![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Smoo on May 4, 2015, at 7:28:01
I'm writing a feature article on MAOIs, particularly Nardil, about its history and what it's like to be on and many MAOIs newer applications for other neurological diseases. It's for a journalism class for a university in Australia.
I was wondering if anybody would be willing to answer a few questions on here that they don't mind being quoted on? The article, if it's good enough, might be published. Hopefully :) You don't need to use your real name but if I could use your 'username' that would be great. Let me know if not. If it is published I'll put a post on here to let people know.
So! Here we go!
1. How long have you been/were you on your MAOI?
2. What illness do you have?
3. What was the worst side effect?
4. What dose were you on?
5. How long did it take to treat your illness?
6. Was it better/worse than a first line SSRI
7. Did you experiment or augment it with anything?
8. Did you find it hard to get prescribed?
9. How many drugs approx. were you on before trying a MAOI?
aaaaaand lastly
10. What kind of impact did it have on your life, socially, your relationships etc.?I hope you can help. If you want to ask me any questions feel free.
Posted by ikasug on May 4, 2015, at 7:46:20
In reply to Qs about MAOIs for anybody who has taken them, posted by Smoo on May 4, 2015, at 7:28:01
1. 3 years on Parnate with 2 years of Nardil in between
2. Major depressive disorder, Generalized anxiety disorder.
3. On nardil, I would have to pee urgently, but my bladder wouldn't release. Sometimes for 4-6 hours. I'd sit on the toilet for a whole hour... to pee. It happened only a few times.
4. Parnate: 30mg tid. Nardil: 60mg qd
5. I felt noticeably better in 3 weeks with each
6. Way better. SSRIS are not even comparable in my opinion
7. With mood stabilizers at first, then Risperdal, now Abilify. And benzodiazpines for anxiety because BuSpar is contraindicated.
8. Not at all. I didn't want to try antipsychotics and asked to try an MAOI instead.
9. About 15, all classes of antidepressants, many mood stabilizers, and many combinations of the 15.
10. I went from a cycle of drug abuse and reclusivity to working normally and having friends. Now in a relationship going on almost a year. Within 3 months of trying an MAOI I had a new job, car and apartment.
Posted by Smoo on May 4, 2015, at 9:09:09
In reply to Re: Qs about MAOIs for anybody who has taken them, posted by ikasug on May 4, 2015, at 7:46:20
Thank-you! Do you mind me asking why you stopped Parnate the first time for Nardil? And lucky you at 3 weeks, that's so quick!
I had the same urinary retention issues on Geodon. People really underestimate how nasty it is as a side effect-I didn't sleep for 36 hrs at a time even on knockout drugs.
Posted by ikasug on May 4, 2015, at 10:25:29
In reply to Re: Qs about MAOIs for anybody who has taken them » ikasug, posted by Smoo on May 4, 2015, at 9:09:09
I tried Nardil because I was still anxious on Parnate.
Posted by europerep on May 4, 2015, at 10:31:12
In reply to Qs about MAOIs for anybody who has taken them, posted by Smoo on May 4, 2015, at 7:28:01
Hey Smoo,
I have been on two MAOIs (tranylcypromine and phenelzine), but they both made the condition they were supposed to treat (treatment-resistant depression) considerably worse, so I'm not sure in how far info from me would be useful for you. But I'll just answer some questions and say a couple of things that may be relevant.
The question of how difficult it was to get a prescription is a very important one. I had to actively seek out a psychiatrist who would prescribe an MAOI to me. This would make sense if certain characteristics of my disease suggested that MAOIs would be a bad choice, or if I hadn't been on a whole range of other meds before, but neither is the case. They said things like "no, we haven't been prescribing MAOIs anymore for twenty years" or even "I've never prescribed MAOIs to anyone". And those were specialists in university hospitals here in Europe. Older doctors are generally more open.
Side effects are important as well. I'm quite lucky to never have had big trouble with side effects on any meds, except MAOIs that is. MAOIs gave me pretty bad insomnia, particularly on higher doses. But when an MAOI works, the insomnia problem can usually be dealt with in some way. The food restrictions are important too, but their impact on my daily life was really minimal.
And, just a few other points. I don't know if you know Ken Gillman or have been to his website (www.psychotropical.com), but he's an Australian psychiatrist and researcher who has published quite a lot on MAOIs.
