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Dr. Bob is Robert Hsiung, MD,
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Posted by Bobbiedobbs on August 4, 2002, at 23:56:24
In reply to Re: MAOI diet » jsarirose, posted by LLL on August 4, 2002, at 21:55:28
Re the sleeplessness. I'm taking Parnate and it also keeps me from getting (and staying) asleep.At 20-30 mg. it only has a mild effect but at 40 and up it is pronounced. The best remedy, short of one of the drugs mentioned, is to space it so that you don't take any after dinner. I think the effect may recede slightly in time. If you think Parnate if bad in this regard, you should try Nardil. I think I averaged about 4-5 hours a night the years I was on it. Phil.
Posted by LLL on August 5, 2002, at 8:46:17
In reply to Re: MAOI diet, posted by Bobbiedobbs on August 4, 2002, at 23:56:24
>Re the sleeplessness. I'm taking Parnate and it also keeps me from getting (and staying) asleep.At 20-30 mg. it only has a mild effect but at 40 and up it is pronounced. The best remedy, short of one of the drugs mentioned, is to space it so that you don't take any after dinner. I think the effect may recede slightly in time. If you think Parnate if bad in this regard, you should try Nardil. I think I averaged about 4-5 hours a night the years I was on it. Phil
So, IF I can work my way back up to the dose I used to take of 50 (of which I took 30 in am and 20 in the afternoon) I will now have to take only 10 mg at a time, like every 2hours between the hours of 7:00 am and 5:00 pm? or do you take more than one pill at a time - I've heard from others that taking more than 10 mg at a time causes them problems. At the rate I'm going this time with only 5 mgs and moving up slowly, I imagine I'll be one to have problems with taking multiple pills at one time.
Also, I had the opposit effect, I found Nardil more sedating and had the best naps during the day. Now, not only do I not sleep well at night, I'm WIDE AWAKE all day - and again only on 5 mgs!
Posted by cybercafe on August 6, 2002, at 13:34:44
In reply to Re: MAOI diet » LLL, posted by jsarirose on August 4, 2002, at 21:26:25
Hey Jess care to tell us how the Lamictal has been treating you?
Posted by Bobbiedobbs on August 6, 2002, at 15:01:08
In reply to Re: MAOI diet » Bobbiedobbs, posted by LLL on August 5, 2002, at 8:46:17
Re Parnate and sleeplessness.
Yeah, the idea is to bunch them up so as not to take any after dinner but also to spread them out sufficiently so that you don't take too much at once. It's a slippery slope. For 50 mg, I'd take go something like 8 a.m., 10, 12, 2, 4 (sounds like Dr. Pepper).
I'm going away for 3 weeks (unfortunately work-related). As usual I'll try to avoid people as much as possible. Don't eat too much Cheeze Whiz (actually we can eat as much of this as we want) in my absence! These posts have been informative and supportive. Good luck you guys. Phil aka bobbie dobbs.
Posted by jsarirose on August 6, 2002, at 15:10:01
In reply to Jess -- update, posted by cybercafe on August 6, 2002, at 13:34:44
>
> Hey Jess care to tell us how the Lamictal has been treating you?So far no problems at all. I'm only on 150mg which isn't very high at all. The primary reason for this is since insurance only covers 50% (and it's quite expensive) I'm still waiting for the patient assistant program kick in. I'm kind of hoarding the pills I do have.
I can't really tell if it's making a difference in my mood. I have tapered down to 60mg of Parnate (from 100mg) very slowly and think I'm still doing okay. It's always a little hard to tell since I have regular ups and downs but never know what's normal and what's depression. I've so rarely been "normal" in my life! I wait about three weeks before I reduce the Parnate by 10mg and try to really evaluate my mood before I do.
I'm hoping to start therapy again soon and hopefully she can help me evaluate my moods a bit more.
