Quote:

Moral of the story: don't be prejudiced or ashamed, go to a doctor and maybe it will improve your life. Better than doing nothing and continuing feeling the same eternal indifference. Worse case scenario you don't like it, and you try to find another option.

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Ped said:

It's not really precise to say that duloxetine (Cymbalta) is chemically similar to cocaine.  On a chemical level, they are not remotely similar.  On a pharmacological level, they have some overlap in terms of their mechanism, but the comparison remains apples to oranges.  One trait duloxetine has in common with cocaine and uncommon with other prescription antidepressants is its sodium channel blockade.  Be that as it may, this blockade is quite a bit more selective than that of cocaine.

SSRI/SNRI antidepressants are not the only antidepressants available, and in fact they aren't even the best antidepressants available.  In terms of therapeutic index, SSRI/SNRI medications are an inferior category of antidepressant, as they tend to cause more in the way of unpleasant or intolerable side effects than they do therapeutic gain.  Some people find tremendous relief and recovery in SSRI/SNRI medications, but this percentage is low. 

Tricyclic antidepressants, many of which behave as SSRI/SNRI medications in their own right (with some supplemental activity), tend to cause fewer, more tolerable side effects.  Somnolence, for example, is a more tolerable side effect than emotional flattening or sexual incapacitation.  Tricyclic antidepressants are much more likely to cause somnolence than they are emotional flattening or sexual incapacitation.

I personally take a tetracyclic antidepressant, mirtazapine.  It is, for me, orders of magnitude superior to any other antidepressant I've attempted, including the tricyclics, and including the SSRI/SNRI medications, which were by far the least effective and least tolerable of the lot.  Its primary side effects have been somnolence, increased appetite, and dry mouth. 

Within a few weeks, I will be attempting a 45 day course of tianeptine, at 12mg twice daily.  Tianeptine is an atypical tricyclic antidepressant which operates according to a completely different mechanism than conventional medications.  Unlike conventional medications, tianeptine may actually help to normalize or even reverse some of the persistent neurological aberrations involved in depressive pathologies.  This places it in a class unto itself, and I am greatly looking forward to the experiment.  I'll report on this when appropriate.

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tito123 said:

Have they helped you out at all?  Could you elaborate?

Did they hurt you?  Were the problems they caused permanent? 



I'm beginning to consider them.  Meditating for a few years, tons of healthy food, + just recently been doing pushups and situps.  Not a very active sex life.
I push myself out of my comfort zone and try socializing.  I just quit smoking.  I don't dwell on negative feelings. 




It's simply hard for me to experience pleasure, happiness, fear, or excitement.  Besides drugs, very very few things will cause those feelings.



Anhedonia is probably the diagnosis.  Nothing debilitating.  Just no enjoyment or satisfaction.

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Quote:

The propaganda Breggin offers here will be easily dismissed by the scientific and clinical professional communities as having nothing to add to the important issues related to understanding and managing ADHD. But to the lay reader, such misguidance as Breggin provides in Talking Back to Ritalin can do real harm. Breggin literally encourages parents of ADHD and developmentally disordered children to turn away from the established fields of pediatrics, psychiatry, and psychology and the professionals who practice within them. Instead, Breggin instructs parents to seek outdated, unscientific, and ineffective pop-psychological views of disorders and their treatment. What was so dismaying to me as a professional by the end of the book was the knowledge that Dr. Breggin took an oath as a physician to "first, do no harm." In my opinion, his book has violated that sacred oath.

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Quote:

The word "quack" derives from the archaic word "quacksalver", of Dutch origin (spelled kwakzalver in contemporary Dutch), literally meaning "hawker of salve". In the Middle Ages the word quack meant "shouting". The quacksalvers sold their wares on the market shouting in a loud voice.

An untrained person who pretends to be a physician and dispenses medical advice and treatment.'

