![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 419 to 443 of 488. Go back in thread:
Posted by Rich340 on May 14, 2005, at 22:41:20
In reply to Re: hypertensive experiences? (nm) » KaraS, posted by Rich340 on May 14, 2005, at 22:06:48
Typed lengthy followup. Must have screwed up on submit process.
Can I retrieve the text or must I (uggh!)start again?
Help!
Posted by KaraS on May 15, 2005, at 2:14:50
In reply to Re: hypertensive experiences? » Rich340, posted by Rich340 on May 14, 2005, at 22:41:20
> Typed lengthy followup. Must have screwed up on submit process.
>
> Can I retrieve the text or must I (uggh!)start again?
>
> Help!
Bummer! I think you checked the box that says "no message" (because you have the "nm" in your message title) so the program erased all that you had typed. I appreciate the effort anyway.K
Posted by Dr. Bob on May 15, 2005, at 2:15:07
In reply to Re: hypertensive experiences? » Rich340, posted by Rich340 on May 14, 2005, at 22:41:20
> Typed lengthy followup. Must have screwed up on submit process.
>
> Can I retrieve the text or must I (uggh!)start again?
>
> Help!Sorry, but at this point you probably have to start again. Sometimes you can go “back” and your text will be there. Sometimes a new window will open with your text. Sometimes people compose in Word or something and cut-and-paste to post. Better luck next time,
Bob
Posted by Rich340 on May 15, 2005, at 6:55:20
In reply to Re: hypertensive experiences? » Rich340, posted by Rich340 on May 14, 2005, at 22:41:20
Its never as good the second time 'round, however here goes.
Regarding your request re the MAOI which I take, it is Nardil.
It is part of a cocktail of drugs for minimising the impact of Bipolar disorder 2 which has adversley impacted my professional career as a practicing international lawyer over the last 33 years.
Availability of the drug itself is no problem in Australia: rather, it is the avaiability of Psychiatrists who will prescribe it that is the problem.
My original psychopharmacologist insisted I try Nardil for some years. The list of unacceptable foods contained many of my favourites! In the end, my absences from work dictated I had no option. He compared Nardil and the other MAOI avilable in Australia, Parnate, to a tried and true 'cannon' as opposed to the slick 'rifle shot' weapons that the later generations of anti depressants comprise.
Regarding the cocktail, just in case this may help someone- not necesarily the specifics, but the rewards for having gotten there: I have titrated the drugs comprising the cocktail, with the blessing of my current psych., to the point where I have reduced the Lithium and introduced carbamazepine. My present cocktail comprises the following:
Morning-4 Nardils + 1/2 Carbamazepine(400mgCR)+1 20 mg Propanalol.
Lunch- 2 nardils + 1 20mg Propanalol.
Bedtime- 1 Carbamazepine (400mgCR) + 1 Lithium (250).Now hear this! I have for almost all of my life suffered a depressive episode 1 week in every four. Since I began the present regime, I have now completed 26 weeks in a row (or 6 months or half a year!) without a significant depressive episode (not more than one day of questionable mood).
This has inevitably resulted in some cockiness on my part causing me to 'push the envelope' with foods,drinks, etc, ever so carefully. I thought I had the 'beast' under control. Hence the H.T.C. and my time in Hospital. Thankfully, no resultant depression , at all!
My G.P. suggested Adalat (Nifedipine/ Procardia to you?) 3 x daily yesterday. Headaches have gone. Blood pressure has returned to normal, for me.One unforgettable lesson.
Really value this support group in cyberspace.
Hope some of this helps someone else, somehow.
R.
Posted by awatts on May 15, 2005, at 12:01:26
In reply to Re: screwed up on submit process, posted by Dr. Bob on May 15, 2005, at 2:15:07
> Sorry, but at this point you probably have to start again. Sometimes you can go “back” and your text will be there. Sometimes a new window will open with your text. Sometimes people compose in Word or something and cut-and-paste to post. Better luck next time,
>
> BobDr. Bob,
I have tried to compose in Word and then cut and paste to babble. I lost all of the Word formatting. What's the proper was to do this and retain the Word formatting?
Posted by KaraS on May 15, 2005, at 18:10:35
In reply to Re: hypertensive experiences? » Rich340, posted by Rich340 on May 15, 2005, at 6:55:20
> Its never as good the second time 'round, however here goes.
>
> Regarding your request re the MAOI which I take, it is Nardil.
