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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by UgottaHaveHOPE on April 19, 2006, at 0:12:46
What is the best one for anxiety, then depression? Is it hard to convince a doc to let you try one with all the new meds? Are they better than the SSRI's (to me, it sounds like ppl swear by them).
Any insight would be appreciated.
Posted by willyee on April 19, 2006, at 7:44:45
In reply to When is it time to try a MAOI?, posted by UgottaHaveHOPE on April 19, 2006, at 0:12:46
Nothing is better than one or the other,dont let things fool you,i think the maoi hype here is because the drugs have been ridiculed so long and kept in the dark that now users feel apart of something not alone,but i dont think the users out number ssri numbers,its just at last they have somewhere to say hey,ur on a maoi too,cool,since most pharmisict techs dont even know about them.
As for getting it from a doc,oh yeah it is very hard,unless u have a peon minded doc who will be happy to oblige then it can actualy be impossable.When i first learned of parnate,i had been on every ssri,ssri combo,ssrir twice,three times etc,i then came to docs pleading for something different and was flat out told no a LOT.
I went through possably five doctors before finding one willing to let me try it.
Again are they better,who knows no one does for sure and anyone like people touting there drug is THE BEST and they perhaps are some king or champoin of it and down right saying it IS the best are dangerous,no everyone will respond differently,but failing ssris as u have mentioned you are definatly a candiate for something in a new class of drugs,and people who fail on ssris can find maois to be a life saver,good luck.
Posted by Crazy Horse on April 19, 2006, at 9:04:23
In reply to Re: When is it time to try a MAOI?, posted by willyee on April 19, 2006, at 7:44:45
> Nothing is better than one or the other,dont let things fool you,i think the maoi hype here is because the drugs have been ridiculed so long and kept in the dark that now users feel apart of something not alone,but i dont think the users out number ssri numbers,its just at last they have somewhere to say hey,ur on a maoi too,cool,since most pharmisict techs dont even know about them.
>
>
> As for getting it from a doc,oh yeah it is very hard,unless u have a peon minded doc who will be happy to oblige then it can actualy be impossable.
>
> When i first learned of parnate,i had been on every ssri,ssri combo,ssrir twice,three times etc,i then came to docs pleading for something different and was flat out told no a LOT.
>
> I went through possably five doctors before finding one willing to let me try it.
>
>
> Again are they better,who knows no one does for sure and anyone like people touting there drug is THE BEST and they perhaps are some king or champoin of it and down right saying it IS the best are dangerous,no everyone will respond differently,but failing ssris as u have mentioned you are definatly a candiate for something in a new class of drugs,and people who fail on ssris can find maois to be a life saver,good luck.Hey Willyee..Long time Man. I changed my Name from Tyler to Crazy Horse (Tyler is my 7yr. old son's name) my real name is Monte..sorry for the confusion.
How are you? I'm still doing very well on Parnate. So, did you find a dif pdoc? What are you taking? Let me know how you are doing, etc.
Monte
Posted by Crazy Horse on April 19, 2006, at 10:14:48
In reply to When is it time to try a MAOI?, posted by UgottaHaveHOPE on April 19, 2006, at 0:12:46
> What is the best one for anxiety, then depression? Is it hard to convince a doc to let you try one with all the new meds? Are they better than the SSRI's (to me, it sounds like ppl swear by them).