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Quote:

Peter R. Breggin, MD, has been called "The Conscience of Psychiatry" for his many decades of successful efforts to reform the mental health field. His scientific and educational work has provided the foundation for modern criticism of psychiatric drugs and ECT, and leads the way in promoting more caring and effective therapies. He has authored dozens of scientific articles and more than twenty books including the bestseller Talking Back to Prozac (1994, with Ginger Breggin), Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime (2008), and Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families (2013). In 2010 he testified before Congress about psychiatric-drug induced violence and suicide in the military.

  Dr. Breggin acts as a medical expert in criminal, malpractice and product liability suits, often involving adverse drug effects such as suicide, violence, brain injury, death, and tardive dyskinesia. A review of Dr. Breggin's forensic work can be found at Legal Cases. He began testifying in the early 1970s and has been qualified in court 85 times or more since 1987.

Dr. Breggin is a Harvard-trained psychiatrist and former full-time consultant at NIMH. Dr. Breggin's private practice is in Ithaca, New York where he treats adults, couples, and families with children. He has a subspecialty in clinical psychopharmacology, including adverse drug effects and psychiatric drug withdrawal.

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Ped said:

The usefulness of MAOI antidepressants is at best unclear.  These medications target the serotonin hypothesis of depression, which believes that depression is largely or wholly mediated by serotonin.  We now know that serotonin is just one piece of a much larger puzzle.  MAO inhibition may have a role in the treatment of some depressive phenotypes, but its role in treating depression on the whole probably isn't very broad.

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Ped said:

While MAOIs to might be useful to some, they are not a solution to depression unto themselves.

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Ped said:

Generally speaking, I'm not a big fan of MAOIs, because the risk-benefit ratio usually isn't high enough.  MAO inhibition comes with a host of drug interactions and ancillary effects on metabolism, both of which present some significant dangers.  While MAO inhibition might be useful to many people, and while this shouldn't be discounted, I tend to feel that other treatment strategies are surely preferable, provided of course they are viable in their own right.

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The MAOI warnings I always hear about sound incredibly uninsightful to me. Even my old psychiatrist shook his head and said 'I've never seen it' when sspeaking of 'the cheese effect.' And before I even continue I'd like to point out that if one of those foods is consumed when on a beta-carboline, the beta-carboline will simply be kicked out of your system, allowing you to metabolize the offending stuff as normal. It is only with the so-called irreversible MAOIs where the effect of the MAOI cannot be reversed. Anyway, the restricted food are classified as follows:

Hypertensive crises with MAOIs have occurred in some patients following ingestion of foods containing large amounts of tyramine or tryptophan. In general, patients taking MAOIs should avoid protein foods that have undergone protein breakdown by aging, fermentation, pickling, smoking, or bacterial contamination.

Foye's Principles of Medicinal Chemistry, Seventh Edition. Thomas L. Lemke, Ph.D., David A. Williams, Ph.D., Victoria F. Roche, Ph.D., S. William Zito, Ph.D. 2013.


That's pretty narrow and many of those foods are expensive. The type of cheese used on pizza simply doesn't contain enough tyramine to present a problem. It is only aged cheese.


-Can I still get drunk on it and eat pepperoni pizza?
-Yes.
05-02-2014 - http://www.socialanxietysupport.com/forum/1072244025-post515.html


I drink beer on Nardil all the time. 4 is the most I've ever had and I've never once had a sneaking suspicion that I was putting myself in danger.
08-09-2008 - http://www.socialanxietysupport.com/forum/651105-post7.html

Most store bought beer is pasteurized, where the tyramine has decomposed. 'Raw' beer is an issue, however but once again that's an exotic thing. Some MAOI guides warn that beer on tap can be unpasteurized.


MAOI "diet" by psychiatrists - a joke?

A person in the above thread says that even when he did eat something he truly wasn't supposed to eat, all he got was a splitting headache.

It's very rare to have a hypertensive crisis while on MAOIs, but the danger is there and you can get one when you least expect it. Took me two years to find out how it felt like. I ate spoiled meat and it gave me a splitting headache, felt like my head was about to explode. Before that incident i had been eating everything and paid the diet no concern at all.

I still don't care about the diet, but gourmet cheese and spoiled food should be avoided at all costs.


