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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Denise528 on December 12, 2002, at 8:54:18
Hi,
I was just wondering why MAOIs are considered to be more effective than SSRIs, are there any studies which have proved this?
Are they also more effective than tryciclics?
Denise
Posted by Ed O`Flaherty on December 12, 2002, at 9:27:45
In reply to MAOIs-why are they considered more effective?, posted by Denise528 on December 12, 2002, at 8:54:18
> Hi,
>
> I was just wondering why MAOIs are considered to be more effective than SSRIs, are there any studies which have proved this?
>
> Are they also more effective than tryciclics?>
> They are not considered to be more effective overall and are rarely used except as a last resort because they have dangerous interactions if somebody takes cheese,alcohol and certain other food items while on them.
> Neither are tricyclices more effective as a rule,although the sedating ones do help people to sleep.
>
>
Posted by daizy on December 12, 2002, at 9:40:36
In reply to Re: MAOIs-why are they considered more effective?, posted by Ed O`Flaherty on December 12, 2002, at 9:27:45
Does anyone know what psychosis is, or have been through it? What are the symptoms? what medication can you take, do you have to go to hosp?
Posted by cosis on December 12, 2002, at 11:39:01
In reply to MAOIs-why are they considered more effective?, posted by Denise528 on December 12, 2002, at 8:54:18
I would definately say they are stronger than SSRI's... They have potential risky side effects, but the diet you must follow isn't that bad.
Posted by linkadge on December 12, 2002, at 11:44:07
In reply to Psychosis, posted by daizy on December 12, 2002, at 9:40:36
MAOIs for some indeviduals are considered to
be more effective than both SSRI's and
Trycyclics.
Some think that Tricyclics are more effective than SSRI's and there is some evidence to support that. I think asside from side effects, tricyclics can provide more robust recovery because of their effect on norepinephrine as well as serotonin.From my understanding, the MAOI's tend to cause fewer mental side effects. The tyramine food interaction can be dangerous however. Some people say that they're more like themselves on MAOIS and less like it changes their personallity.
I would work backwards and only go to the previous generations AD's if the current is not successful. If you plan on medicating for a while, the SSRI's are safer on the body.
Linkadge
Posted by linkadge on December 12, 2002, at 11:58:18
In reply to Psychosis, posted by daizy on December 12, 2002, at 9:40:36
Paychosis generally starts with an abject
sence of fear, perhaps paranoia - like somthing bad is always about to happen. People then tend to change their life-style and living habits
in attempts to controll their sence of fear.
At this stage, psychosis generally is based on
a world event. (most often something on the news)
They may feel it necessary to keep many guns an amunition in the house, or perhaps install many locks.The sensations typically grow and become more abstract. The person will prepare for things that they have absolutely no involvement in. People in this stage start to think that they are a very important person. (That the survival of mankind somehow depends on them) They start to believe they are a part of abstract or nonexistant scenarios, involving space aliens, god, Jesus, the pope, the president of the united states etc. They may form strage rituals that they believe are sustaining them or the world etc.
In the more advanced stages, people feel extremely paranoid of everybody, and everything. They generally seclude themselves from others because they believe that others are 'in on it' or 'against them' etc. They may hear voices telling them to do things. Some see visual hallucainations but this is generally rare.
You do not need to be at the ending stages to be diagnosed, or treated.
Example of classical psychosis.
------------------------------
Anna, who was 15 yrs old began to believe
that her older brother was sneeking into
her bed at night and injecting her with
cocaine. She began to lock her door
at night to keep him out. When asked
by her parrents, she could provide no evidence
but she just had this very unqunchable sensation that this was what was happeningHope this helps a little
Linkadge
Posted by daizy on December 12, 2002, at 12:42:02
In reply to Re: Psychosis, posted by linkadge on December 12, 2002, at 11:58:18
>i Thought it was just anxiety that i had at first, then i took effexor and stared to get really depressed, am still on it now, but i just kinda feel like im in space somewhere, I do get really paranoid and i see things that arent there, like in the crners of my eyes, fast movements make me confused and i muddle my speech sometimes. I have changes=d my living habits i dont go anywhere or do anthing, stuck at home all day, dont sleep at night. Just kinda got a sence of doom is coming, something bad is going to happen. Thanx for your explanation, i just needed to know if what i had was bad depression or something else. what do you think? and do you have any suggestions of hoew i tell my doctor what im going through? Anyone? im getting desperate. Thanx, much appreciated.......