>
> Any insight would be appreciated.Best one? Some swear by Nardil, some swear by Parnate, and others are doing great on EMSAM "the patch". Really you just have to try one to see if it's good for you or not. Parnate is more activating then Nardil, some say Nardil is better for Anxiety..just have to try to find out for you. My pdoc likes maoi's so it was no problem for me, however some pdocs are afraid of them usually because of lack of knowledge or in my opinion laziness...it's easier to put someone on an ssri and say see ya in a month. Are MAOI's better than the other AD's. MY OPINION ONLY..I say Yes, not only because i'm doing very well on one (parnate) but because of their effect on more neurotransmitters than ssri's, snri's and TCA's. MAO inhibitor antidepressants(i.e., Nardil, Parnate and EMSAM)inhibit Monoamine oxidase which destroys neurotransmitters, thus prolonging the life of the neurotransmitters, and increasing neurol flow of Noradrenaline, dopamine,serotonin,acetycholine and GABA. So instead of increasing neurol flow of just serotonin (SSRI's-Prozac, zoloft, etc.) you are getting a lot of other neurotransmitters involved when using an MAOI. I hope this helps a little, and i wish you the very best. :)
Monte
Posted by Phillipa on April 19, 2006, at 17:14:31
In reply to Re: When is it time to try a MAOI? » UgottaHaveHOPE, posted by Crazy Horse on April 19, 2006, at 10:14:48
Problem Ace is contradicting the xanax and hasn't answered Tepi back yet at the bottom of the page. Plese one of you answer him he is on nardil. Please willyee? Or Monte? And my doc said I could try the Patch or even nardil or parnate. Trying for the Ensam Patch though even though the cost is so high. But even he has no problem with the MAOI's. And he said the diet restrictions are not Bad. I'll Email you both in a bit. Love Jan/ Phillipa
Posted by Crazy Horse on April 19, 2006, at 21:18:03
In reply to Re: When is it time to try a MAOI? » Crazy Horse, posted by Phillipa on April 19, 2006, at 17:14:31
> Problem Ace is contradicting the xanax and hasn't answered Tepi back yet at the bottom of the page. Plese one of you answer him he is on nardil. Please willyee? Or Monte? And my doc said I could try the Patch or even nardil or parnate. Trying for the Ensam Patch though even though the cost is so high. But even he has no problem with the MAOI's. And he said the diet restrictions are not Bad. I'll Email you both in a bit. Love Jan/ Phillipa
I did e-mail him Jan. I'm still baffled by the Xanax situation. I' sorry but i have to disagree about that, in Tepi's out of control high anxiety state he needs a benzodiazapine, one that works for him (Xanax does) and a dose high enought to HELP. I bet Ed would agree.
Love, Monte A.K.A. the "Wang" man :) I've got way too many names. LOL
Posted by Racer on April 19, 2006, at 21:47:15
In reply to When is it time to try a MAOI?, posted by UgottaHaveHOPE on April 19, 2006, at 0:12:46
Well, that depends on a lot of things... Probably a lot of different answers, because there are a lot of different situations people experience.
For what it's worth, there is somewhere out there -- and I can't find it right now -- a protocol showing what drugs to try in what order. Maybe on Internet Mental Health? That says one thing, other similar lists show another...
For some people, the dietary restrictions aren't a problem, they're healthy, have a good enough relationship with their doctor, etc, and MAOIs are probably pretty high on the list of options. From what I read, they're the Big Guns for depression: if you're depressed, they pretty much *will* help. But there are cases when they're much less attractive an option.
This just came up with my T, after my pdoc suggested EMSAM as an option for me. I'm not sure it would be, because my blood pressure runs so low, and is easily affected by medications. (I can't take TCAs, for instance, because of it.) But when my T heard "MAOI" -- well, you probably heard her yell, right? Her first words were about calling the pdoc to "talk about" that. And you know what? It wasn't from ignorance, it was from knowledge. Knowledge of my condition, my history, my psychopathology. The dietary restrictions are intimidating for me, but there's also a part of me that says, "But if I *had* to restrict what I ate..." My T knows that, and she knows that restricting *any* food, for pretty much any reason, is not a good idea with an anorexic. So, for me, MAOIs would be pretty far down the list, realistically. Especially for indefinite use, because about half of what the things I eat without going through craziness are on the restricted list.
In terms of effectiveness, though, it sounds to me, from reading here and elsewhere, that MAOIs are the most reliably effective drugs for treating depression.
Hope that helps, and that it wasn't too long a ramble.
Posted by willyee on April 19, 2006, at 22:18:20
In reply to Re: When is it time to try a MAOI? » willyee, posted by Crazy Horse on April 19, 2006, at 9:04:23
Not well,either i have a lot of strentgh from dealing with it,or people around me,but i usualy am able to stay at a min standered of life,and suffer mostly inside.
From time to time the pendalum will sway downard and that does frighten me,im used to living a unhappy life but i have to be functional,hygiene for example,haircuts,shaves etc,working out since im obssesed,and getting out at least a few times a week as well as keeping my bills in order.