>
> It is part of a cocktail of drugs for minimising the impact of Bipolar disorder 2 which has adversley impacted my professional career as a practicing international lawyer over the last 33 years.
>
> Availability of the drug itself is no problem in Australia: rather, it is the avaiability of Psychiatrists who will prescribe it that is the problem.
>
> My original psychopharmacologist insisted I try Nardil for some years. The list of unacceptable foods contained many of my favourites! In the end, my absences from work dictated I had no option. He compared Nardil and the other MAOI avilable in Australia, Parnate, to a tried and true 'cannon' as opposed to the slick 'rifle shot' weapons that the later generations of anti depressants comprise.
>
> Regarding the cocktail, just in case this may help someone- not necesarily the specifics, but the rewards for having gotten there: I have titrated the drugs comprising the cocktail, with the blessing of my current psych., to the point where I have reduced the Lithium and introduced carbamazepine. My present cocktail comprises the following:
> Morning-4 Nardils + 1/2 Carbamazepine(400mgCR)+1 20 mg Propanalol.
> Lunch- 2 nardils + 1 20mg Propanalol.
> Bedtime- 1 Carbamazepine (400mgCR) + 1 Lithium (250).
>
> Now hear this! I have for almost all of my life suffered a depressive episode 1 week in every four. Since I began the present regime, I have now completed 26 weeks in a row (or 6 months or half a year!) without a significant depressive episode (not more than one day of questionable mood).
>
> This has inevitably resulted in some cockiness on my part causing me to 'push the envelope' with foods,drinks, etc, ever so carefully. I thought I had the 'beast' under control. Hence the H.T.C. and my time in Hospital. Thankfully, no resultant depression , at all!
>
> My G.P. suggested Adalat (Nifedipine/ Procardia to you?) 3 x daily yesterday. Headaches have gone. Blood pressure has returned to normal, for me.One unforgettable lesson.
>
> Really value this support group in cyberspace.
>
> Hope some of this helps someone else, somehow.
>
> R.
Yes, that helps a lot. Thank you for all of that information. I'm glad to hear that you're getting better. It's so inspiring to hear about someone having such success. Finding the right combination of medications can be so difficult. Depression has taken up my entire adult life. I think it's probably time to try an MAOI. As for my friend in Australia, do you have any advice as to how he can go about finding a doctor to prescribe an MAOI? He doesn't have a lot of money so that makes it more difficult. Would you mind telling me what city you're in and what your doctor's name is? If you're not comfortable posting that here, could you e-mail me the information at k8samms@yahoo.com ?
Thanks so much.
Cheers,
Kara
Posted by Dr. Bob on May 15, 2005, at 21:39:58
In reply to Re: screwed up on submit process - Hey, Dr. Bob, posted by awatts on May 15, 2005, at 12:01:26
> I have tried to compose in Word and then cut and paste to babble. I lost all of the Word formatting. What's the proper was to do this and retain the Word formatting?
Sorry, no fancy formatting in posts...
Bob
Posted by Levi on June 14, 2005, at 19:57:17
In reply to Re: MAOIs and Painkillers, posted by jsarirose on November 14, 2002, at 16:23:42
I stumbled upon this site and read about your problem regarding MAOI's and your options of painkillers and I think I may have a solution.
I take parnate (30mg/day) and a few months back my doctor prescribed me a quasi-narcotic painkiller which worked fairly well. It's called Ultram(tramadol).I was taking around 200mg/day for a significant time period and experienced no adverse reactions at all.
BUT, I did, however, read that there is some risk of hypertensive problems but let me add that my brother takes Parnate and also was prescribed Ultram and he experienced no adverse effects either
-Levi
Posted by Psychopharmaca on October 3, 2005, at 18:39:36
In reply to Re: MAOIs and Painkillers » jsarirose, posted by Levi on June 14, 2005, at 19:57:17
Just be careful. Tramadol is one of the drugs known to react with MAOIs. Some people are able to tolerate such combinations, but those who are not run the risk of hypertensive crises and/or seizures.
Posted by shasling on October 8, 2005, at 9:55:39
In reply to MAOI diet short list, posted by Elizabeth on August 17, 2001, at 13:43:12
Any experience out there with tegretol/parnate interaction? Literature all screams DONT, but I've also heard it is overstated. Also, it doesn't say why not to - i.e., does it affect the level of tegretol as many things do, (which I can manage), or does it lead to hypertensive crisis?
