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Re: How effective are MAOIs?

Posted by JohnL on July 21, 2001, at 4:29:20

In reply to How effective are MAOIs?, posted by Else on July 20, 2001, at 18:53:16

> Last summer I was on Parnate for about three weeks and felt great but my doctor took me off it when I casually happenned to mention I had done cocaine in the past (NOT while on Parnate, of course). Since then, it's been NO but I am left with the frustrating sense that this might have been the magig pill had I kept my big mouth shut. (Please, I don't want to hear about how cocaine is bad for me, I already know).

If I were you I would simply see another doctor who will prescribe Parnate for you. You could even ask up front if they will. If they won't, call another doctor. Someone will be willing to help you out, but you might have to do a little hunting to find them.

If you want to stay with your current doctor, here is a strategy that can work. It's called incrementalism. Do whatever you have to do, beg, plead, get on your knees, whatever, to get a two week supply of Parnate for trial. You'll have to go overboard to sell the doc on the fact that you will not do cocaine. Only ask for two weeks and agree to see the doc in two weeks. In a worst case scenario, bargain for just a one week supply instead. At that point, if all is well, ask for another two week supply. And set another appointment. The whole idea here is to slowly build trust with the doc and ease into the situation without any longterm commitments. Keep in mind the doc is protecting himself/herself from a lawsuit, and that is likely the main reason he/she is reluctant. If he/she prescribes Parnate, and then you do cocaine, and something bad happens, the doc could be in trouble.

Some doctors are in the business because they have a passion for it. But for most, it is their profession, it is the money that brings them into the office each day. By asking for only a small supply and rescheduling frequent visits, the doc will silently know he/she will be making easy money.

Anyway, assuming all goes well, over time you will earn the doc's trust. And, once the doc sees how well you are doing (assuming Parnate does work well), then both of you will have carefully eased into a more committed situation. Then longterm Parnate use won't be such a reluctant issue. The whole idea is to ease into it very gradually and incrementally. This often helps overcome any reluctance on the doc's part.

Hope something here helps.
John


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poster:JohnL thread:71122
URL: http://www.dr-bob.org/babble/20010720/msgs/71166.html