Thanks for asking,
Jessica
Posted by jsarirose on August 6, 2002, at 15:13:47
In reply to Re: MAOI diet, posted by Bobbiedobbs on August 6, 2002, at 15:01:08
> Re Parnate and sleeplessness.
> Yeah, the idea is to bunch them up so as not to take any after dinner but also to spread them out sufficiently so that you don't take too much at once. It's a slippery slope. For 50 mg, I'd take go something like 8 a.m., 10, 12, 2, 4 (sounds like Dr. Pepper).I had much better luck when I divided my dose too. I just went with three times a day - when I woke, three hours later, and three hours after that. You can feel what's best for you. I definitely tried to stay aware from "pilling" close to bed. It's not always easy to take them so frequently throughout the day too.
Good luck!
And Phil, have a great trip - hope you get to play a little bit. We'll miss your input.
-Jessica
Posted by cybercafe on August 7, 2002, at 0:49:48
In reply to Re: Jess -- update, posted by jsarirose on August 6, 2002, at 15:10:01
>so rarely been "normal" in my life! I wait about three weeks before I reduce the Parnate by 10mg and try to really evaluate my mood before I do.
... at what dose did your acne really get worse and how is it doing now that you have gone down so much? ....
... i am thinking about going swimming again, it might have had a good effect on my acne (not parnate related), i don't remember exactly...... oh actually my friend pointed out that for him and i've found for myself as well -- changing your sleeping tends to be really bad -- and parnate sure can keep you up sometimes... not to mention that desire to socialize and do things...
... and of course as soon as you get that antidepressant socialize + libido effect the last thing you want is a dermatological problem (i've actually got four now, though none serious -- possibly from valporate)...... i actually tried taking a look at a dermatology website to diagnose myself, but... i just could not stand looking through all of those disgusting pictures (yuck!)... so much for a career in medicine for me :(
... perhaps if i could get my doc to let me take lamictal i could get the rash and then i really would be dermatology boy :)
> I'm hoping to start therapy again soon and hopefully she can help me evaluate my moods a bit more.
how about if i ask you "how would you therapist help you evaluate your moods" and then you could just take that answer and ask it yourself? :)
perhaps keep a mood chart with journal entries... btw you must have a good idea what works well and what doesn't for acne... what would you recommend? i think tretonin (sp?) was probably the best ... though i hear accutane works quite well (between liver problems and depression, that's one i aint touchin)
hope the lamictal kicks in soon
Posted by jsarirose on August 7, 2002, at 1:14:44
In reply to Re: Jess -- update, posted by cybercafe on August 7, 2002, at 0:49:48
> ... at what dose did your acne really get worse and how is it doing now that you have gone down so much? ....I can't recall exactly, I know when I hit 60mgs it seemed to be getting worse and by the time I was at 100mg it was really terrible. It took me a bit to pin it down to Parnate - it wasn't listed as a known side-effect. But from talking to other people and figuring things out for myself I narrowed the cause to Parnate.
> ... i am thinking about going swimming again, it might have had a good effect on my acne (not parnate related), i don't remember exactly...
Swimming is good because the chlorine helps dry out the skin. I try to go too.
> ... oh actually my friend pointed out that for him and I've found for myself as well -- changing your sleeping tends to be really bad -- and parnate sure can keep you up sometimes... not to mention that desire to socialize and do things...
I try hard to take a similar dose of Trazodone and go to sleep at the same time every night. I also set my alarm to make sure I wake at around the same time in the morning. I do allow myself up to 10 hours of sleep usually though - although sometimes I need less, sometimes more, and sometimes I wake up after three hours (even with the Trazodone).
