MAOIs

[nick222]

I have been talking to my doctor and none of the previous antidepressants I had tried worked. Considering a MOAI as a last resort.

Has anyone here ever been prescribed one of these before?

[folken]

I have been talking to my doctor and none of the previous antidepressants I had tried worked. Considering a MOAI as a last resort.

Has anyone here ever been prescribed one of these before?

Had to look up what MOAI was; but yeah this is a last resort nick.

Please make sure you have indeed exhausted alternatives be it meds or cognitive behavior etc.; before you start on MOAI--- plenty of alternatives in threads here. 

Keep you head up nick - your worth it...………………….

Folken

[Charon]

That was really the first of the anti depressants. it was called an MAO then. My doctor sister reminded me of trauma in my life. she paid for a psych for me. i would not have to deal with the abuse when older then.

My second AD he put me on. They all suck. They make it impossible to concentrate. And I was spending 25 yrs in school to become a doctor of law. May as well make it count.

So second AD we try, and I was the first group to do so, was the MAO. And no one knew a damned thing about it but sure they did prescribe it for the rewards the drs. get.

I took it. I got bronchitis and pneumonia as per usual. And i had tickets to a big concert. Blind Date. My same pharmacist whom filled the MAO pills, never told me that I cannot take any codeine med for bronchitis. None. I can become paralyzed and that paralyzed bit may never go away. So my pharmacist filled a heavy codeine cough syrup.

Off i go and as the concert starts, I go down. Paralyzed. The cops that ran to me, had me call my Dr. sister. She checked her new PDR and saw the possible side effects of MAOs. And told me we hope the paralysis wears off. And the cop carried me and i got the front aisle.

It wore off.

I would never go near any medicine that could permanently paralyze me if i took a medicine to lessen my coughing when i have an upper respiratory.

Further, I could not think clearly on that crap.

And school was far more important. *whom knew i would develop autoimmunes that bring on changes in the brain*

Ok, i never discussed with the nutjob doctor about abuse. And he would get so angry at me cuz i figured out psych kept the clock in plant next to me. Oh he would scream. And I would say I cannot concentrate. But, for a psych, he had a really hard time concentrating so he must have thought that was normal. It was a large bldg on central park south or west, and one appt he jumped up screaming cuz he heard a tiny piano song in the far distance.

So that is the type of doctor whom prescribes that med. He also dx'd me as a catholic prude, which i doubt anyone else would have. I had some issues with men. And that i put others before me. Yeah, so?

And then i did research because i collapsed down the stairs at highschool.

Side Effects of
MAOIs
FIND A PHARMACIST WHO OFFERS GENETIC TESTING FOR MAOIS

Home>Side Effects>MAOIs
Description: MAOIs (monoamine oxidase inhibitors) are an older class of antidepressant that carry the risk of considerable side effects and drug interactions. Modern MAOIs used to treat depression (mostly atypical depression), include phenelzine, selegiline, or tranylcypromine. Selective MAOI inhibitors (selegiline, rasagiline) may be prescribed to people with Parkinson’s disease.
(Australasian Psychiatry “MAOIs – does the evidence warrant their resurrection,” Aug 2016).

Mechanism of Action
As the name implies, an MAOI blocks the action of a chemical called the “monoamine oxidase” enzyme. Inhibiting the monoamine oxidase enzyme makes several chemical levels rise. These include the common neurotransmitters (brain chemicals) dopamine, serotonin, and norepinephrine. (Journal of Clinical Psychiatry “Mechanism of action of antidepressant medications,” Apr 1990).

Serious Side Effects of MAOIs: Hypertensive Crisis and Serotonin Syndrome
People who eat substantial amounts of tyramine in conjunction with MAOIs may experience an unsafe increase in norepinephrine levels. Too much norepinephrine may lead to a state called “hypertensive crisis,” which is a dangerously high blood pressure level. Another potentially severe side effect of MAOIs is serotonin syndrome, which causes elevated blood pressure, agitation, tremor, sweating, and other symptoms. In severe cases, serotonin syndrome may lead to seizures, muscle destruction, coma and death. (CNS Drugs “Current place of monoamine oxidase inhibitors in the treatment of depression,” Oct 2013).