Thanks!!
Posted by Rich340 on October 8, 2005, at 16:57:58
In reply to Re: MAOI and Tegretol?, posted by shasling on October 8, 2005, at 9:55:39
> Any experience out there with tegretol/parnate interaction? Literature all screams DONT, but I've also heard it is overstated. Also, it doesn't say why not to - i.e., does it affect the level of tegretol as many things do, (which I can manage), or does it lead to hypertensive crisis?
>
> Thanks!!
I take Nardil (6x15mg p.d.) with 1/2 400mg CR Tegretol in the morning and 1 400mg CR Tegretol at night.
The objective was to reduce the amount of Lithium I was taking (3)and replace most of it (I still take 1 250mg Li at night)with the Tegretol.
It has worked well for me. Certainly NO hypertensive crisis!
Posted by shasling on October 9, 2005, at 15:52:20
In reply to Re: MAOI and Tegretol?, posted by Rich340 on October 8, 2005, at 16:57:58
> > Any experience out there with tegretol/parnate interaction? Literature all screams DONT, but I've also heard it is overstated. Also, it doesn't say why not to - i.e., does it affect the level of tegretol as many things do, (which I can manage), or does it lead to hypertensive crisis?
> >
> > Thanks!!
> I take Nardil (6x15mg p.d.) with 1/2 400mg CR Tegretol in the morning and 1 400mg CR Tegretol at night.
> The objective was to reduce the amount of Lithium I was taking (3)and replace most of it (I still take 1 250mg Li at night)with the Tegretol.
> It has worked well for me. Certainly NO hypertensive crisis!
>
> Thanks for the info!
Posted by peridown on January 11, 2006, at 8:29:27
In reply to Re: MAOI and Tegretol?, posted by shasling on October 9, 2005, at 15:52:20
Hello all,
I hope I'm doing this right -- I'm a first timer and I just typed it all in and then lost it somehow!! So here I try again!!I'm about start an MAOI (parnate) and have been looking at the MAOI diet and am feeling rather confused (a fairly state of affairs for me!) While I don't want to go to extremes, I do tend to be very sensitive to side effects and have a history of bp problems (hypotension -- low blood pressure). Without inundating everyone, let me ask a specific question which I haven't seen anywhere and which will come up for me on a regular basis.
Every MAOI diet I've seen mentions fresh meat and fish. I live in an orthodox Jewish community where one doesn't buy or cook meat from sundown Friday until sundown Saturday. The following is the normal, or "good case" scenario, of the meat traveling for a Saturday (Sabbath) lunch:
Tue-Wed: arrives in store
Wed-Th: buy
Th-Fr: cook
Friday: place in crockpot overnight (slow cooker)
or
Saturday: place on hot plate (where it might sit several hours before eaten -- think Thanksgiving dinner every Saturday.)Can I eat this on a regular basis?? (I emailed my doctor and received a one word answer: yes. I am waiting for a reply to my request for further explanation/basis.)
This is all of course assuming the meat wasn't bought earlier and frozen, also fairly common, perhaps especially due to kosher meats more limited availability and higher expense. In fact, I have meat, chicken & fish in my freezer, including a $25 roast I'm planning to make for friends this weekend -- I just hope it's okay for me to also eat it! Speaking of which...
One more question: what's the safest way to defrost meat?
Thank you in advance for any help
confused
Posted by Kneeko on January 14, 2006, at 3:09:34
In reply to Re: MAOI diet short list, posted by peridown on January 11, 2006, at 8:29:27
K, just started the MAOI Nardil and must have your valued feedback on this.
Is it ok to eat foods containing Soybean oil or Partially hydronated Soybean oil? Fast food is good every once awhile, not everyday of course. Most of it contains one of these ingredients: Soybean oil, partially hydrogenated soybean oil, or processed American cheese(ex:french fries, burger, Big Mac and so forth). What is your opinion of them?