And yeah, I've just started seeing someone and I'm definitely not looking forward to exposing my acne. At least it's getting better as I reduce my Parnate. Also I've been taking Erythromycin (Minacycline is better, but I can't tolerate it). And I went back on the birth control pill which really helps. Probably not anything you can take! ; )
I've never heard of Tretonin. I've been on Accutane a number of years ago and it worked great. I've read a lot about the depression link and it really isn't proven. There is no proof either way and after talking to my dermatologist I felt my suspicions were confirmed regarding the dangers involved. I don't believe there really are any with depression. I would take it, but my insurance doesn't cover it at all and it's incredibly expensive.
A course of antibiotics and a good topical (Benzac 10% is great) is a good first line of defense.> how about if I ask you "how would you therapist help you evaluate your moods" and then you could just take that answer and ask it yourself? :)
> perhaps keep a mood chart with journal entriesI should start a mood chart again - I've kept them on and off throughout my depression. I sometimes have a hard time figuring out what are normal reactions to changes in my life and what I'm overreacting to. My therapist can also help me work through some more recent things that have come up for me that I seem to be having trouble dealing with. I hate to burden my sister with everything! : )
Oh - there are some vitamins that are supposed to help with acne too. Vitamin A & E. I haven't noticed any difference at all from taking them though.
-Jessica
Posted by jsarirose on August 9, 2002, at 5:33:45
In reply to Re: Jess -- update, posted by jsarirose on August 7, 2002, at 1:14:44
I did it - I had a greek salad with lovely, tasty feta. No problems at all. So far it's mozzarella, chevre, montrachet, parmesan, feta & one big bite of goat brie. And no reactions. Not sure if I'm ready to try something else. I feel like I'm pushing my luck.
-Jessica
Posted by LLL on August 9, 2002, at 9:16:10
In reply to Re: MAOI Cheese Update, posted by jsarirose on August 9, 2002, at 5:33:45
Posted by jsarirose on August 9, 2002, at 15:43:32
In reply to Phewwww! Be Careful Jess! (nm) » jsarirose, posted by LLL on August 9, 2002, at 9:16:10
Well, it was on the okay list (the most recent posted). I don't think I'll be trying anything else for a while. I was just excited to eat something new again! It's been several months since my last crisis - but I should remind myself how awful they are.
-Jessica
Posted by fierc on August 14, 2002, at 1:47:55
In reply to Re: MAOI diet - For jsarirose, posted by cybercafe on August 4, 2002, at 20:52:18
Glad to finally hear some smiliar experiences. When I began Parnate I didn't sleep for the first 3 weeks...I got about 2 hours a day. Eventually I began getting about 5 hrs. However I am wondering if anyone has had a problem getting Parnate from their pharmacy. I was told it was on back order and that there is no release date yet for it. So in the mean time my dr. has put me on moclobimide (i'm not sure of the spelling) and I am still waiting.
I also am kinda curious about what you all take when you have a hypertensive crisis. My dr. told me not to worry about it and not to really be concerned about the food restrictions. Of course I didn't listen and am rather cautious. I know I need a new dr. however he is the only psychiatrist where I live. I must say though both of these meds have been wonderful after trying effexor, remeron, paxil, wellbutrin, celexa, and tonnes more that I can't even spell or say half of the time!
Posted by jsarirose on August 14, 2002, at 2:18:06
In reply to Re: MAOI diet -, posted by fierc on August 14, 2002, at 1:47:55
However I am wondering if anyone has had a problem getting Parnate from their pharmacy. I was told it was on back order and that there is no release date yet for it.
Wow - changing your meds just like that isnt' so easy. Is there another pharmacy you can go to? What about mail order?
> I also am kinda curious about what you all take when you have a hypertensive crisis. My dr. told me not to worry about it and not to really be concerned about the food restrictions.
I can't believe how many times I've heard this! You should have an emergency pill - I take Chlorpromazine (Thorazine). It is safe, it works, and you can take it even if you aren't sure if your blood pressure is spiking.
And if you're on Parnate, you should be adhering to the diet restrictions. I don't know why your doctor thinks you can ignore them. It's true the current lists are more lax than the ones prior to 1996, but you still need to stay away from certain foods. You may ask him why he thinks you won't have hypertensive crisis if you eat one of the items.