If you write your piece about phenelzine in particular, you want to take a look at atypical depression. This subtype of depression responds particularly well to phenelzine, and less well to most modern antidepressants.
Lastly, you can also look for publications from Stephen Stahl. He's an American psychiatrist and researcher who has done quite some work on MAOIs as well.
I hope this helps you a bit, and feel free to ask more questions if you have any.
ER
Posted by Smoo on May 4, 2015, at 22:43:14
In reply to Re: Qs about MAOIs for anybody who has taken them, posted by europerep on May 4, 2015, at 10:31:12
Thank you, thank you so much, your information is fabulous! I'm looking at those two psychs right now.
I'm looking for all different kinds of experiences on MAOIs so yours is perfectly valid for this feature.
Do you mind telling me how long you were on both Parnate and Nardil? Would you say you share more symptoms with melancholic or atypical depression-as far as they're currently classifying them? Have you found a successful treatment regimen now? (I hope!)
How old were you when your first episode of depression hit?
Did your psydoc give you anything for your insomnia?
How high were your doses? Oh and do you identify as male or female? Sorry, I keep forgetting how important sex is. It seems higher levels of estrogen improve Nardil (I'll find the study) performance. Yet orthostatic hypotension for both drugs (and in general) affects women more than men. Double edged sword.
I've seen so many psychs unwilling to prescribe MAOIs but reach for ECT or combinations with TCAs that make hypotension tachycardia look like bradycardia. The fear of lack of research and unwillingness to trust patients (yet give them easy to overdose TCAs) is pretty astounding.
Posted by europerep on May 5, 2015, at 15:10:57
In reply to Re: Qs about MAOIs for anybody who has taken them » europerep, posted by Smoo on May 4, 2015, at 22:43:14
Hey there,
good to hear you find my response useful! ;)
My memory of back then is a bit hazy, but I think I was on tranylcypromine for something like three to four months. I started at very low doses, without feeling any kind of effect, then I went a bit higher and started to feel mildly worse, and then when further raising the dose I definitely started to feel much worse relatively quickly. The dose where I ended up was 50mg/d I think. But I made a post about it back then, so if you want to take a look at that: http://www.dr-bob.org/babble/20101231/msgs/975831.html Although I do have to say that I was in a very bad spot back then, so that thread is not exactly the high point of my life :/...
I share some features with atypical (especially hypersomnia) and some with melancholic (for example I never had issues with weight gain). And I first got ill at 16. Although that was when it definitely kicked in, there was already something there before, but I think it was subsyndromal.
I tried phenelzine after tranylcypromine, but when a worsening of my mood started to appear again I quickly went off of it, so I don't think I have had a full trial of it.
By the way, as far as phenelzine is concerned, two members might be able to help you: jedi, whom I haven't seen in quite a while, and Tomatheus, who has been posting as recently as yesterday, so he may actually discover this thread on his own. Jedi has had a lot of experience taking phenelzine successfully over years, after having been on many many meds unsuccessfully.
Anyway, back to me, I'm a guy and identify as such. And as far as my experience with MAOIs is concerned, a doctor in the US who has decades of experience with prescribing MAOIs told me (via email) that he had never seen a patient actually deteriorate on any of the MAOIs, so I think my reaction is really quite rare. There have been many people here who reported significant improvement on MAOIs. The thing is that most people who improve and maybe even reach remission eventually stop posting (or only show up very rarely), whereas most of those who are here are still struggling a bit. So I think that, in a way, all meds have a worse "rep" among members here when compared to all patients... but MAOIs still have a pretty good rep here, so that means they must be really pretty neat :)...
Ok, I hope I have addressed all important points? If not, don't hesitate to ask again!
Posted by europerep on May 5, 2015, at 17:10:04
In reply to Re: Qs about MAOIs for anybody who has taken them, posted by europerep on May 5, 2015, at 15:10:57
Ah, and just to clear things up, for phenelzine I did eventually find a doctor who was willing to prescribe it, but not for tranylcypromine, so that's where I had to "cheat" a bit as I mentioned in the course of the thread that I linked to...