Common Side Effects of MAOIs
Nausea occurs in more than 10% of people who take an MAOI, according to Journal of Clinical Psychiatry “Mechanism of action of antidepressant medications” (Apr 1990).

Other relatively common side MAOI effects, according to CNS Drugs “Current place of monoamine oxidase inhibitors in the treatment of depression” (Oct 2013) include:

Headaches
Sleeplessness
Dizziness
Dry mouth
Drowsiness
Low blood pressure
Abdominal pain
Urinary problems
Understand Your Risks with the Rxight® Genetic Test
The Rxight® pharmacogenetic testing program is designed to provide patients who are considering an MAOI or who are currently on an MAOI with a profile of their own gene variants and the corresponding chemicals in the liver responsible for breaking down and processing MAOIs. Additionally, an entire suite of over 200 prescription and over-the-counter medications across 50 clinically relevant drug classes are analyzed based on a simple DNA cheek swab.

How Does Pharmacogenetic Testing Work?
PGx testing with Rxight® specifically tells you if your genetic makeup makes the activity of these enzymes higher or lower than normal, thus making some medications ineffective or, worse, potentially dangerous or fatal. This could have important ramifications for side effects and drug effectiveness, and guide your prescriber in finding the safest dose or if necessary an alternative medication.
(Read more about psychiatric medication side effects and genetic testing for antidepressant response.)

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Contributors to this Article:
Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

Read more about Rxight® Genetic Testing For Depression Medication

[Charon]

hxxps://www.healthline.com/health/depression/what-are-mao-inhibitors#monoamine-oxidase

Tyramine and foods to avoid
One downside to MAOIs is that they come with dietary restrictions because of the elevated tyramine levels in the blood.

When this class of drug first entered the market, no one knew about the concerns over tyramine and blood pressure. This caused a wave of deaths that prompted further research. Now we know that certain foods contain excess tyramine, and these should be avoided when taking MAOIs.

The more food ages, the more concentrated the levels of tyramine become. This is true for aged meats, cheeses, and even leftovers in your fridge. Foods with dangerously high levels of tyramine include:

soy sauce and other fermented soy products
sauerkraut
salami and other aged or cured meats
Other foods that contain high levels of tyramine are:

aged cheeses, such as Brie, cheddar, Gouda, Parmesan, Swiss, and blue cheese
alcohol, especially chianti, vermouth, and beers
fava beans
raisins, dates, and other dried fruits
tofu
all nuts
Get more information about tyramine-free diets.

Other precautions
Besides blood pressure problems, people taking MAOIs should also beware of a condition called serotonin syndrome. Symptoms can include:

confusion
fever
irregular or rapid heartbeat
dilated pupils
occasional unconsciousness
The condition can manifest if a person on MAOIs takes other antidepressants or the herbal supplement St. John’s wort.

To avoid serotonin syndrome, people taking MAOIs shouldn’t take anything for two weeks when ending MAOI treatment and starting another.


Types of MAOIs
These days, MAOIs are rarely the first choice of prescription medication to treat depression. However, the U.S. Food and Drug Administration (FDA) — the regulating agency of all prescription medication — has approved the following MAOIs:

isocarboxazid (Marplan): can take three to six weeks to fully take effect
phenelzine (Nardil): can take up to four weeks to fully work
tranylcypromine (Parnate): can take up to 3 weeks to achieve its desired effects
Selegiline
Selegiline (Emsam, Atapryl, Carbex, Eldepryl, Zelapar) is a newer type of MAOI. It works by selectively blocking monoamine oxidase B (MAO-B). This reduces the breakdown of dopamine and phenethylamine and means there are no dietary restrictions. It’s available in patch form. Learn about other medications used to treat depression.