Good luck and I hope you can get back on it soon.
-Jessica
Posted by cybercafe on August 14, 2002, at 12:01:44
In reply to Re: MAOI diet -, posted by fierc on August 14, 2002, at 1:47:55
> Glad to finally hear some smiliar experiences. When I began Parnate I didn't sleep for the first 3 weeks...I got about 2 hours a day. Eventually I began getting about 5 hrs. However I am wondering if anyone has had a problem getting Parnate from their pharmacy. I was told it was on back order and that there is no release date yet for it. So in the mean time my dr. has put me on moclobimide (i'm not sure of the spelling) and I am still waiting.
weird when i began reading this message i thought for a second that *I* had written it :)
... yes i have had a problem getting it from a few pharmacies... my solution? just call around a bit... actually i asked my doc and apparently my problem was i was calling up one pharmacy chain that had all of their drugs in a central location... ! you're much better calling different chains, particularly smaller ones...
... you don't happen to be in toronto do you?
> I also am kinda curious about what you all take when you have a hypertensive crisis. My dr. told me not to worry about it and not to really be concerned about the food restrictions. Of course I didn't listen and am rather cautious. I know I need a new dr. however he is the only psychiatrist where I live. I must say though
... yeah my doc didn't give me a pill and only told me to avoid about 4 types of food...
i havn't had a crisis in the 10 weeks i've been on it, so i'm feeling pretty confident...what makes you think you need a new doc??
>both of these meds have been wonderful after trying effexor, remeron, paxil, wellbutrin, celexa, and tonnes more that I can't even spell or say half of the time!
... what were your experiences on these drugs? ... did remeron help anxiety more than the rest? did wellbutrin help depression more than the rest? ...
... actually i guess i should have asked your diagnosis first :) ... i'm bipolar II - mainly depressed
Posted by cybercafe on August 14, 2002, at 12:06:48
In reply to Re: MAOI diet -, posted by jsarirose on August 14, 2002, at 2:18:06
> I can't believe how many times I've heard this! You should have an emergency pill - I take Chlorpromazine (Thorazine). It is safe, it works, and you can take it even if you aren't sure if your blood pressure is spiking.
... maybe your case is different because you were taking a super duper high dose? ....
or perhaps most docs think that if you are in serious trouble you shouldn't be treating it yourself (but should go to the emergency ward instead)...
if fierc is in canada or another socialized medical system like myself (i assume so, if he's taking moclobemide) it's probably more practical (read: affordable) to go to an emergency ward than in the states <showers mrs. rosenberg with sympathy for having to pay for medical help>
> And if you're on Parnate, you should be adhering to the diet restrictions. I don't know why your doctor thinks you can ignore them. It's true the current lists are more lax than the ones prior to 1996, but you still need to stay away from certain foods. You may ask him why he thinks you won't have hypertensive crisis if you eat one of the items.
... i assume when he says "ignore them", he means ignore them and instead follow a more basic list his doc provided
... i think any doc who is hardcore enough to prescribe an MAOI is probably also competent enough to know the risks
Posted by fierc on August 15, 2002, at 0:37:12
In reply to Re: MAOI diet -, posted by cybercafe on August 14, 2002, at 12:06:48
> > I can't believe how many times I've heard this! You should have an emergency pill - I take Chlorpromazine (Thorazine). It is safe, it works, and you can take it even if you aren't sure if your blood pressure is spiking.
>
> ... maybe your case is different because you were taking a super duper high dose? ....
>
> or perhaps most docs think that if you are in serious trouble you shouldn't be treating it yourself (but should go to the emergency ward instead)...