Posted by Tomatheus on May 5, 2015, at 18:46:45
In reply to Qs about MAOIs for anybody who has taken them, posted by Smoo on May 4, 2015, at 7:28:01
Smoo,
I currently have what the doctors who've treated me would all consider to be an affective psychosis, which I think is most likely a form of bipolar disorder involving psychotic features and a mixture of depressive and manic symptoms. I took all of the MAOIs (separately, of course) during a span ranging from the summer of 2005 through early 2007, when I was experiencing what were mainly depressive symptoms without any psychosis. I experienced temporary relief from my depressive symptoms on all of the MAOIs, with the strongest effects coming from Nardil (phenelzine), followed by Marplan (isocarboxazid), Parnate (tranylcypromine), oral selegiline, and moclobemide. I would describe the temporary responses that I had to the MAOIs that I took -- especially Nardil, Parnate, and Marplan -- as being quite robust. At the time I took the medications, my energy levels were extremely low, leaving me to spend most of my days in bed. I found my energy levels, and consequently my activity levels, to be quite improved on the MAOIs when I was responding to them, but unfortunately, I never could seem to respond to the medications for very long (for longer than a few months at a time in Nardil's case and for longer than a few days at a time in the cases of the other MAOI medications).
I haven't taken any MAOI medications since 2007, and I probably won't attempt another MAOI trial in part because the nature of my illness has changed (I now have what's probably a mix of an anergic depression and a psychotic mania) and because I find it doubtful that I'd respond to an MAOI in the long run now when I didn't before.
Since you mentioned that you were looking to include information about Nardil's history in your article, I'm going to post a writeup with some background information on Nardil that I put together a few years ago. I wrote the "writeup" a few years ago, when I was thinking about creating a Web site with information about the 2003 Nardil formulation change, which affected Nardil produced for the U.S. market. I never did end up creating the Web site, though.
I'll post the "writeup" in a moment.
Tomatheus
Posted by Tomatheus on May 5, 2015, at 18:53:01
In reply to Re: Qs about MAOIs for anybody who has taken them, posted by Tomatheus on May 5, 2015, at 18:46:45
Smoo,
Here's the writeup with the background information on Nardil (phenelzine) that I said that I would post.
Tomatheus
==
Nardil, or phenelzine, is a medication used to treat depressive and anxiety disorders. The mechanism of action thought to be primarily responsible for its therapeutic effects is the inhibition of the monoamine oxidase, or MAO, enzymes. Nardil is one of several monoamine oxidase inhibitors, or MAOIs, a class of medications that are usually used as second or third-line treatments for psychiatric disorders because of their potential to interact with certain foods and other medications. Warner-Lambert Company manufactured Nardil for the U.S. market from the time the medication was approved in the 1950s until Pfizer purchased the company in 2000 (U.S. Food and Drug Administration, 2002; Knox, 2000). Pfizer has manufactured Nardil for the U.S. market since 2000, changing the medication's formulation in 2003.
The first MAOI was a medication called iproniazid, a drug derived from hydrazine that was originally indicated for tuberculosis. In 1951, it was discovered that some patients taking iproniazid became euphoric (Anderson et al., 1962), and later studies found the compound to possess "psychic energizing," or antidepressant, properties (Furst, 1959). Iproniazid use, however, was associated with an unacceptably high risk of liver damage, which prompted American pharmaceutical companies to examine other hydrazine-derived chemicals for their potential as antidepressant medications (Furst, 1959). During the mid 1950s, Warner-Lambert Company developed and tested phenelzine sulfate, which they marketed under the brand name of Nardil years later. Phenelzine, which was known experimentally as W-1544-A, was made available for clinical screening in September 1958 (Furst, 1959).
A preliminary study of phenelzine by Furst (1959) found its therapeutic effectiveness in non-hospitalized depressed patients to approach that of iproniazid with the remission rate of participants completing the study being 69 percent and the overall remission rate being 50 percent. An analysis of 580 case records found that 85 percent of patients with endogenous depression responded favorably to phenelzine, with 66 percent of patients achieving remission on the drug (Arnow, 1959). Approximately half of patients with "various neuroses" whose reports were included in the analysis responded favorably to phenelzine. A study of 39 inpatient and 21 outpatient depressed individuals, most of whom were described as having "neurotic depression," found that 70 percent of participants who were treated with a combination of phenelzine and psychotherapy experienced symptomatic improvement and that 55 percent of those treated were considered to be "helped" in terms of the "total therapeutic outcome" (Sawyer-Foner et al., 1959).
