening. I assume you are not getting extreme side effects, or otherwise you'd be off of it? If you don't mind me asking, what types of things did you augment Nardil with, assuming that none of the SSRIs are available?
>
> Again, it's not that I am somehow against the MAOIs, just that I've had a bad time with so many meds for so long that I'm real skittish now.
>
> I basically have major depression, major anxiety, and some obsessional/rumination problems.

Hi Bob,
I do get side effects from the Nardil. I am on a fairly high dosage of between 75 and 105mg. Most of the side effects have gone away over time. I no longer get orthostatic hypertension. In fact Nardil will decrease borderline hypertension, so that if you are affected with this ailment, another med for this is probably not necessary.

The main side effects that are still with me are carbohydrate cravings which cause my weight gain and delayed ejaculation. The weight gain can be controlled with vigorous exercise. When you are severely depressed, forcing yourself to exercise can be very difficult. Weight gain is also a symptom of my atypical depression. The delayed ejaculation has not been much of a problem for me, there are augmentations to handle this, also.

What it comes down to is a choice. I can fight though some minor side effects or lay in bed for 16 hours a day and watch my life and family disappear.

Currently, I am augmenting with 1mg of clonazepam. There is some current research that augmenting with up to 3mg of clonazepam can help resistant depression. I may try this for a month while reducing my Nardil dosage, just to see what happens. I've also augmented with nortriptyline which is the major metabolite of amitriptyline & effects mostly NE. I've used bupropion with Nardil also. This is officially contraindicated but helped with my Nardil induced weight gain. I found the bupropion caused some initial agressiveness but the Nardil counteracted the anxiety producing effects of bupropion. Never augment Nardil or Parnate with an SSRI. They potentiate serotonin in the brain by different pathways. Serotonin syndrome is the result. Anyway Bob, there are many things left to try. It can be a long hard road, but we do what's put in front of us.
Take care,
Jedi

 

Re: MAOIs and psycho-surgery

Posted by linkadge on November 20, 2005, at 15:47:40

In reply to Re: MAOIs and psycho-surgery » ed_uk, posted by Bob on November 19, 2005, at 15:58:11

I don't mean to sound rude, but having to avoid a few types of food for an extended period of time seems to me to pale in comaprison to me to having to live with the kind of illness you're describing.

+ there are meds you can cary with you to abort hypertensive crisis.

Linkadge

 

Re: MAOIs and psycho-surgery » linkadge

Posted by Bob on November 20, 2005, at 16:52:23

In reply to Re: MAOIs and psycho-surgery, posted by linkadge on November 20, 2005, at 15:47:40

> I don't mean to sound rude, but having to avoid a few types of food for an extended period of time seems to me to pale in comaprison to me to having to live with the kind of illness you're describing.
>
> + there are meds you can cary with you to abort hypertensive crisis.
>
> Linkadge

Don't worry, I don't think your comment is rude, but I do think it can be misleading. I've heard that rationale many times, but once I'm on a medecine and presented with myriad side effects but still miserable, I then wonder why it's worth it. For example, both Effexor and Anafranil produced prodigious weight gain, inability to ejaculate, a lack of motivation, impaired ability to concentrate, profuse sweating, and so on. Most seriously, over time it got harder and harder to wake up in the morning, no matter what time I went to bed, until eventually I was not able to make it to work until mid-afternoon. Other SSRIs have done this also, but not quite to the same extent. I have tried many, many things to deal with this, but nothing, and no one has ever helped. So I have to wonder whether being on the med is worth it. About the only thing it does do is emotionally blunt me and, for the most part get rid of suicidality. What kind of life is that? I guess better than being suicidal.

The only way I ever got a girlfriend during all this time was when I stubbornly went of SSRIs and temporarily using Lithium with low-dose Celexa and Welbutrin. I achieved a small window where I had little motivation and was able to perform sexually (although poorly). The window soon faded.