>
> if fierc is in canada or another socialized medical system like myself (i assume so, if he's taking moclobemide) it's probably more practical (read: affordable) to go to an emergency ward than in the states <showers mrs. rosenberg with sympathy for having to pay for medical help>
>
> > And if you're on Parnate, you should be adhering to the diet restrictions. I don't know why your doctor thinks you can ignore them. It's true the current lists are more lax than the ones prior to 1996, but you still need to stay away from certain foods. You may ask him why he thinks you won't have hypertensive crisis if you eat one of the items.
>
> ... i assume when he says "ignore them", he means ignore them and instead follow a more basic list his doc provided
>
> ... i think any doc who is hardcore enough to prescribe an MAOI is probably also competent enough to know the risks
>
>
My so-called diagnosis is atypical depression, however I mostly suffer from anxiety....my dr. hasn't made a clear statement about what it is. I have a lot of problems with my dr. Not to make him sound so aweful. I just get extremely frustrated because I ask educated questions and he just gives me the blow off as little girl doesn't know what she is talking about, just cause she learned a couple of things in university.....He is famous for pulling me off meds after 2 weeks even after I object and put me on others. Luckily I have good health coverage since I'm still in university.
I guess I'm just going to have to annoy the man and ask many more questions....is there anything i'm missing that i should know about other than diet and hpyertensive crisis'?? Let me know....More I can learn I'd be thrilled!
Posted by jsarirose on August 15, 2002, at 0:47:58
In reply to Re: MAOI diet -, posted by fierc on August 15, 2002, at 0:37:12
> My so-called diagnosis is atypical depression, however I mostly suffer from anxiety....my dr. hasn't made a clear statement about what it is. I have a lot of problems with my dr. Not to make him sound so aweful. I just get extremely frustrated because I ask educated questions and he just gives me the blow off as little girl doesn't know what she is talking about, just cause she learned a couple of things in university.....
>
> He is famous for pulling me off meds after 2 weeks even after I object and put me on others. Luckily I have good health coverage since I'm still in university.
>Do you have any option of seeing someone else? He sounds awful. He may have some good knowledge, but attitude is very important when dealing with depressed patients! I would not be able to stand for being talked down to. And the bells really go off when he wants to take you off meds so quickly. Especially when you have treatment resistant depression it is very important to give meds a full run and even push them to higher than normal levels. I have had depression for 25 years - that's an awful lot of drugs to go through. It isn't really a test of a drug unless you give it a full run (unless the side effects are too bad). You don't want to have to go back to a drug you've already tried and test it again - you waste a lot of time that way.
And I just don't know what to say about the MAOI advice he gave you. I would try to pin him down on the why's of no diet restrictions and no emergency pill.
If I don't have a good feel from a doctor, I try someone new. It's my life I'm playing with!
-Jessica
(Did I give you the site for Treatment Resistant Depression and the suggested medication route? If not, check out: http://www.acnp.org/g4/GN401000105/Default.htm
Posted by LLL on August 15, 2002, at 10:01:16
In reply to Re: MAOI diet -, posted by jsarirose on August 15, 2002, at 0:47:58
After failing with the Parnate I'm going to ditch AD's for now. How long must I wait before starting vitamin mega therapy including Omega 3 fish oil, and gamma-aminobutyric acid (GABA)? I also plan on resuming St. John Wort, something that helped me maintain fairly well for 4 yrs following cessation of Parnate in the past.
What period of time do I need to wait on the vitamins and supplements? and how long for the St. John Wort?Thanks,
Lisa
Posted by jsarirose on August 15, 2002, at 14:41:19
In reply to Wash Out period » jsarirose, posted by LLL on August 15, 2002, at 10:01:16
> After failing with the Parnate I'm going to ditch AD's for now. How long must I wait before starting vitamin mega therapy including Omega 3 fish oil, and gamma-aminobutyric acid (GABA)? I also plan on resuming St. John Wort, something that helped me maintain fairly well for 4 yrs following cessation of Parnate in the past.
> What period of time do I need to wait on the vitamins and supplements? and how long for the St. John Wort?