The list is right here: http://www.dietriot.com/fff/mcd/mcd.html#SANDWICH
If Nardil helps, giving these up will be no problem, but just wondering what Fast Food is Go and what isn't from the Major Chains. Obviously straight soy products and many cheeses are out. One additional question is whether Whey protein is ok! Thank you for your valuable input
Posted by musky on March 20, 2006, at 23:14:19
In reply to Re: Success with Marplan? » tansy, posted by ZeeZee on April 13, 2003, at 16:31:28
>just reading this old posting.. hmmm wonder if this is true as my experience with paxil was hell.
made me psychotic and wanting to get out of my body. extreme anxiety.. ended up in pyche ward .. never had any of these feelings ever!!
you say you feel great??? interesting .. wondering if you are just "high"... and you can honestly say you have NO side effects.. anyone ive ever talked to on this has had the same side effects as me and also sexual dysfunction.. now thats really scary...sorry, I dont support paxil.. maybe your body chemistry is different...
I always wonder what people will be like down the road from long term use of this drug... worries me
Thanks Tansy. I am now on Paxil and am doing fabulously!!!!! I feel GREAT!!! and am back to doing things and going places I previously feared (panic disorder and agoraphobia) In addition, I'm having absolutely NO side effects and enjoy the fact that I don't have to restrict my diet or medication. I'm so glad I stuck this one out, it's really paid off for me.
> Thanks anyway for your input and am glad you're doing well!
Posted by jkshrews on May 16, 2006, at 23:21:11
In reply to Re: hypertensive experiences?, posted by cybercafe on July 21, 2002, at 1:10:30
Eliminate Migraine Sideeffects And Misery (EMSAM)
That's my mnemonic phrase to help me remember the name of a new MAOI delivery system called EMSAM. It is a transdermal Selegiline (l-deprenyl) patch. When taken in smaller doses, this drug is specific to the brain MAO rather than the digestive MAO. When taken in larger doses (and the MAOI diet is then recommended), it probably is still safer due to the fact that it is delivered via the skin rather than the digestive system. By this method, the digestive system is not exposed to the high concentrations of the drug that occur with oral administration.
Posted by elanor roosevelt on June 2, 2006, at 8:40:26
In reply to Re: MAOI diet short list, posted by djmmm on January 15, 2002, at 23:04:54
Thank you all.
This has all been very helpful as far as parnate no-no foods. I still do not understand the extremes.
If someone puts a salad in front of me that has feta cheese tossed in -- do I just avoid the feta cheese or do I go without salad?
I am starting parnate in 5 days.
Stopped taking pseudophedrine for seasonal allergies and have to see my MD about options. Any suggestions?
Posted by kimcrazylady on June 2, 2006, at 9:59:32
In reply to Re: MAOI diet short list, posted by elanor roosevelt on June 2, 2006, at 8:40:26
> Thank you all.
> This has all been very helpful as far as parnate no-no foods. I still do not understand the extremes.
> If someone puts a salad in front of me that has feta cheese tossed in -- do I just avoid the feta cheese or do I go without salad?
> I am starting parnate in 5 days.
> Stopped taking pseudophedrine for seasonal allergies and have to see my MD about options. Any suggestions?Pick around the cheese. The diet it really not as complicated as it seems. I've been on and off Parnate for 20+ years and many of the 'forbidden' foods are fine in moderation. It all depends on how high/low the tyramine content is.
I can't remember the drug I take for my allergies but it's over the counter and works for 12 hours or more. Since mine are seasonal, I'll have to go look it up. I'll post again once I get the name.
Good luck and let us know how it goes.
Posted by jkshrews on June 2, 2006, at 10:50:59
In reply to Re: MAOI diet short list, posted by kimcrazylady on June 2, 2006, at 9:59:32
It's decongestants you have to avoid. Antihistamines should be OK. So, for example, you should be able to take Claritin, but not Claritin-D. But be sure to get your doctor's exact approval of anything you take, because this can be fatal. Also, the package usually has an MAOI warning in the very fine print if it is incompatible.
> > Thank you all.
> > This has all been very helpful as far as parnate no-no foods. I still do not understand the extremes.
> > If someone puts a salad in front of me that has feta cheese tossed in -- do I just avoid the feta cheese or do I go without salad?
> > I am starting parnate in 5 days.
> > Stopped taking pseudophedrine for seasonal allergies and have to see my MD about options. Any suggestions?
>
> Pick around the cheese. The diet it really not as complicated as it seems. I've been on and off Parnate for 20+ years and many of the 'forbidden' foods are fine in moderation. It all depends on how high/low the tyramine content is.
>
> I can't remember the drug I take for my allergies but it's over the counter and works for 12 hours or more. Since mine are seasonal, I'll have to go look it up. I'll post again once I get the name.
>
> Good luck and let us know how it goes.