Its easy to say that putting up with a few side effects is no big deal, but side effects coupled with ineffective meds is another issue. I think in my case, I am having bad reactions to meds, also. It seems that now, whenever I take a med with any SSRI action, I suffer physical effects, like general discomfort all over my body, especially after physical exertion, or exposure to heat, such as in a hot shower. It's a reaction that is very disturbing to me, yet no professional has ever even remotely suggested to me what it might be. This is one reason why I sough out meds like Topomax and Neurontin, as well as the ECT treatments. I've been desperately, desperately trying to find ways to subsist of meds. Not only have my efforts failed, but they have really, really close to bringing and end to everything. These were not issued I was dealing with way back when I first started these things. I guess many diseases evolve, or as I'd like to think, devolve.

 

Re: MAOIs » Jedi

Posted by Bob on November 20, 2005, at 20:06:25

In reply to Re: MAOIs » Bob, posted by Jedi on November 20, 2005, at 1:50:44

> > Your info is heartening. I assume you are not getting extreme side effects, or otherwise you'd be off of it? If you don't mind me asking, what types of things did you augment Nardil with, assuming that none of the SSRIs are available?
> >
> > Again, it's not that I am somehow against the MAOIs, just that I've had a bad time with so many meds for so long that I'm real skittish now.
> >
> > I basically have major depression, major anxiety, and some obsessional/rumination problems.
>
> Hi Bob,
> I do get side effects from the Nardil. I am on a fairly high dosage of between 75 and 105mg. Most of the side effects have gone away over time. I no longer get orthostatic hypertension. In fact Nardil will decrease borderline hypertension, so that if you are affected with this ailment, another med for this is probably not necessary.
>
> The main side effects that are still with me are carbohydrate cravings which cause my weight gain and delayed ejaculation. The weight gain can be controlled with vigorous exercise. When you are severely depressed, forcing yourself to exercise can be very difficult. Weight gain is also a symptom of my atypical depression. The delayed ejaculation has not been much of a problem for me, there are augmentations to handle this, also.
>
> What it comes down to is a choice. I can fight though some minor side effects or lay in bed for 16 hours a day and watch my life and family disappear.
>
> Currently, I am augmenting with 1mg of clonazepam. There is some current research that augmenting with up to 3mg of clonazepam can help resistant depression. I may try this for a month while reducing my Nardil dosage, just to see what happens. I've also augmented with nortriptyline which is the major metabolite of amitriptyline & effects mostly NE. I've used bupropion with Nardil also. This is officially contraindicated but helped with my Nardil induced weight gain. I found the bupropion caused some initial agressiveness but the Nardil counteracted the anxiety producing effects of bupropion. Never augment Nardil or Parnate with an SSRI. They potentiate serotonin in the brain by different pathways. Serotonin syndrome is the result. Anyway Bob, there are many things left to try. It can be a long hard road, but we do what's put in front of us.
> Take care,
> Jedi

Jedi

I feel deeply for you. I know exactly what you mean about a "long hard road". Not only that, but nobody can possibly imagine this plight who hasn't gone through it. I guess that's the way it is for other plights too. Still, the burden of this situation is unbelievably difficult, and to think that it's for life is just brutal. Ok, enough said.

It seems like it would be very difficult to tolerate Nardil along with Nortriptyline! Those are two heavy drugs. I didn't know that adding clonazepam would help depression. I thought benzos would only calm someone down, but that's it.

Are you saying that you have had success controlling your weight with exercise, that you have not been able to exercise because of your depression?

I assume that since you are taking a relatively high dose of Nardil and that you have augmented with different things that you experienced at least a partial fade out with the therapeutic effects of Nardil?

Bob

 

Re: MAOIs » Bob

Posted by Jedi on November 21, 2005, at 1:51:22

In reply to Re: MAOIs » Jedi, posted by Bob on November 20, 2005, at 20:06:25

> It seems like it would be very difficult to tolerate Nardil along with Nortriptyline! Those are two heavy drugs.

Bob,
I only augmented with 100mg of nortriptyline. I had no additional side effects. There are quite a few controlled studies that show that an MAOI augmented with some tricyclics can be beneficial for treatment resistant depression. There are also some studies which show that augmenting with tricyclics can reduce the problems with ingested tyramine. The nortiptyline did not seem to add any additional benefit for me. So when I got my MAO inhibition up to a therapeutic level, I dropped the nortriptyline.

> I didn't know that adding clonazepam would help depression. I thought benzos would only calm someone down, but that's it.