Paychosis generally starts with an abject
> sence of fear, perhaps paranoia - like somthing bad is always about to happen. People then tend to change their life-style and living habits
> in attempts to controll their sence of fear.
> At this stage, psychosis generally is based on
> a world event. (most often something on the news)
>
>
> They may feel it necessary to keep many guns an amunition in the house, or perhaps install many locks.
>
> The sensations typically grow and become more abstract. The person will prepare for things that they have absolutely no involvement in. People in this stage start to think that they are a very important person. (That the survival of mankind somehow depends on them) They start to believe they are a part of abstract or nonexistant scenarios, involving space aliens, god, Jesus, the pope, the president of the united states etc. They may form strage rituals that they believe are sustaining them or the world etc.
>
> In the more advanced stages, people feel extremely paranoid of everybody, and everything. They generally seclude themselves from others because they believe that others are 'in on it' or 'against them' etc. They may hear voices telling them to do things. Some see visual hallucainations but this is generally rare.
>
> You do not need to be at the ending stages to be diagnosed, or treated.
>
> Example of classical psychosis.
> ------------------------------
> Anna, who was 15 yrs old began to believe
> that her older brother was sneeking into
> her bed at night and injecting her with
> cocaine. She began to lock her door
> at night to keep him out. When asked
> by her parrents, she could provide no evidence
> but she just had this very unqunchable sensation that this was what was happening
>
>
>
> Hope this helps a little
>
> Linkadge
Posted by linkadge on December 12, 2002, at 17:55:59
In reply to Re: Psychosislinkadge, posted by daizy on December 12, 2002, at 12:42:02
What dosage of Effexor are you on ?
I had some very strange problems on
Effexor that I never had on SSRI'sPsychosis is supposidly percipitated
by Dopimanergic drugs. Effexor slightly
raises dopamine, which is no good
If you have a bent toward psychotic
type anxiety. Some of the side effects
I had on Effexor that I don't have
on Celexa are.- Feeling strange, slightly detached
from reality.- Feeling like I had to do something
like I couldn't stop and rest.- Slight paranoia, and sometimes a
psychotic effect like when people
were clapping I thought they were
laughing at me.Mind you, I was severly depressed at
the time, and I was only on it a few
weeks. You may want to try lowering
the effexor dose, and see what it does
to your paranoia type symptoms. If
it seems to help you may want to try
another AD. If not, you may gain relief
by adding a antispychotic. Many people
don't have fully fleged psychoic symptoms
but are always living on the verge
of it.With your syptoms I would definately seek
some sort of relief.Let me know If you have any other questions.
Linkadge
Posted by cybercafe on December 13, 2002, at 1:46:07
In reply to MAOI's, posted by linkadge on December 12, 2002, at 11:44:07
> MAOIs for some indeviduals are considered to
> be more effective than both SSRI's and
> Trycyclics.
> Some think that Tricyclics are more effective than SSRI's and there is some evidence to support that. I think asside from side effects, tricyclics can provide more robust recovery because of their effect on norepinephrine as well as serotonin.
>
> From my understanding, the MAOI's tend to cause fewer mental side effects. The tyramine food interaction can be dangerous however. Some people say that they're more like themselves on MAOIS and less like it changes their personallity.
>
> I would work backwards and only go to the previous generations AD's if the current is not successful. If you plan on medicating for a while, the SSRI's are safer on the body.
>MAOIs are the number one treatment for treatment
resistant depressionMAOIs are the number one treatment for anergic atypical depression
tricyclics are the number one treatment for melancholic depression
SSRIs are the first line treatment because they have more mild side effects (who needs a libido right?),
they're harder to overdose on, and marketing probably has a lot to do with it tooparnate was probably the best antidepressant i have ever been on ...