In a study that compared the efficacy of Nardil with that of the tricyclic antidepressant imipramine and electroconvulsive therapy in 250 patients with depressive illness, the Medical Research Council (1965) found that Nardil was no more effective than placebo in male patients and even less effective than placebo in female patients. The study, however, has been criticized because the patients studied were inpatients and chosen because of their suitability for ECT. Pare (1985), who criticized the Medical Research Council (1965) study, suggested that the "general view" regarding the efficacy of Nardil and other MAOIs is that they can be effective treatments for any type of depression, but tend to be most effective in individuals without "classical endogenous" depression. An analysis by Quitkin et al. (1979) found that Nardil is "clearly effective" in the treatment of "atypical depression," which is also sometimes referred to as "neurotic depression." The analysis, however, stated that findings were inconclusive with respect to the medication's ability to treat endogenous depression.
The Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (American Psychiatric Association, 2000), defines atypical depression as a subtype of depressive illness that is characterized by mood reactivity with at least two of the following symptoms: overeating, hypersomnia, a "leaden paralysis" feeling, and interpersonal rejection sensitivity. However, several of the comparative research studies that found Nardil and other MAOIs to be more effective than tricyclic antidepressants in treating atypical depressives were conducted before the DSM criteria for the depressive subtype were established. In older studies that examined the efficacy of various antidepressants in individuals with atypical depression, the term "atypical" was frequently used to refer to manifestations of depression that involved comorbid symptoms of anxiety or depressive symptoms that were believed to be characterological in nature (Quitkin et al., 1979). Other than being noted for its efficacy in treating atypical depression, Nardil has also been found to be useful in patients with treatment-refractory depression (Fiedorowicz & Swartz, 2004).
Nardil has demonstrated efficacy as an antidepressant not only in short-term clinical trials, but also in a controlled study that examined its use as a maintenance treatment. Robinson et al. (1991) found that patients who had experienced an initial response to Nardil responded significantly more favorably to two-year treatment with either 45 mg/day or 60 mg/day of Nardil than two-year treatment with placebo.
Although Nardil has only been approved by the U.S. Food and Drug Administration for the treatment of major depressive disorder, controlled studies have found the medication to be effective in the treatment of panic disorder with agoraphobia, social anxiety disorder, bulimia, posttraumatic stress disorder, and borderline personality disorder (Liebowitz et al., 1990). Nardil has been shown to be more effective than the tricyclic antidepressant imipramine in the treatment of dysthymic disorder (Vallejo et al., 1987), and there is some evidence from controlled trials that Nardil may be more effective than the tricyclics in treating anergic bipolar depression (Fiedorowicz & Swartz, 2004). Patients with obsessive-compulsive disorder, trichotillomania, dysmorphophobia, and avoidant personality disorder whose conditions have been responsive to Nardil have also been documented in the medical literature (Liebowitz et al., 1990).
One of four monoamine oxidase inhibitor antidepressants on the market in the U.S., Nardil inhibits both type A monoamine oxidase and type B MAO irreversibly, or for the lives of the enzymes (Thase et al., 1995). The compounds serotonin and adrenaline are metabolized primarily by MAO-A, while the compounds phenylethylamine, phenylethanolamine, benzylamine, tele-Methylhistamine, and MPTP are metabolized primarily by MAO-B. Both types of MAO metabolize the compounds norepinephrine, dopamine, tyramine, octopamine, and tryptamine (Glover & Sandler, 1986). In addition to reducing the breakdown of neurotransmitters by inhibiting the MAO enzymes, Nardil inhibits the enzymes GABA-transaminase (McKenna et al., 1994) and alanine-transaminase (Tanay et al., 2001).
Nardil and other MAOIs tend to be prescribed only after other antidepressant medications have failed to be effective because of their potential to interact with other medications and even some foods. Taking Nardil with sympathomimetic amine, anorexiant, and dopamine precursor medications can trigger a potentially fatal reaction known as a "hypertensive crisis" (Perry & Lund, 2001). A person experiencing this phenomenon typically experiences a severe occipital and temporal headache, diaphoresis, mydriasis, elevated systolic and diastolic blood pressure, neck stiffness, and neuromuscular excitation, but cardiac dysrhythmias, heart failure, and intracerebral hemorrhage can also occur (Perry & Lund, 2001). Several foods, particularly those containing the trace amine tyramine, may also trigger a hypertensive crisis if eaten while taking Nardil or other MAOIs. Gardner et al. (1996) recommended that patients taking MAOIs avoid aged cheeses; aged or cured meats; potentially spoiled meat, poultry, or fish; broad bean pods; Marmite concentrated yeast extract; sauerkraut; soy sauce and soybean condiments; and tap beer. Combining Nardil and other MAOIs with antidepressants that inhibit the reuptake of serotonin can result in a condition called "serotonin syndrome," which is characterized by hyperthermia, neuromuscular irritability, and confusion (Perry & Lund, 2001).