>
> Thanks,
> LisaWow - sorry the Parnate didn't work out. I'm glad you have some other options that might work for you and it sounds like you're keeping your spirits up, at least you're still hopeful. And being hopeful is the most important thing for us - it lets us keep trying.
Unfortunately I have no advice on either of your questions since I'm not personally familiar with either option. But I wish you luck.
-Jessica
Posted by LLL on August 15, 2002, at 15:59:05
In reply to Re: Wash Out period, posted by jsarirose on August 15, 2002, at 14:41:19
Although I may sound hopeful, actually I'm not. I see a bleak future of living within a 5 mile radius of my home.
Posted by jsarirose on August 15, 2002, at 16:35:40
In reply to Re: Wash Out period » jsarirose, posted by LLL on August 15, 2002, at 15:59:05
> Although I may sound hopeful, actually I'm not. I see a bleak future of living within a 5 mile radius of my home.
Well, please keep us informed about how you're doing. And don't give up - I tried almost every drug in the book before I found Parnate. Don't underestimate therapy (if you can find a good therapist - sometimes not so easy). At the very least it can help you to stay hopeful. Feel free to email any time (jsarirose1@attbi.com).
Take care,
Jessica
Posted by Bobbiedobbs on September 8, 2002, at 13:44:01
In reply to Re: Jess -- update, posted by jsarirose on August 7, 2002, at 1:14:44
I'm curious whether any of the MAO users experimented with any of the cheeses and/or soy products mentioned as "OK" in the 1999 Sunnybrook study. I remember Jess talking about some preliminary trials with feta and goat cheese. While I was away I got a copy of the Kenneth Shulman study on the tyramine content of pizzas and soy products alluded to by a prior poster. While the study relaxes prohibitions on cheese (extending the OK to double cheese/double pepperoni pizzas from the major pizza chains) it is quite restrictive on all soy products, including any tofu. I have put soy sauce on my chinese food for years without any ill effect. I'm speculating that the soy sauce commonly used in the US is a bastardized, weakened version. Welcome all replies. Phil.
Posted by jsarirose on September 8, 2002, at 14:27:53
In reply to MAO cheese, soy, etc followup, posted by Bobbiedobbs on September 8, 2002, at 13:44:01
> I'm curious whether any of the MAO users experimented with any of the cheeses and/or soy products mentioned as "OK" in the 1999 Sunnybrook study.
Well I tried the feta with no problems at all. And I've been eating soy sauce and tofu all along trouble-free. I really wanted to continue trying some of the other cheeses they mentioned that previously were thought to be off-limits. I think brie (without the rind) was on there and perhaps Gruyere? I can't for the life of my find where I saw the list online though. Can you point me to the site again, and I'll be happy to guinea pig myself with cheese! All in the name of science (and happy taste buds) of course.
Thanks,
Jessica
Posted by LLL on September 8, 2002, at 15:46:21
In reply to Re: MAO cheese, soy, etc followup » Bobbiedobbs, posted by jsarirose on September 8, 2002, at 14:27:53
Here's the link I posted earlier with the tyramine content of the cheeses:
http://www.vh.org/Providers/Conferences/CPS/19.html
It's towards the end of the document.
Posted by jsarirose on September 8, 2002, at 15:57:19
In reply to Re: MAO cheese, soy, etc followup » jsarirose, posted by LLL on September 8, 2002, at 15:46:21
> Here's the link I posted earlier with the tyramine content of the cheeses:
> http://www.vh.org/Providers/Conferences/CPS/19.html
> It's towards the end of the document.Thank you! I was looking everywhere for it! I volunteer to try Muenster & Swiss Gruyere. I'll be unbelievably happy if I can expand my cheese choices. (Obviously an honorary Canadian cheesehead.)
-Jessica
ps - who is going to volunteer to test the "19-104 beers" necessary to provoke an attack?
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