Thinking about trying an MAOI

[Ben12]

So for the past few years I've been on various antidepressants. None of them except Wellbutrin was of any benefit. I was on wellbutrin for a good year and a half. I was doing really well on it but I had a seizure and so I had to get off of it. It's been a year and a half since I've been off of the Wellbutrin and my mood is starting to get low again and my anxiety is bad. So I'm thinking about trying an MAOI but am not sure which one would be best. I've heard and read good things about Nardil and parnate regarding there efficacy. They seem to have a lot of side effects though. I'm actually very well aware of he these drugs work so. Don't really need any explanation about how they work. But it would be nice to know some of people's experiences on them.

So some things that I was wondering about them are, how strict do you have to follow the dietary instructions? How often do you have to take it? Is it a once a day sort of thing or is it in multiple doses? Is urinary retention a likely side effect? Based on what I've read it can be a side effect but I'd like to know more based on people's experiences on this class of drugs.

Thank you for any replies, I look forward to posting.

[gilmourr]

Originally Posted by Ben12

So for the past few years I've been on various antidepressants. None of them except Wellbutrin was of any benefit. I was on wellbutrin for a good year and a half. I was doing really well on it but I had a seizure and so I had to get off of it. It's been a year and a half since I've been off of the Wellbutrin and my mood is starting to get low again and my anxiety is bad. So I'm thinking about trying an MAOI but am not sure which one would be best. I've heard and read good things about Nardil and parnate regarding there efficacy. They seem to have a lot of side effects though. I'm actually very well aware of he these drugs work so. Don't really need any explanation about how they work. But it would be nice to know some of people's experiences on them.

So some things that I was wondering about them are, how strict do you have to follow the dietary instructions? How often do you have to take it? Is it a once a day sort of thing or is it in multiple doses? Is urinary retention a likely side effect? Based on what I've read it can be a side effect but I'd like to know more based on people's experiences on this class of drugs.

Thank you for any replies, I look forward to posting.

Don't follow the diet. Never has caused any issues.

Take it every day atm, 45 mg/daily.

Urinary retention is a likely side effect, the severity differs. It gets worse as you increase the dose, it was non-existent at 45 mg for me, noticeable at 60 mg, and took me 5 mins to begin to pee at 75 mg. While drinking at 75 mg like alcohol I might have needed a cathedar it took so long.

This is for Nardil btw.

[Ben12]

Thanks for the reply gilmour. I was reading your thread about Nardil + stimulant. So you've been on Nardil in the past as well? I'm planning on seeing my psychiatrist soon, hopefully in a month or so. It takes so long to get in to see one. I can remember being on Effexor, man that was hell. I needed a caphater. The urinary retention was really bad.

I know that there are other MAOIs like parnate and marplan. I guess it all comes down to which one will be more tolerate for me. If the doctor says I Have to follow the dietary restrictions than I'll follow them. Just so as long as my anxiety and mood improves.

[gilmourr]

Originally Posted by Ben12

Thanks for the reply gilmour. I was reading your thread about Nardil + stimulant. So you've been on Nardil in the past as well? I'm planning on seeing my psychiatrist soon, hopefully in a month or so. It takes so long to get in to see one. I can remember being on Effexor, man that was hell. I needed a caphater. The urinary retention was really bad.

I know that there are other MAOIs like parnate and marplan. I guess it all comes down to which one will be more tolerate for me. If the doctor says I Have to follow the dietary restrictions than I'll follow them. Just so as long as my anxiety and mood improves.

They'll always tell you to follow the diet. It's just a way of reducing liability. I would recommend by testing out what you can handle in a safe environment. That's what I did until I realized I have no issues with anything, I just avoid blue cheese and that's it.

Nardil worked fairly well last time, it is in the top 2 out of 9 meds I've tried. Tied with Zoloft. I really need it to work this time as I've been in severe depression again since March and I think I'm literally losing my mind. I really am not sure how long I can put up with this incredibly negative emotions on a 24/7 basis. It's now affecting the way I think and I'm having trouble even seeing straight, not sure how. But I think the depression is really ****ing me up hardcore.

[puppy]

Originally Posted by Ben12

So some things that I was wondering about them are, how strict do you have to follow the dietary instructions?

I've only been on Nardil for two weeks, but I've been eating thai food (which supposedly is a no-no because of the fish sauce) and stuff with soy sauce and teriaki. No problems so far, but I never eat super huge portions. I even ate a couple slices of pizza the other day which is funny because I never liked cheese before starting Nardil. I've always been a super picky eater and have always ate just to get rid of my stomach ache, even though no food ever sounded good. I think I will gain a lot of weight on Nardil which is good in my case. Ironic that the Nardil makes me like cheese but now I can't eat it, isn't it?

Originally Posted by Ben12

How often do you have to take it? Is it a once a day sort of thing or is it in multiple doses?

I take 60 mg twice daily, 30 in the morning, 30 at night. I read somewhere that it was supposed to work best if you take your whole daily dose all at once, but the side effects are also supposed to be worse that way. I think it has to do with the Nardil interfering with it's own metabolism, since Nardil is primarily metabolized via oxidation by MAO.

Originally Posted by Ben12

Thank you for any replies, I look forward to posting.

Great to have another member in the MAOI club. Be sure to keep us updated!

[puppy]

Haha, now i'm getting the urinary retention, too. I almost didn't believe you guys when you said the side effects were coming, but sure enough they are here.

[gilmourr]

Originally Posted by puppy

Haha, now i'm getting the urinary retention, too. I almost didn't believe you guys when you said the side effects were coming, but sure enough they are here.

Apparently adding bethanechol with Nardil will help you pee again.