weight loss, increasing energy, increased libido....oh and as a bipolar i found MAOIs to be much less likely to induce cycling
Posted by daizy on December 13, 2002, at 10:38:11
In reply to Re: Psychosislinkadge, posted by linkadge on December 12, 2002, at 17:55:59
Thank you for your advise, its been helping. my story kinds goes that I was having really fast heart palputations because of other stuff, and anxiety, so i went to the doctors because i became depressed about them, got put on effexor, was okay, not by any means better, but just okay for about 3 month, then last week got woken in sleep by palputations, was very scared, now soo depressed again. happened again last night,I wanted to just die i felt so bad. the doctors said that it is probably panic, and nothing wrong with the heart, but i feel like how could i make my heart go that fast and depress myself at random times of the day and have absolutely no control over it. I dont go out because im scared it will happen infront of people. Most of my problem is that i find it hard to tell anyone. Someone on here suggested that because i felt spaced out that i might have psychosis, thats where your advise has been helpful. because i am cutting down my dose of effexor it might be due to that, but then all of this just becomes a vicious circle. got some sleeping tablets that i might resort to taking over weekend till i see doctors on tuesday, right now that seems like a lifetime away.
Posted by Dinah on December 13, 2002, at 10:48:21
In reply to Re: Psychosis..linkadge, posted by daizy on December 13, 2002, at 10:38:11
Hi Daizy,
It sounds like panic attacks to me. I didn't find Effexor to be very effective for anxiety. The fear of going out is called anticipatory anxiety, and it all becomes a vicious cycle.
In addition to medications you might want to see a cognitive behavior therapist and read "The Anxiety and Phobia Workbook". At least you'll find out that you are far from alone.
Dinah
Posted by Mr Cushing on December 13, 2002, at 11:00:37
In reply to Re: Psychosis..linkadge, posted by daizy on December 13, 2002, at 10:38:11
> Thank you for your advise, its been helping. my story kinds goes that I was having really fast heart palputations because of other stuff, and anxiety, so i went to the doctors because i became depressed about them, got put on effexor, was okay, not by any means better, but just okay for about 3 month, then last week got woken in sleep by palputations, was very scared, now soo depressed again. happened again last night,I wanted to just die i felt so bad. the doctors said that it is probably panic, and nothing wrong with the heart, but i feel like how could i make my heart go that fast and depress myself at random times of the day and have absolutely no control over it. I dont go out because im scared it will happen infront of people. Most of my problem is that i find it hard to tell anyone. Someone on here suggested that because i felt spaced out that i might have psychosis, thats where your advise has been helpful. because i am cutting down my dose of effexor it might be due to that, but then all of this just becomes a vicious circle. got some sleeping tablets that i might resort to taking over weekend till i see doctors on tuesday, right now that seems like a lifetime away.
Hey Daizy, the heart speeding up, like your Doctors say, is most likely panic attacks. That's how I felt when I was having them anyways. I take 1.5mg of Klonopin per day now in order to get those under control. Works very well for that.
The mood swings between being overly anxious and flat out depression can be caused by a Mood Disorder. That's how I was before I was diagnosed as being Bi-Polar. That just means that you'll need to take a Mood Stabilizer (like Depakote) and that you'll have to make a few lifestyle changes, but you'll feel indefinitely better because of it.
How did the Effexor make you feel anyways? Did you find yourself flipping more quickly between being overcome by anxiety and then overcome by depression? Did you ever have any periods where you felt like you were on E? Like really really really happy, so happy that other people have asked you if you were on anything?
Oh, and don't feel bad about not being able to control things like this, because quite simply, you can't. Though you can learn to have control over them, manage them, and still live a very productive life.
I'd bring this all up with my Doctor as soon as possible though. Because if you're switching more rapidly between depressed/anxiety periods, then it could be because of the Effexor. This is bad. If you quit Effexor cold turkey, that's worse. Damn... getting off of Effexor PERIOD is hard....
Posted by daizy on December 13, 2002, at 11:24:37
In reply to Re: Psychosis..linkadge, posted by Mr Cushing on December 13, 2002, at 11:00:37
> One day i'd be ok, depressed but not panicked then the next id be panicked. I did feel like i was on E when I upped the dose of effexor but because i had a bad panic attack when i was on E (from which all this stuff started) I relate being on E to bad things happening, so when the effexor started to make me feel high in a bad way, (not just like a nice high i got prviously from E) I got panicked. Does that make sence? its complicated to explan. Ive never felt a happy kind of high like manic ithink? from effexor, ive just felt weird, like im not in control and that im goin to lose it and have a panic attack. The effexor has dfinitely made me more irritable, and i go from feelin so depressed im suicidal, thenm just really angry.
