Posted by cybercafe on May 11, 2004, at 9:01:26
In reply to Why MAOI's rarely prescribed » kittencat, posted by harryp on May 11, 2004, at 2:57:41
> The studies that exist seem to indicate that MAOI's are the most broadly effective AD's around, and they have a good side effect profile (esp. Parnate--which may have the best SE profile of any AD).
>
> The "fly in the ointment" is the risk of hypertensive crisis. There have been only a few cases where an untreated crisis caused a stroke or death, but that's enough to make doctors terrified of prescibing them.
>
> Psychiatrists loved the SSRI's because they could be prescribed like candy, with almost no liablity concerns. It's very hard to kill yourself with an SSRI!
>
> Part of the problem with MAOI's is that psychiatrists tend not to trust their patients, and they are afraid that their pt. will not pay attention to diet, have a crisis and just take aspirin for it, and possibly get a stroke.
>
> In practice, avoiding the problem foods and drugs is not hard, and if you get prompt treatment for a hypertensive crisis it will not do you any harm.
>
> The main problem is that you have to be careful when traveling. Carrying a copy of your medical chart with instructions from your doctor wouldn't be a bad idea, because many ER staff haven't seen a MAOI-hypertensive crises before, and may have trouble figuring out what's going on.i went to the states to pick up some abilify.... it's been a wonder drug for me... and apparently the states has no walkin clinics for family doctors/general practictioners like we do in canada... but i did manage to find a special mental health walk in clinic..... so i asked them for a perscription for abilify since i saw them once before a year ago and they said it would be okay... they said no.... i said fine, i'll see a doctor and they can evaluate me.... and they gave me some long story about how you have to pay to $300 to see a counsellor and doctor every 2 weeks if you want medication...
so i just told them i would wait for my antipsychotic to run out, then i would come back when i'm in a manic rage and they could deal with me then :)
i ended up seeing a doctor, and had no problem getting abilify.. but was told how wrong it was that i was taking parnate .. no one takes that anymore apparently... my response was to just stare at her like she was a retard... though i'm thinking an alternative reply would have been to say .. "and in the UK they perscribe antipsychotics rather than benzos for anxiety but i don't think either country has psychiatrists who know what they are doing" ....
poster:cybercafe
thread:345262
URL: http://www.dr-bob.org/babble/20040510/msgs/345661.html