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Re: Why are US pdocs so hesitant to prescribe MAOI

Posted by med_empowered on April 24, 2006, at 6:28:19

In reply to Re: Why are US pdocs so hesitant to prescribe MAOI? » Crazy Horse, posted by Phillipa on April 23, 2006, at 21:55:22

I don't really believe in tort reform (the problem is really the insurance companies and incompetent docs who pop up now and then, not everyday patients), but I do think pdocs need to take a deep breath, calm down, and stop thinking about liability or..whatever, and start doing what's best for their patients. They are, after all, doctors who supposedly specialize in this stuff--they really should act like it.

Anyway--MAOIs are a pain, and they have gone in and out of fashion. For a while, docs thought they weren't much better than placebo, b/c of some poorly designed studies with too low doses. Then some docs went crazy with them--MAOIS plus TCAs (and stims), MAOIs plus phenothiazines, so on and so forth. SSRIs are much easier to handle, and even the TCAs are more appealing when compared to the kind of patient management (eg, "work") required to manage MAOI usage. Plus...docs these days are obssesed with antipsychotics, SNRIs, and mood stabilizers (b/c apparently everyone is bipolar). With EMSAM now on the market, I think the pill form of other MAOIs may see a bit of a rise in popularity, possibly starting a new "trend" in RXing. Or not.


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