Posted by Donna Louise on June 6, 2006, at 9:12:54
In reply to Endogenous (Chemistry) vs. Exogenous (Life Events), posted by Rick on January 24, 2002, at 19:19:43
During my perusal of old posts, and procrastinating on stuff I don't want to do, I came across this old editorial by Dr. kramer that I bet alot of you have already read. But I have a question about something he says. He talks about psychmeds effecting receptor sites and not transmitter levels and I see what he is saying there but he includes MAOI's as doing the same thing. I don't see that. I see the inhibition of the oxidation of the neurotransmitters as raising the amounts available without acting on the the receptor sites at all. Would someone please comment. Thanks.Donna
> I probably shouldn't reprint an entire editorial here (the one I printed a snippet of in another post), but it may add some historical perspective to the Burns discussion. (Although it does veer off in a different direction.)
>
> If I understand what folks are saying, Burns is suggesting that unipolar depression in general is what used to be called exogenous depression, i.e. caused by life events (vs. chemistry) and thus treatable only with talk.
>
> From
> Medscape Mental Health
> Medscape Psychopharmacology Today
> Endogenous Versus Exogenous: Still Not the Issue
>
> Thomas AM Kramer, MD
>
> [Medscape Mental Health 7(1), 2002. © 2002 Medscape, Inc.]
>
> Many readers may recall a time during the early 1980s when it was believed to be important to classify depression as either endogenous or exogenous. The idea was that there was a difference between depression precipitated by life events, called exogenous depression, and depression that was inherent to the patients' physiology, referred to as endogenous depression. The theory was that patients with exogenous depression did not respond to antidepressants -- ie, tricyclic antidepressants or monoamine oxidase inhibitors (MAOIs) -- because, presumably, their depression was not a function of their physiology but rather a reaction to their life situation. As such, they required treatment with some form of talking therapy. This theory, as it was promoted at the time, not only made the distinction between endogenous and exogenous depression based on symptoms (ie, did they or did they not have vegetative symptoms of depression), but also by assumed etiology. Thus, it was believed that depression precipitated by the loss of a loved one or any other grief-inducing event would not respond to antidepressants because it was exogenous, ie, not physiological.
>
> In retrospect, this rather dualist approach to depression seemed to imply that only some behaviors had anything to do with the chemistry of the brain, but other behaviors were somehow exempt. All of this thinking came, to a certain extent, from the discovery of monoamine neurotransmitters and their role in depression. Since antidepressants seemed to increase the amount of norepinephrine, serotonin, and perhaps dopamine by making more neurotransmitters seemingly available, it made sense at the time to understand depression as a deficit of these neurotransmitters. Ignoring the fact that the effect of these drugs on the neurotransmitters was virtually immediate, their effect on the patient took considerably longer. The assumption was that the depressed patients clearly needed more of something, and the neurotransmitters were the best candidate at the time. It was hard to believe, then, that life events could change fundamental biochemistry. We now are fairly certain -- armed with new knowledge from various studies about dietary manipulation, blood and CSF level monitoring, and other sophisticated methodology -- that the deficit model of neurotransmitters is considerably more simplistic than whatever the reality of the pathophysiology of depression is.
>
> Much more recently, we came up with a new application of the semantic distinction between endogenous and exogenous. In spite of the data that question the validity of a deficit paradigm, we continue to think of psychopharmacology as somehow having an effect on some sort of balance. One often hears patients parroting this idea by referring to themselves as having a chemical imbalance. As we strive to somehow rebalance that imbalance, we struggle to conceive of exactly what it is that is out of balance. Throughout most of the history of the treatment of depression, we have done this with reuptake blockers, which ostensibly increase the amount of neurotransmitter available to the outside of the neuron by blocking reuptake. These drugs, by the semantic distinction described above, would be exogenous, ie, they are not something that the body naturally produces but are ingested to achieve an impact on the balance of neurotransmitters.
>
> More recently, we have begun to get interested in the use of endogenous compounds, ie, hormones or other substances that are naturally produced by the body, in the treatment of depression. The idea is that if we administer substances that the body already has, but perhaps doesn't have enough of, this may treat the depression. Recent studies have shown that estrogen supplementation, growth hormone, and even secretin, which is used in the treatment of autism, may have beneficial effects in depressed patients. The idea here is once again to rebalance an imbalance by giving the actual substance that the body may be in deficit of. This brings about interesting discussions concerning the actual definition of a drug and whether it is somehow better or safer to give, as treatment, substances that are already found within the body.