>
> Hey Daizy, the heart speeding up, like your Doctors say, is most likely panic attacks. That's how I felt when I was having them anyways. I take 1.5mg of Klonopin per day now in order to get those under control. Works very well for that.
>
> The mood swings between being overly anxious and flat out depression can be caused by a Mood Disorder. That's how I was before I was diagnosed as being Bi-Polar. That just means that you'll need to take a Mood Stabilizer (like Depakote) and that you'll have to make a few lifestyle changes, but you'll feel indefinitely better because of it.
>
> How did the Effexor make you feel anyways? Did you find yourself flipping more quickly between being overcome by anxiety and then overcome by depression? Did you ever have any periods where you felt like you were on E? Like really really really happy, so happy that other people have asked you if you were on anything?
>
> Oh, and don't feel bad about not being able to control things like this, because quite simply, you can't. Though you can learn to have control over them, manage them, and still live a very productive life.
>
> I'd bring this all up with my Doctor as soon as possible though. Because if you're switching more rapidly between depressed/anxiety periods, then it could be because of the Effexor. This is bad. If you quit Effexor cold turkey, that's worse. Damn... getting off of Effexor PERIOD is hard....
Posted by daizy on December 13, 2002, at 11:29:55
In reply to Re: Psychosis..linkadge, posted by Mr Cushing on December 13, 2002, at 11:00:37
Do you think that Diazepam would provide relief while im getting off effexor?
Posted by Mr Cushing on December 13, 2002, at 13:01:10
In reply to Re: Psychosis..mr c, posted by daizy on December 13, 2002, at 11:24:37
Any of the Benzo's would provide relief for you while coming off of Effexor (such as Clonazepam and I believe Diazepam). Anyways, none of them will free you from the symptoms of coming off of the drug. They'll give you a sweet buzz and calm you down quite a bit though. It's going to be hard.... like really bad withdrawal, but you can do it.I'd still talk to your Doctor first about everything though because it definitely sounds like more than a simple anxiety disorder that you're going through.
I was the same way at first... I don't have a Mood Disorder, I'm Depressed. Then like 2 years later, I don't have a Mood Disorder, everything is just moving too damned fast and I keep losing my temper and having panic attacks. Then after, when I looked over everything else that i've been through, I'm like oooooh....
lol, anyways, talk to your Doctor like Today!!
Posted by linkadge on December 13, 2002, at 13:52:10
In reply to Re: Psychosis..mr c, posted by Mr Cushing on December 13, 2002, at 13:01:10
You may want to change antidepressants.
I had the exact same effects, that were
indeed caused by effexor. I had a racing
heartbeat of a sustained 120+ that did
not subside till I got off effexor and on
celexa. My heart rate is now 50-60 and
it doesn't feel like it will burst any
time soon.I really think you should give another
antidepressant a try - I know many who
have had similar effects as results of
effexor.Also be cautious if the doc prescribes
Wellbutrin - for a lot of people who
have problems with Effexor also have
problems with this.
Good Luck
Linkadge
Posted by Bob on December 13, 2002, at 14:00:41
In reply to Re: MAOI's, posted by cybercafe on December 13, 2002, at 1:46:07
You mention that Parnate was possibly the best AD you had ever been on. I assume you are no longer on it. May I ask why you stopped it?
> MAOIs are the number one treatment for treatment
> resistant depression
>
> MAOIs are the number one treatment for anergic atypical depression
>
> tricyclics are the number one treatment for melancholic depression
>
> SSRIs are the first line treatment because they have more mild side effects (who needs a libido right?),
> they're harder to overdose on, and marketing probably has a lot to do with it too
>
> parnate was probably the best antidepressant i have ever been on ...
> weight loss, increasing energy, increased libido....
>
> oh and as a bipolar i found MAOIs to be much less likely to induce cycling
>
Posted by ItsHowdyDudyTime on December 13, 2002, at 17:53:41
In reply to MAOIs-why are they considered more effective?, posted by Denise528 on December 12, 2002, at 8:54:18
> Hi,
>
> I was just wondering why MAOIs are considered to be more effective than SSRIs, are there any studies which have proved this?
>
> Are they also more effective than tryciclics?