Many people on this board think that clonazepam causes worsening of depression. There have been some resent studies which show that at least 3mg of clonazepam added to an antidepressant can have a synergistic effect.

Example:
Nihon Shinkei Seishin Yakurigaku Zasshi. 2004 Apr;24(2):75-8.
[Clonazepam as a therapeutic adjunct to improve the management of depression]
Morishita S.
Depression Prevent Medical Center, Jujo Hospital, 32 Hattandacho, Kishoin, Minami-ku, Kyoto, 601-8325 Japan.

Clonazepam, which is a benzodiazepine structurally related to chlordiazepoxide hydrochloride, diazepam and nitrazepam, has been available for the treatment of seizure disorders in the USA since 1976 and in Japan since 1981. Increasingly, clonazepam has been used in the treatment of a variety of psychiatric disorders. The effect of clonazepam on depression was first reported by Jones and Chouinard in 1985. Since their report, many investigators have reported on the antidepressive properties of clonazepam. A daily dose of at least 3.0 mg clonazepam in augmentation of ongoing antidepressant treatment should be considered in depression. Regarding clonazepam augmentation therapy, if a patient does not show improvement by the end of four weeks, the treatment regimen should be altered. Age at onset of the first depressive episode and a history of family psychiatric illness should be considered the predictor of prognosis. The author discusses specific guidelines for the use of clonazepam in depression.

> Are you saying that you have had success controlling your weight with exercise, that you have not been able to exercise because of your depression?

My weight has gone up and down on Nardil. When I am able to exersise for an hour or two per day, the weight comes off. Without medication, my atypical depression makes it almost immpossible to exercise. I just can't force myself out of bed.

> I assume that since you are taking a relatively high dose of Nardil and that you have augmented with different things that you experienced at least a partial fade out with the therapeutic effects of Nardil?

You assume correctly. I would call the level of depression that I suffer on Nardil, intermittent dysthymia. The augmentation that I try is to control this and the side effects. The two times I have been off Nardil in the past decade, I have regressed to major depression within a couple of months.

I have had partial responses with other medications. Effexor and Celexa combined with Wellbutrin SR have given partial response. The main problem with the SSRIs and SNRIs is a level of anhedonia and apathy which keep me from doing anything productive.

As mentioned before, I'm a lifer. I'm still hoping for that miracle medication to come along, but until then it is Nardil with augmentation.
Take care,
Jedi

 

Re: MAOIs » Jedi

Posted by Bob on November 21, 2005, at 15:32:05

In reply to Re: MAOIs » Bob, posted by Jedi on November 21, 2005, at 1:51:22


>
> I have had partial responses with other medications. Effexor and Celexa combined with Wellbutrin SR have given partial response. The main problem with the SSRIs and SNRIs is a level of anhedonia and apathy which keep me from doing anything productive.
>
> As mentioned before, I'm a lifer. I'm still hoping for that miracle medication to come along, but until then it is Nardil with augmentation.
> Take care,
> Jedi
>
>

I did a stint on Effexor alone, as well as Celexa combined with Welbutrin SR. I too got a partial response from both, but the second one especially started producing unpleasant physical side effects, like breathing problems. One thing that makes these drugs hard for me is getting off of them when the situation turns sour. Effexor was nasty to get off of, and so was Anafranil. They were the worst. Oh, and benzos! Any change down in a benzo dose really hits me hard. It causes almost immediate suicidality.

 

Re: MAOIs » Bob

Posted by 4WD on November 21, 2005, at 21:53:46

In reply to Re: MAOIs » Jedi, posted by Bob on November 21, 2005, at 15:32:05

Bob, I sympathize completely. People talk about side effects and how it's worth it to feel better. Well, I think so, too. However, and this is the big thing, if you just get the side effects and not much therapeutic action, it's NOT worth it. And the side effects seem to be intensified or at least less bearable if you are still depressed or anxious. What I'd be able to stand (side effect wise) is a whole lot different when I'm depressed versus when I'm feeling well.