[blakeyz]

I'm on Parnate and eat/drink anything with no problems.
Take dose multiple times a day just because of it's shot half life.
It's been pretty good S/E wise.
If wellbutrin is the only med that has helped you, wouldn't something like nortriptyline be better then MAOI ?

[puppy]

Originally Posted by gilmourr

Apparently adding bethanechol with Nardil will help you pee again.

Thanks for the tip. It's not quite bad enough yet to need another med, but I'll ask my doc about that if it gets worse.

[Ben12]

Originally Posted by blakeyz

I'm on Parnate and eat/drink anything with no problems.
Take dose multiple times a day just because of it's shot half life.
It's been pretty good S/E wise.
If wellbutrin is the only med that has helped you, wouldn't something like nortriptyline be better then MAOI ?

I don't know much about nortriptyline. In fact I don't really know much about any of the tricyclics. I've just heard such good things regarding the efficacy of MAOIs that I thought they would be a next good option. Currently I'm taking 100mg of seroquel and a prn of clonazepam of 0.5mg each night if needed. When I was on the Wellbutrin the seroquel was at 200-300mg plus 4mg of clonazepam. I really needed that for the anxiety that the Wellbutrin gave me. But it was excellent though for boosting my energy levels though. It does worry me though that there's this sleepiness side effect from the Nardil though based on what I've read in people's responses.

Honestly though I don't know what a good drug would be to ask my doctor about. In the past it was just telling them my symptoms, they prescribe me something and that's that. But it just always seemed like trial and error and I'm tired of this trial and error crap. I just want whatever I'm given to work.

[Ben12]

Originally Posted by gilmourr

Apparently adding bethanechol with Nardil will help you pee again.

Is bethanechol offered in Canada?

[ourwater]

My Councilor that treated be for PTSD said she only had treated prior patients with MAOI medications. She had to ask my doctor what to give me. My doctor contacted a Pdoc that specialized in depression and PTSD, and he recommended Zoloft. The whole process took more than a month and was very annoying. My doctor said that she normally prescribed Prozac.

[viper1431]

Pizza is usually ok because it more often than not uses a fresh cheese like mozzerella, the aged mouldy cheeses are the bad ones. I havn't had any problems with food though so i pretty much ignore the restrictions.

I've been lucky enough not to get the urinary retention to any great degree, constipation is the main side effect i get first on nardil.

Nardil fixes my overeating and over sleeping, if it wasn't for those 2 things i'd find tricyclics the best.

[Ben12]

Thanks for all the advice guys. I must say though, I don't think that it's worth it to be on any MAOI. The side effects and that just seem ridiculous and as I'm sure they are certainly helpful for people, it would make more sense for me to just go on something different. Plus there are so many drug interactions.

[gilmourr]

Originally Posted by Ben12

Thanks for all the advice guys. I must say though, I don't think that it's worth it to be on any MAOI. The side effects and that just seem ridiculous and as I'm sure they are certainly helpful for people, it would make more sense for me to just go on something different. Plus there are so many drug interactions.

The side effects go hand in hand with efficacy -- usually. There are really not many drug reactions, everything is overstated. Just stay away from things like clomipramine, paxil, imipramine (anything very serotonergic).

And of course stay away from cough syrup, and that's about it!

You can use benzos, less serotonergic drugs as augmenters (nortryptiline, desipramine, doxepin etc), anti-histamines like seroquel, remeron, ambien, lunesta.

But if you are OCD about "dying" then ya a MAOI probably isn't a good match. Not because you'll die, but the fact that you think you'll be dead any given moment might make you crazy.

[Ben12]

Lol I'm certainly not OCD from dying. I don't know I'll give it some more thought. Maybe when I see my doctor next he will make a better recommendation. I just don't want to go in there and get prescribed something that I know won't do anything.

But I also think that I should be thankful that at least I'm more stable than I have been in the past. I might still have anxiety but I don't think that drug seeking behavior is the way to go. Besides, there's more to life for me than trying to find the perfect fit that probably is in itself, unrealistic.

[gilmourr]

Originally Posted by Ben12

Lol I'm certainly not OCD from dying. I don't know I'll give it some more thought. Maybe when I see my doctor next he will make a better recommendation. I just don't want to go in there and get prescribed something that I know won't do anything.

But I also think that I should be thankful that at least I'm more stable than I have been in the past. I might still have anxiety but I don't think that drug seeking behavior is the way to go. Besides, there's more to life for me than trying to find the perfect fit that probably is in itself, unrealistic.

I don't think anyone that comes on this forum is looking for perfection, just looking for a way to enjoy normal things again and not have 24/7 thoughts of fear or depression like wanting to cut a hole in your chest, rip out your heart and stab it countlessly.

[Ben12]

Originally Posted by gilmourr

I don't think anyone that comes on this forum is looking for perfection, just looking for a way to enjoy normal things again and not have 24/7 thoughts of fear or depression like wanting to cut a hole in your chest, rip out your heart and stab it countlessly.

That's a good point.

[Ben12]

Originally Posted by blakeyz

I'm on Parnate and eat/drink anything with no problems.
Take dose multiple times a day just because of it's shot half life.
It's been pretty good S/E wise.
If wellbutrin is the only med that has helped you, wouldn't something like nortriptyline be better then MAOI ?

From what I've read I don't think that there really is much similarity to nortryptiline and Wellbutrin. In fact it sounds like nortryptiline is sedating and not stimulating like what the Wellbutrin is.

[gilmourr]

If you were to compare wellbutrin to different classes and choose the most similar med, I'd say for SSRI = zoloft, TCA = desipramine
MAOI = parnate

But in reality, wellbutrin is just kinda like a stimulant but to a lower degree. It's an interesting drug.. might be easier to get than a stimulant that I've been trying for..