>
> This kind of work can be misleading or deceiving. Virtually every medical disorder that results from having too little of a hormone has a companion disorder that is a result of too much of that same hormone. In addition, it is often impossible to deliver a naturally occurring neurotransmitter or hormone to its target in all cases.
>
> One intriguing example of this was the development of gabapentin. Gabapentin is a biologically derived compound that was developed with a very simple idea. Many of the drugs that we use to treat epilepsy are active in the gamma-aminobutyric acid (GABA) system. The idea was that if we could somehow give the patient GABA, instead of drugs that accentuate the GABA system, we would somehow have a better, purer response. There was only one problem with this idea: GABA does not cross the blood-brain barrier. All of the GABA that is in the brain was manufactured there. In order to give the brain a dose of GABA, you would either have to inject it directly into the brain, a procedure that most patients would object to if it were done on a regular basis, or modify the GABA molecule in some way that would maintain its action but allow it to cross the blood-brain barrier. That clever thing was done; a pentin ring was attached to GABA, and thus gabapentin was born. It works quite well, and everyone was happy until someone actually conducted studies of gabapentin receptor binding. What they discovered was that gabapentin had absolutely no interest in GABA receptors or any GABA circuitry, but seemed to be very interested in the glutamate system, where it turns out all of its actions take place. In other words, the drug's efficacy had nothing to do with the ideas behind its development. I have been told this story informally, and I have no idea if it is actually true, but it illustrates the point I am trying to make quite nicely.
>
> I propose a reframing of the paradigms that we use for psychopharmacology and its relationship to neurotransmitters. Neurotransmitters slosh around the body, and specifically inside the brain, in relatively constant amounts. The drugs that we give, even MAOIs, do not really affect the number of neurotransmitters in the body very much. What these drugs do is affect receptors. Instead of being concerned about the effect of norepinephrine and serotonin, we really need to redefine our concept of psychopharmacology as receptor drugs. Saying, for example, that selective serotonin reuptake inhibitors (SSRIs) treat depression by increasing serotonin is like saying that a boat sinking on the ocean needs to have reduced water levels. The water is there and all around. To fix the boat you need to plug the holes. That will be a great deal more effective than worrying about decreasing the overall amount of water in the system.
>
> SSRIs affect the serotonin transporters in cell membranes; they do not necessarily affect the overall level of serotonin. There is no deficit or surplus of serotonin; there are cells with impaired ability to have certain levels of serotonin on either side of their membranes. If serotonergic drugs really did affect serotonin overall, they would cause absolutely horrible GI side effects, since the gut has considerably more serotonin and serotonergic neurons than the brain has. This is also why different patients get better on different SSRIs. These agents may all block serotonin reuptake, but each is structurally distinct and thus may bind differently to serotonin transporters, depending on the patient. Similarly, dopamine blockers that are used to treat psychosis do not affect dopamine as much as they lower the sensitivity of certain cells to dopamine by blocking some of their receptors. This has no effect on the total volume of dopamine. It is even more likely that some drugs that appear to work by serotonin receptor blockade actually work by shunting the serotonin moving around from one receptor group to another. In other words, if a certain class of serotonin receptors is completely blocked, the serotonin has no choice but to bind to other receptors.
>
> For years we have struggled to attribute fluctuations in neurotransmitters to drugs' mechanisms of action. Once we begin to conceive of drugs as affecting receptors, things generally seem to make more sense. Even the hormonal treatments described above have their effects at the actual receptors on the cells. Newer exciting treatments, such as the use of corticotrophin-releasing factor antagonists to treat depression and anxiety, and the most recent work, involving the noncontroversial use of a controversial compound, RU486, for the treatment of depression, are aimed at antagonizing hormonal receptors. Why should we concern ourselves with receptors? Because of Willie Sutton's law. Sutton, the noted bank robber, when asked why he robbed all those banks, replied, "Because that's where the money is."
>
>
> Disclaimer
> The opinions expressed are those of Dr. Kramer and do not reflect those of the American Board of Psychiatry & Neurology or the Directors of the ABPN.
>
>
> --------------------------------------------------------------------------------
>
> Thomas AM Kramer, MD, is Clinical Associate Professor of Psychiatry, Northwestern University, Chicago and Deputy Executive Vice President of the American Board of Psychiatry and Neurology.