Aside from depression, selegiline is also prescribed for early onset Parkinson’s disease and dementia.

Side effects of MAOIs
MAOIs carry more side effects than other antidepressants, which is why they’re often the last drug prescribed to treat depression. Some side effects of MAOIs include:

fatigue
muscle aches
nervousness
insomnia
reduced libido
erectile dysfunction (ED)
dizziness
lightheadedness
diarrhea
dry mouth
high blood pressure
tingling of the skin
difficulty urinating
weight gain
MAOIs and suicide risk
The FDA requires a warning on antidepressants that they may increase the risk of suicide in children and young adults. While MAOIs are rarely prescribed for children, all people beginning any kind of antidepressant therapy should be watched for changes in mood, mindset, or attitude. Successful antidepressant treatments should lower suicide risk by increasing mood.

However, you should consult your doctor before you stop taking MAOIs or any other prescribed medication.

The takeaway
MAOIs are only one type of medication used to treat depression. Like most antidepressants, they may not be right for everyone and take weeks of use to reach their full effect. However, when used in combination with other therapies and lifestyle changes, they can be highly effective at combating depression symptoms. Talk to your doctor for more information to see if MAOI therapy suits your lifestyle.

HEALTHLINE PARTNER SOLUTIONS
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Medically reviewed by Alan Carter, PharmD on September 5, 2017 — Written by Brian Krans

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[Charon]

Man, i dont have a PDR now. I miss it.

They had no clue of any side effects when i was started on it. a few cough cough years ago.

occasional unconsciousness is to be expected? isn't that special?

no one said to taper. Or to watch foods.

And the vast majority of young people in those days would see a psych because they were major league depressed. With life. With others. Good idea to give them a med that encourages suicide.

You sure about this?

If you feel that suicide is the only way out, then i may check out that med. But, its like snake oil, the way it was introduced.

I kept journals. And i studied psychiatry cuz to be a psych was my original dream. Until my elder sister vivisected a baby pig in medical school. So that day i chose to be a doctor of law, as was me father.

The journals help. Add music and poetry and write them in code. And read how a psych should be talking to u to help u with ur issues.

My psych was on TV a couple yrs ago. He is a drug expert now. Ha. He wanted me to do some very bad things. To prove I am not a christian. If i had told my dr. sister, she would have had his license. The idiotic scripting of meds he knew nothing about that helped keep me in fight or flight mode, that was the icing on the cake.

Feel better. I remember you from other forums, nick.

[nick222]

Man, i dont have a PDR now.  I miss it.

They had no clue of any side effects when i was started on it.  a few cough cough years ago.

occasional unconsciousness is to be expected?  isn't that special?

no one said to taper. Or to watch foods.

And the vast majority of young people in those days would see a psych because they were major league depressed.  With life.  With others.  Good idea to give them a med that encourages suicide.

You sure about this?

If you feel that suicide is the only way out, then i may check out that med.  But, its like snake oil, the way it was introduced.  

I kept journals.  And i studied psychiatry cuz to be a psych was my original dream.  Until my elder sister vivisected a baby pig in medical school.  So that day i chose to be a doctor of law, as was me father.

The journals help.  Add music and poetry and write them in code. And read how a psych should be talking to u to help u with ur issues.

My psych was on TV a couple yrs ago.  He is a drug expert now.  Ha.  He wanted me to do some very bad things.  To prove I am not a christian.  If i had told my dr. sister, she would have had his license.  The idiotic scripting of meds he knew nothing about that helped keep me in fight or flight mode, that was the icing on the cake.

Feel better.  I remember you from other forums, nick.

Thanks so much for your reply Charon, sounds like such an awful experience you had. 

I have decided to stick with moclobemide (a RIMA, reversible MAOI) because you don't have the same dietary requirements. It won't work as well for the symptoms but it doesn't have as many sides. 

As for an update on my life in general, I've been pretty much off benzos since October (no reason to guess why). I have re-enrolled to finish law school this year. Hopefully things are on the up for me.