Other than Nardil, the MAOI antidepressants that are available on the U.S. market are Parnate (tranylcypromine), Marplan (isocarboxazid), and the transdermal patch EMSAM (selegiline). Like Nardil, Parnate and Marplan inhibit both MAO-A and MAO-B irreversibly (Thase et al, 1995). EMSAM has been found to pose a significantly smaller risk of triggering a hypertensive crisis than Nardil or Parnate (Dubitsky, 2005), which is likely due to the fact that selegiline is preferential in its inhibition of MAO-B over MAO-A, especially at lower doses (Amsterdam, 2003). A fifth MAOI, moclobemide, which reversibly inhibits MAO-A, is available in more than 50 countries, but not the U.S. (Lotufo-Neto et al., 1999).
REFERENCES
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
Amsterdam, J.D. (2003). A double-blind, placebo-controlled trial of the safety and efficacy of selegiline transdermal system without dietary restrictions in patients with major depressive disorder. Journal of Clinical Psychiatry, 64, 208-214.Anderson, F.E., Kaminsky, D., Dubnick, B., Klutchko, S.R., Cetenko, W.A., Gylys, J., et al. (1962). Chemistry and pharmacology of monoamine oxidase inhibitors: Hydrazine derivatives. Journal of Medicinal and Pharmaceutical Chemistry, 5, 221-230.
Arnow, L.E. (1959). Phenelzine: A therapeutic agent for mental depression. Clinical Medicine, 6, 1573-1577.
Dubitsky, G.M. (2005, October 26). Tyramine safety with EMSAM. Retrieved December 9, 2005, from the U.S. Food and Drug Administration's Web site: http://www.fda.gov/ohrms/dockets/ac/05/slides/2005-4186S2_02_FDA-Dubitsky.ppt
Fiedorowicz, J.G., & Swartz, K.L. (2004). The role of monoamine oxidase inhibitors in current psychiatric practice. Journal of Psychiatric Practice, 10, 239-248.
Furst, W. (1959). Therapeutic re-orientation in some depressive states: Clinical evaluation of a new mono-amine oxidase inhibitor (W-1544-A) (phenelzine (Nardil)). American Journal of Psychiatry, 116, 429-434.
Gardner, D.M., Shulman, K.I., Walker, S.E., & Tailor, S.A.N. (1996). The making of a user friendly MAOI diet. Journal of Clinical Psychiatry, 57, 99-104.
Glover, V., & Sandler, M. (1986). Clinical chemistry of monoamine oxidase. Cell Biochemistry and Function, 4, 89-97.
Knox, N. (2000, February 7). Pfizer to acquire Warner-Lambert in $90 billion deal. SFGate.com. Retrieved March 16, 2006, from http://www.sfgate.com/cgi-bin/article.cgi?file=/news/archive/2000/02/07/national0825EST0511.DTL
Medical Research Council (1965). Clinical trial of the treatment of depressive illness. British Medical Journal, 1, 881-886.
Liebowitz, M.R., Hollander, E., Schneier, F., Campeas, R., Welkowitz, L., Hatterer, J., et al. (1990). Reversible and irreversible monoamine oxidase inhibitors in other psychiatric disorders. Acta Psychiatrica Scandinavica, Suppl 360, 29-34.
Lotufo-Neto, F., Trivedi, M., & Thase, M.E. (1999). Meta-analysis of the reversible inhibitors of monoamine oxidase type A moclobemide and brofaromine for the treatment of depression. Neuropsychopharmacology, 20, 226-247.
McKenna, K.F., McManus, D.J., Baker, G.B., & Coutts, R.T. (1994). Chronic administration of the antidepressant phenelzine and its N-acetyl analogue: Effects on GABAergic function. Journal of Neural Transmission, 41 Suppl, 115-122.
Pare, C.M.B. (1985). The present status of monoamine oxidase inhibitors. British Journal of Psychiatry, 146, 576-584.