>
.
Posted by pulse on June 6, 2006, at 16:41:45
In reply to Re: Endogenous (Chemistry) vs. Exogenous (Life Events) » Rick, posted by Donna Louise on June 6, 2006, at 9:12:54
no, far as anything i've ever read or experienced, unipolar refers to chemical/ endogenous depression.
exogenous simply means depression coming from the outside, and is also know as reactive depression.
'they' say that both forms can be remitted by taking ADs, but also, for the best outcomes ADs + therapy, usually of the talk variety - one on one.
way back when i did enjoy kramers book 'listening to prozac.'
not at all sure that i would nowadays...pulse
Posted by elanor roosevelt on June 6, 2006, at 22:35:26
In reply to Re: MAOI diet short list, posted by elanor roosevelt on June 2, 2006, at 8:40:26
what is the story with coffee and colas
how do they react with the parnate?
i am starting tomorrow after a wekk of feeling okay off meds
high energy but volaltile
thought for once i wouldn't wait to crash and burn
my big concern is the anxiety that it won't work
i have been through so many meds
Posted by Donna Louise on June 7, 2006, at 6:07:15
In reply to Re: Endogenous (Chemistry) vs. Exogenous (Life Eve, posted by pulse on June 6, 2006, at 16:41:45
> no, far as anything i've ever read or experienced, unipolar refers to chemical/ endogenous depression.
>
> exogenous simply means depression coming from the outside, and is also know as reactive depression.
>
> 'they' say that both forms can be remitted by taking ADs, but also, for the best outcomes ADs + therapy, usually of the talk variety - one on one.
>
> way back when i did enjoy kramers book 'listening to prozac.'
> not at all sure that i would nowadays...
>
> pulse
>
Yes, I get all that, I just don't understand how he lumps MAOI's in with other AD's as effecting nerve terminals as mechanism for changing transmiter levels. I understand that an MAOI increased levels of neurotransmitters by inhibiting the enzyme that removes them. Not as the others do by either not allowing reuptake at the originating terminal or preventing or overactivating reception at the recieving terminal. It is not important what he says, I just wondered if anyone knew something about this that would shed some light on why he would say that. I should have just printed that paragraph, but maybe the whole thing has been helpful to others unfamiliar with the concepts. I never read listening to prozac. I was afraid of any book at the time that might tell me not to take it, I was so fragile about it, and did not know what it was about. Do you think it is worth a read? I don't know,.. if he is lumping MAOI's with other AD's in terms of how they work....Donna
Posted by Donna Louise on June 7, 2006, at 6:13:05
In reply to Re: MAOI diet short list, posted by elanor roosevelt on June 6, 2006, at 22:35:26
> what is the story with coffee and colas
> how do they react with the parnate?
> i am starting tomorrow after a wekk of feeling okay off meds
> high energy but volaltile
> thought for once i wouldn't wait to crash and burn
> my big concern is the anxiety that it won't work
> i have been through so many medsI understand that fear all too well..we gotta keep on trying though, maybe this on will be the one..
I am on the patch and I like the MAOI. I don't have to worry about diet this way but from what I have read, coffee and cola's are ok to drink. The only think is from what I hear, Parnate can be activiting and the caffeiene can exacerbate the activation. I can drink more or less coffee depending on what I am taking. With the patch, which is activating, my coffee intake has not changed. I guess you will have to see how much is too much for you on Parnate or if it even makes a difference. I wish you the very best of luck this time around. Let us know how you are doing.Donna
Posted by SFY on June 7, 2006, at 11:55:18
In reply to Re: Endogenous (Chemistry) vs. Exogenous (Life Eve, posted by pulse on June 6, 2006, at 16:41:45
> no, far as anything i've ever read or experienced, unipolar refers to chemical/ endogenous depression.
>
> exogenous simply means depression coming from the outside, and is also know as reactive depression.
>
> 'they' say that both forms can be remitted by taking ADs, but also, for the best outcomes ADs + therapy, usually of the talk variety - one on one.
>
> way back when i did enjoy kramers book 'listening to prozac.'
> not at all sure that i would nowadays...
>
> pulseThis isn't the Kramer who wrote "Listening to Prozac", that's Peter Kramer.
In my case, I'm more vulnerable to being affected by outside events but even absent any upsetting events I still carry my depression to one degree or another.
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