So yes, if a med took away my depression and anxiety and I felt well on it but had dry mouth and anorgasmia or whatever, it would be worth it. (Though why we should have to tolerate a lowered quality of living doesn't seem fair). But having dry mouth and anorgasmia and restless legs while one is depressed is just about unbearable.

Marsha

 

Re: MAOIs and psycho-surgery

Posted by linkadge on November 22, 2005, at 15:53:52

In reply to Re: MAOIs and psycho-surgery » linkadge, posted by Bob on November 20, 2005, at 16:52:23

I can understand how the cumulative side effect profile can make life miserable in itself, especially when the drug isn't doing what it should.

But for goodness sakes if an MAOI works then take it. You'll never really be able to ballance the positives/negatives unless you try and see.

I found that parnate had no side effects as compared to the SSRI's. And geez giving up a few foods was not a big deal, I very quickly learned to find foods I enjoyed that were allowable.

Severe depression is life threatening in my books. Avoiding sardenes is not.

Linkadge

 

Re: MAOIs

Posted by linkadge on November 22, 2005, at 15:56:53

In reply to Re: MAOIs » Bob, posted by 4WD on November 21, 2005, at 21:53:46

I know what you are saying about sleep though. Most AD's screw up your sleep, that is how they work by reducing REM sleep. It mimics sleep deprivation. Its not healthy.

Linkadge

 

Re: MAOIs » 4WD

Posted by Bob on November 22, 2005, at 18:25:54

In reply to Re: MAOIs » Bob, posted by 4WD on November 21, 2005, at 21:53:46

> Bob, I sympathize completely. People talk about side effects and how it's worth it to feel better. Well, I think so, too. However, and this is the big thing, if you just get the side effects and not much therapeutic action, it's NOT worth it. And the side effects seem to be intensified or at least less bearable if you are still depressed or anxious. What I'd be able to stand (side effect wise) is a whole lot different when I'm depressed versus when I'm feeling well.
>
> So yes, if a med took away my depression and anxiety and I felt well on it but had dry mouth and anorgasmia or whatever, it would be worth it. (Though why we should have to tolerate a lowered quality of living doesn't seem fair). But having dry mouth and anorgasmia and restless legs while one is depressed is just about unbearable.
>
> Marsha

Very well said Marsha. You've summed it up perfectly. We wouldn't have legions of people motivated to try another antidepressant if they truly were being greatly helped by the one they are on, even if there were a few side effects. What you can or will tolerate depends greatly on how well you feel to begin with.

 

Re: MAOIs » linkadge

Posted by Bob on November 22, 2005, at 18:29:00

In reply to Re: MAOIs, posted by linkadge on November 22, 2005, at 15:56:53

> I know what you are saying about sleep though. Most AD's screw up your sleep, that is how they work by reducing REM sleep. It mimics sleep deprivation. Its not healthy.
>
> Linkadge

That fact that ADs word by creating sleep deprivation - I don't think I've ever actually heard that. At least not as the mechanism of action. So you are saying that because they reduce REM sleep, that the body actually needs more? If so, why do I personally seem to need about 10 times more than anyone else I've heard about, even others oh meds?


 

Re: MAOIs and psycho-surgery » linkadge

Posted by Bob on November 22, 2005, at 18:32:34

In reply to Re: MAOIs and psycho-surgery, posted by linkadge on November 22, 2005, at 15:53:52

> I can understand how the cumulative side effect profile can make life miserable in itself, especially when the drug isn't doing what it should.
>
> But for goodness sakes if an MAOI works then take it. You'll never really be able to ballance the positives/negatives unless you try and see.
>
> I found that parnate had no side effects as compared to the SSRI's. And geez giving up a few foods was not a big deal, I very quickly learned to find foods I enjoyed that were allowable.
>
> Severe depression is life threatening in my books. Avoiding sardenes is not.
>
>
>
>
>
> Linkadge
>
>


I agree with you totally, and I'm not ruling MAOIs out. But again, I've had such a horrific history with meds that I'm a little skittish. Especially since those things need two week washout periods before and after. I don't know if I could actually handle that if I ended up having to be on nothing. Interestingly, it seems that my doctor is not ready to turn to the MAOIs yet because of all the hassle with diet and med interactions. I wonder if he had a patient who made a mistake? He's not ruling them out though.


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