Perry, P., & Lund, B.C. (2001). Monoamine oxidase inhibitors: Adverse effects. Virtual Hospital: A Digital Library of Health Information. Retrieved September 30, 2005, from http://www.vh.org/adult/provider/psychiatry/CPS/19.html
Quitkin, F., Rifkin, A., & Klein, D.F. (1979). Monoamine oxidase inhibitors. Archives of General Psychiatry, 36, 749-760.
Robinson, D.S., Lerfald, S.C., Bennett, B., Laux, D., Devereaux, E., Kayser, A., et al. (1991). Maintenance therapies in recurrent depression: New findings. Psychopharmacology Bulletin, 27, 31-39.
Sawyer-Foner, G.J., Koranyi, E.K., Meszaros, A., & Grauer, H. (1959). Depressive states and drugs II: The study of phenelzine dihydrogen sulfate (Nardil) in open psychiatric settings. Canadian Medical Association Journal, 81, 991-996.
Tanay, V.A.-M.I., Parent, M.B., Wong, J.T.F., Paslawski, T., Martin, I.L., & Baker, G.B. (2001). Effects of the antidepressant/antipanic drug phenelzine on alanine and alanine transaminase in rat brain. Cellular and Molecular Neurobiology, 21, 325-339.
Thase, M.E., Trivedi, M.H., & Rush, A.J. (1995). MAOIs in the contemporary treatment of depression. Neuropsychopharmacology, 12, 185-219.U.S. Food and Drug Administration. (2002). Office of Clinical Pharmacology and Biopharmaceutics review (NDA 11-909/SCM-032). City of publication not available: Author.
Vallejo, J., Gasto, C., Catalan, R., & Salamero, M. (1987). Double-blind study of imipramine versus phenelzine in melancholias and dysthymic disorders. British Journal of Psychiatry, 151, 639-642.
Posted by Smoo on May 6, 2015, at 3:56:20
In reply to Nardil/phenelzine background info writeup, posted by Tomatheus on May 5, 2015, at 18:53:01
Are you married? Want to be? :p
This is absolutely brilliant. It's fantastic to read it so a layman can understand how it works. If you wanted to email me your real name I can add you down as a reference to give you credit for all this work. I like to add links for people to be better informed at the end of my articles so if you don't want your real name used I can just link to this post.
Posted by Tomatheus on May 6, 2015, at 13:21:35
In reply to Re: Nardil/phenelzine background info writeup » Tomatheus, posted by Smoo on May 6, 2015, at 3:56:20
Smoo,
My real first name is Tom, or Thomas. I'd prefer not to give out my last name for privacy reasons, though. If you'd like to link to my post at the end of your article, that would be fine with me. I appreciate your comments on my Nardil background information writeup, and I wish you luck with your article.
Tomatheus
Posted by Smoo on May 6, 2015, at 22:05:10
In reply to Re: Qs about MAOIs for anybody who has taken them » europerep, posted by europerep on May 5, 2015, at 17:10:04
Thank-you for the thread link, it's very interesting to track someone's experience as they go. How you felt at each stage is greatly insightful. I kept a drug diary for a while but I find I get lazy when something seems to be working.
I had one final question: have you encountered any particular stigma when people learn you've tried MAOIs? Or mental illness in general? Would you mind giving me a brief example if it's not too uncomfortable?
Thank you for all your help!
Smoo/Soph
Posted by Smoo on May 6, 2015, at 22:18:23
In reply to Re: Nardil/phenelzine background info writeup » Smoo, posted by Tomatheus on May 6, 2015, at 13:21:35
Thanks Tom!
I understand fully the need for privacy. You've been incredibly helpful, thank you very much. I will link your post at the bottom of mine.
If you had time for two last questions I was wondering if you had experienced any stigma or reactions good or bad to being on MAOI or having MIs in general. Is there a difference between telling people you have depression or depression with psychosis? Are you 'out' amongst family, friends and work?
Finally, if you could use just one word or phrase to describe MAOIs and your experience on them what would it be?
Is that more than two! Oh dear, nosy nose strikes again.
Thank you again for everything. I wish you a stable, happy and healthy mind and body.