>
>
>
> Denise
>
>
MAOIs are more effective than any other class of antidepressant for several reasons. First, MAOIs affect many more brain neurotransmitters than do tricyclics, SSRIs or any other antidepressants. MAOIs increase all of the "monoamines" in the brain, to include MAO-A and MAO-B. MAO-A includes neurotransmitters serotonin, noradrenaline and dopamine. MAO-B includes the brain neurotransmiters associated with motor control, parkinsons disease and includes dopamine and many obscure, little discussed brain chemicals such as PEA. There is even a "PEA theory of depression" believe it or not.Another reason why MAOIs are more effective is due to their irreversibility. Due to this irreversibility, these brain neurotransmitters build up better and more completely than they do with regular antidepressants. The RIMA MAOIs such as Moclobemide, which are reversible rather than irreversible, do not have the good reputation at treating TRD that the older, original irreversible MAOIs have.
Finally, still another reason why MAOIs are more effective is that some of them have some direct, stimulant (amphetamine) like effects. Parnate feels like speed to some people. Amphetamines are an old time treatment for severe depression and are still used sometimes in severe cases of TRD to this very day.
MAOIs are all very dopaminergic, unlike any of the other antidepressants used. This simple fact may account for much of their usefulness in TRD. MAOIs are the ONLY significantly dopaminergic ADs. The drug companies are afraid to develop modern class dopaminergic antidepressants, due to the "war on drugs" and fears of developing drugs that could be used for pleasure or addiction. The problem with this sort of thinking is that we the severely mentally ill get screwed. Many severely depressed individuals are probably mildly deficient in dopamine levels, not just serotonin.
Howdy Doody
Posted by cybercafe on December 13, 2002, at 19:56:16
In reply to Re: MAOIs-why are they considered more effective?, posted by ItsHowdyDudyTime on December 13, 2002, at 17:53:41
i have to disagree -- tricyclics have been shown superior to MAOIs in treating melancholic depression
but the majority do suffer from atypical, so yes in general MAOIs seem to be the drugs of choice
> > Hi,
> >
> > I was just wondering why MAOIs are considered to be more effective than SSRIs, are there any studies which have proved this?
> >
> > Are they also more effective than tryciclics?
> >
> >
> >
> > Denise
> >
> >
>
>
> MAOIs are more effective than any other class of antidepressant for several reasons. First, MAOIs affect many more brain neurotransmitters than do tricyclics, SSRIs or any other antidepressants. MAOIs increase all of the "monoamines" in the brain, to include MAO-A and MAO-B. MAO-A includes neurotransmitters serotonin, noradrenaline and dopamine. MAO-B includes the brain neurotransmiters associated with motor control, parkinsons disease and includes dopamine and many obscure, little discussed brain chemicals such as PEA. There is even a "PEA theory of depression" believe it or not.
>
> Another reason why MAOIs are more effective is due to their irreversibility. Due to this irreversibility, these brain neurotransmitters build up better and more completely than they do with regular antidepressants. The RIMA MAOIs such as Moclobemide, which are reversible rather than irreversible, do not have the good reputation at treating TRD that the older, original irreversible MAOIs have.
>
> Finally, still another reason why MAOIs are more effective is that some of them have some direct, stimulant (amphetamine) like effects. Parnate feels like speed to some people. Amphetamines are an old time treatment for severe depression and are still used sometimes in severe cases of TRD to this very day.
>
> MAOIs are all very dopaminergic, unlike any of the other antidepressants used. This simple fact may account for much of their usefulness in TRD. MAOIs are the ONLY significantly dopaminergic ADs. The drug companies are afraid to develop modern class dopaminergic antidepressants, due to the "war on drugs" and fears of developing drugs that could be used for pleasure or addiction. The problem with this sort of thinking is that we the severely mentally ill get screwed. Many severely depressed individuals are probably mildly deficient in dopamine levels, not just serotonin.
>
> Howdy Doody
>
Posted by Dr. Bob on December 14, 2002, at 12:38:09
In reply to Psychosis, posted by daizy on December 12, 2002, at 9:40:36
> Does anyone know what psychosis is, or have been through it? What are the symptoms? what medication can you take, do you have to go to hosp?
I'd like follow-ups on psychosis to be redirected to the separate thread that's been started:
http://www.dr-bob.org/babble/20021210/msgs/131489.html
Thanks,
Bob
This is the end of the thread.
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