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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by meAgain on January 8, 2007, at 13:52:29
I have tried almost every SSRI AND SSRNI for the past 9 years and no luck with any of them.What does a MAOI and is it a smart choice to switch to one? I have depression, OCD, and battle eating disorder since I was 12- (Im 26). I would really appreciate any feedback...Thanks :)
Posted by Phillipa on January 8, 2007, at 14:20:10
In reply to MAOIs vs SSRIs, posted by meAgain on January 8, 2007, at 13:52:29
Will your pdoc give them to you? Will it interfer with the eating disorder I don't know much about eating disorders. Love Phillipa good luck with whatever you decidide to do.
Posted by blueberry1 on January 8, 2007, at 15:28:15
In reply to MAOIs vs SSRIs, posted by meAgain on January 8, 2007, at 13:52:29
Hard to say if a maoi would work or not. Maybe choose Parnate since it has stimulating characteristics? With maois, you gotta obey the list of things you cannot eat. Not sure how an eating disorder would play into that.
So up to this point you have done everything possible to increase serotonin and/or norepinephrine and it hasn't helped. Isn't that kind of clue that merely increasing the levels of those chemicals is not the way to go for you? What about dopamine? Other than antidepressants, how about Provigil? Adderall? Xanax? Tramadol? I mean, at this point I think it might make sense to start looking at totally different approaches and mechanisms. Up to this point you've taken everything that makes sense. So now pure logic says to try things that don't make sense. That's how I see it anyway. There are so many people at rememdyfind.com that tried every antidepressant in the book and didn't find significant relief from their longtime depression until they tried something unusual, like Provigil or Adderall or Tramadol or Xanax (just a few ideas off the top of the head) or whatever...things that were not antidepressants.
If you are fatigued a lot and need some stimulation, maybe Parnate would be worth a look. But for someone with an eating disorder, there are rules to follow.
Posted by djmmm on January 8, 2007, at 16:44:11
In reply to MAOIs vs SSRIs, posted by meAgain on January 8, 2007, at 13:52:29
> I have tried almost every SSRI AND SSRNI for the past 9 years and no luck with any of them.What does a MAOI and is it a smart choice to switch to one? I have depression, OCD, and battle eating disorder since I was 12- (Im 26). I would really appreciate any feedback...Thanks :)
I can't tell you for sure if a MAOI would be right for you. It would be easy to say that, a good psychiatrist should be open to prescribing ALL available medical treatments--Unfortunately, having an eating disorder may limit your access to certain medications. Stimulants and Wellbutrin can be very dangerous for depressed persons with eating disorders. Your seizure threshold is lower than a person with healthy eating habits. Also, eating disorders are often cormorbid with substance abuse (I'm not saying you have substance abuse problems). As far as the MAOIs are concerned, Parnate is stimulating, and considered an anorectic medication. Nardil tends to increase your appetite-- It may be more difficult to manage an eating disorder while on either of these meds.
Posted by laima on January 8, 2007, at 17:31:15
In reply to Re: MAOIs vs SSRIs, posted by djmmm on January 8, 2007, at 16:44:11
MAOIs are supposed to be the absolute best option for atypical depression- the overeating, oversleeping kind.
Posted by psychobot5000 on January 10, 2007, at 20:46:12
In reply to MAOIs vs SSRIs, posted by meAgain on January 8, 2007, at 13:52:29
> I have tried almost every SSRI AND SSRNI for the past 9 years and no luck with any of them.What does a MAOI and is it a smart choice to switch to one? I have depression, OCD, and battle eating disorder since I was 12- (Im 26).
___MAOIs are in a class different from most antodepressants. Mostly the idea is to increase levels of certain neurotransmitters, but the standard meds block the 'reuptake' of chemicals back into the nerve cells, after they're released to do signalling, meaning more of it is lying around outside the cells and active. MAOIs are different from others, in that they instead block the enzyme (MAO, or mono-amine-oxydase) that eats the neurotransmitters -inside- your cells. This way, there's a glut of serotonin, norepinephrine, and dopamine waiting inside, and more gets released when the nerve decides to signal.
Also significant is that MAOis act on dopamine, rather than mostly just serotonin and noradrenaline, like most standatd antidepressants. They are somewhat more effective than other antidepressants, but can be dangerous of people take other drugs with them (like SSRIs or cough medicines). Also, you must scrupulously avoid certain foods while taking them--they too can be dangerous. Many doctors are uncomfortable with MAOis, and they have some serious dangers. However, if nothing else works, they can be a good bet.
They can be more effective for eversleeping, overeating depression, as Laima mentioned. I do agree that Parnate would be a good one to try, and also EMSAM, which has the unique advantage of allowing you to avoid dietary restrictions until you get to higher doses. They might be worth talking to your doc about. Have you tried tricyclics? If not, it might be good to try them first.
Best of luck.
Posted by meAgain on January 11, 2007, at 16:43:30
In reply to Re: MAOIs vs SSRIs, posted by psychobot5000 on January 10, 2007, at 20:46:12
Thanks for the feedback! I tried Anafrinil about 10 years ago, it was the first med I was put on, but I was only 14, I dont know the reason I was taken off it. Has anyone had luck with this med?
Posted by psychobot5000 on January 13, 2007, at 12:46:57
In reply to Re: MAOIs vs SSRIs, posted by meAgain on January 11, 2007, at 16:43:30
I haven't been on anafranil, but it's considered a very effective Tricyclic. It has powerful serotonin-reuptake-blocking effects, as well as other tricyclic qualities. Still, there are many different tricyclics that act somewhat differently, and might be more effective for you. Some complain that anafranil has many side-effects, especially when starting it up or increasing the dose.
Nortriptyline is an effective one that is much more noradrenergic than clomipramine/anafranil, and thus more different from SSRIs. It also may be better on side-effects.
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