Posted by Tomatheus on May 7, 2015, at 0:11:48
In reply to Re: Nardil/phenelzine background info writeup » Tomatheus, posted by Smoo on May 6, 2015, at 22:18:23
Smoo,
Here are my responses to your questions:
For the most part, those who I've disclosed my illness to have been supportive and understanding. However, I do think that stigma surrounding mental illness exists, and I think that I've been on the receiving end of it a few times. I saw a therapist a few years back who had seen me previously for my mood-disorder symptoms before I started experiencing psychosis, and once I mentioned that I started experiencing psychosis, the therapist's whole demeanor and line of questioning changed. I also think that when others know that I experience psychotic symptoms, they sometimes tend to take me less seriously than they would otherwise. This was especially true when I was hospitalized for reasons related to my mental illness. Some might think that psychiatric hospitals would be places where staff members treat the patients with dignity and respect, but I haven't always found that to be the case.
Although I have noticed stigma from others as it pertains to my mental illness, I don't think I've encountered any kind of extra stigma relating to taking MAOIs. Then again, only a handful of people knew that I was taking MAOIs when I was taking them.
I do think that I've encountered more stigma since the onset of my psychotic symptoms than I encountered when I was only experiencing depressive symptoms. And as I alluded to earlier, I think that the bulk of the stigma that I've been on the receiving end of has come from individuals who've been involved in my treatment in one way or another. Perhaps one reason for this is that I don't routinely tell those who aren't involved in my treatment about my illness. Members of my immediate family know about my illness, but even though members of my extended family might know about my illness from those in my immediate family, I don't discuss my illness with those in my extended family. I don't really have any friends right now other than one person I correspond with via e-mail, so I don't so much have to grapple with whether or not I should disclose my illness to friends. I did have a friend previously who knew of my illness and seemed to become increasingly distant from me around the time of the onset of my psychosis. We're no longer in touch. I don't work currently, but I disclosed my mood disorder to two employers when I was working prior to the onset of my psychosis. I didn't seem to notice any discrimination or stigma from them.
Regarding MAOIs, I would say that they're very useful for a range of mental-health conditions, but are unfortunately underutilized. However, in my experience, the medications only seemed to be helpful in the short run.
Hope this helps!
Tomatheus
Posted by Lamdage22 on May 8, 2015, at 1:33:09
In reply to Qs about MAOIs for anybody who has taken them, posted by Smoo on May 4, 2015, at 7:28:01
> 10. What kind of impact did it have on your life, socially, your relationships etc.?
Horrendous. Psychosis.
Posted by europerep on May 13, 2015, at 13:46:41
In reply to Re: Qs about MAOIs for anybody who has taken them, posted by Smoo on May 6, 2015, at 22:05:10
> I had one final question: have you encountered any particular stigma when people learn you've tried MAOIs? Or mental illness in general? Would you mind giving me a brief example if it's not too uncomfortable?
Hey Smoo,
sorry for the late reply.
Generally I don't have a lot of experience with being stigmatized, but that is at least partly because I am very selective as to who I share that information with. And I think that we have come to a point where people no longer *openly* discriminate against people with mental illness. Kind of like noone *openly* says that women belong at home or in the kitchen, even if deep down there probably still are a good deal of people who think like that.
What I do experience or observe is a kind of stigmatization of people who take psychiatric drugs. This always comes from what I call the "lifestyle faction", i.e. people who argue that drugs only "mask symptoms" but don't do anything about the "real causes". Real causes for these people are generally the negative experiences that they have had in life and were able to overcome, but when other people go on an antidepressant it's because they are struggling with the same issues but taking the "easy way out". Kind of as if antidepressants were recreational drugs on prescription.
I am at a point where I like to debate with these people because their reasoning is so flawed, but I do worry about other people taking them for the experts that they pretend to be. Sure, drugs aren't perfect, but without them I wouldn't even be alive anymore, so I'm quite happy to "mask my symptoms" as they say ;-)...
I hope this helps. By the way, how long is your article going to be? And if you want, you can also post it here once it's done, I wouldn't mind reading it ;-)... but only if you want of course.
"See you"...
ER
Posted by Smoo on May 30, 2015, at 2:34:27
In reply to Re: Qs about MAOIs for anybody who has taken them » Smoo, posted by europerep on May 13, 2015, at 13:46:41
Hi everyone!
The feature has been written and given to my professor. I got a top mark thanks to all of you and your great information!
I've just finished this semester so have time to fix a few issues (I had my backup fry my drive so had to re-write the whole thing just before it was due so it's shorter and slightly too biased and information heavy).
When it's publish worthy I'll link you to it. It's about 3,000 words so a mid-length feature.
Thanks again and good luck to all of you.
Smoo
This is the end of the thread.
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