But morning afternoon and night is a fight,my life is not a joyous one.
Im still at the same place,taking parnate,and playing mad scientist daily with augmentations ranging from Nurotion,to xyrem,to benzos kava ,beta blockers.
I think im at the point where its a love hate,i am really hating parnate now,i certainly could not take it alone as a primary med,however nothing else works without parnate as the bottom foundation like the bread on a pizza pie.My doc is gone,i seen my new one but he canceled because they set us on a 20 min med check and he said looking at the notes we wants an hour to talk to me before he just becomes anorther doc to hurl medication to my heap.
I told him i could live with that,as long as he promised not to yank me off parnate without warning,and allow me to slowly get off ONLY with a plan of action in place.
So i see him soon,till then every day is a new adventure.
WWW.MYSPACE.COM/REDHOOK23 is my newest homepage update if anyone wonders what i may look like,its hideous only a face mom could love lol.
Posted by Caedmon on April 19, 2006, at 22:38:04
In reply to Re: When is it time to try a MAOI? » UgottaHaveHOPE, posted by Racer on April 19, 2006, at 21:47:15
>> The dietary restrictions are intimidating for me, but there's also a part of me that says, "But if I *had* to restrict what I ate..." My T knows that, and she knows that restricting *any* food, for pretty much any reason, is not a good idea with an anorexic.>>
With EMSAM, diet restrictions wouldn't likely even be an issue. <shrug>
- C
Posted by Racer on April 20, 2006, at 1:47:10
In reply to Re: When is it time to try a MAOI? » Racer, posted by Caedmon on April 19, 2006, at 22:38:04
> >> The dietary restrictions are intimidating for me, but there's also a part of me that says, "But if I *had* to restrict what I ate..." My T knows that, and she knows that restricting *any* food, for pretty much any reason, is not a good idea with an anorexic.>>
>
> With EMSAM, diet restrictions wouldn't likely even be an issue. <shrug>
>
> - CI know, but my T didn't when she reacted. The dietary restrictions, though, aren't an issue at the lower doses. I thought the higher doses still required restrictions? Or is that just the usual "We don't really know, yet, so..." caution?
Posted by Caedmon on April 22, 2006, at 14:49:11
In reply to Re: When is it time to try a MAOI? » Caedmon, posted by Racer on April 20, 2006, at 1:47:10
> > >> The dietary restrictions are intimidating for me, but there's also a part of me that says, "But if I *had* to restrict what I ate..." My T knows that, and she knows that restricting *any* food, for pretty much any reason, is not a good idea with an anorexic.>>
> >
> > With EMSAM, diet restrictions wouldn't likely even be an issue. <shrug>
> >
> > - C
>
> I know, but my T didn't when she reacted. The dietary restrictions, though, aren't an issue at the lower doses. I thought the higher doses still required restrictions? Or is that just the usual "We don't really know, yet, so..." caution?>>Yeah it's some sort of beaureucratic protocol, there's no evidence that ANY dose of Emsam interacts with tyramine. In the original trials they didn't find any reactions in the 2500+ patients despite encouraging people to break the diet rules.
- C
Posted by jedi on April 24, 2006, at 3:19:51
In reply to When is it time to try a MAOI?, posted by UgottaHaveHOPE on April 19, 2006, at 0:12:46
Hi,
IMHO MAOIs should be a 2nd tier choice for treatment resistant atypical depression with social anxiety. With most doctors now, they seem to be the treatment of last resort. They are probably discussed and used here on Babble much more because so many of the people here are treatment resistant. I have been on 30+ different combinations of antidepressants. Nardil with clonazepam is the only combination that worked for my major atypical depression and social anxiety. Sometimes it takes a few weeks to work, but if it does work it is a very amazing feeling; unlike any other antidepressant. You can literally go from being completely hopeless one day to having the world by the tail the next day. It is the only med that has pulled me out of my major depressions. I will not hesitate for a minute to return to the drug should my major depression return.
Good luck,
Jedi
> What is the best one for anxiety, then depression? Is it hard to convince a doc to let you try one with all the new meds? Are they better than the SSRI's (to me, it sounds like ppl swear by them).
>
> Any insight would be appreciated.
This is the end of the thread.
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