This is a good read:

MAO Inhibtors: Risks, benefits, and lore. Wimbiscus, Molly MD; Olga Kostenk, MD; Donald Malone, MD. Cleveland Clinic Journal of Medicine. vol. 77, no. 12, Dec 2010

From the above article:




The first reference in this post (Cole) states that combining MAOIs with tricyclics has been determined to be safe.

We have found all antidepressants that do not involve significant serotonin reuptake inhibition (e.g., bupropion, trazodone, and tricyclics other than clomipramine) can be safely administered with MAOIs. Combination therapy is worth considering because it may be effective when other approaches have failed.


There are two people on SocialAnxietySupport.com who are combining MAOIS with amphetamines:

--
Im not taking Nardil but I'm taking 80mg Parnate. Recent studies show that if you're MAOI resistant stimulants can help. I'm taking 70 mg of Vyvanse and Ritalin (not Adderal). My blood pressure is normal and the MAOI started working. Some people go as high as 120mg with stimulants. Just watch your blood pressure. Of course the higher you go the dietary restrictions become more pertinent.

7/2/2014  MRDIGBY  http://www.socialanxietysupport.com/forum/1073591857-post542.html

NOTE: 120 mg is two times the APA maximum recommended dose and such a dose has received acknowledgement by professionals:

Jay Amsterdam at the University of Pennsylvania goes up as high as 120 mg of Parnate(tranylcypramine) and claims fewer side effects at higher doses.

This Month’s Expert: Jonathan Cole, M.D. Reflections on the Use of MAOIs | Psych Central Professional


Stimulant + MAOI journal
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As for Melatonin and Nardil being contraindicated, a lot of this stuff is just theoretical, I take 3mg evey night without problem. I have also taken LSD in large doses on Nardil without problem. They just make anything that effects the seritonin system contraindicated as a matter of course.

zendog78  04-13-2010  http://www.socialanxietysupport.com/forum/f30/the-greenhorns-guide-to-nardil-51461/#post1343284


Here's a report of soemone who took MDMA, MDA, and MDE in combination with oral DMT:

Jezebel. Fun, Plus 'Ghost People': An Experience with Ayahuasca, Mushrooms, MDMA, MDE, MDA, LSD, LSA, Blue Lotus, Cannabis, Alcohol, & Opium (ID 24742). Erowid.org. Jun 24, 2003. erowid.org/exp/24742


So, MAOIs don't sound that 'contraindicated' afterall. You also seem to be neglecting the fact that people aren't exactly so stupid that they wouldn't abide by relevant restrictions. Seems to me like a few restrictions on things you probably weren't going to ingest anyway is worth it if it's an effective medication...that seems to be the consensus on SocialAnxietySupport.com

Ped said:

They really aren't very similar.  The similarities essentially begin and end with indole.  All the substitutions and functional groups are different, not the least of which is the additional ring structure.

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Quote:

It's simply hard for me to experience pleasure, happiness, fear, or excitement.  Besides drugs, very very few things will cause those feelings. Anhedonia is probably the diagnosis.  Nothing debilitating.  Just no enjoyment or satisfaction.

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Ped said:

One of the reasons I don't post on Bluelight is because it would rapidly develop into a non-stop, 24-hour resistance against the unstoppable tide of silly conjecture and falsehood posted there.  Bluelight is loaded to the hilt with false and misleading information.

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tito123 said:

Quote:

Moral of the story: don't be prejudiced or ashamed, go to a doctor and maybe it will improve your life. Better than doing nothing and continuing feeling the same eternal indifference. Worse case scenario you don't like it, and you try to find another option.

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Worst case scenario, I'll end up like David Foster Wallace who found an anti-depressant that worked for him but eventually tried weening himself off due to the negative side effects, but then he became depressed and nothing worked.  And then he started taking his medicine again, but it didn't work and he killed himself.

Or I'll end up with some permanent "off-feeling" or something.  I'm a bit scared of these drugs.

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sucks. he was great.

zzripz said:

OMFG THEY are here. To OP, all I say is beware. They blind you with fancy lingo. it means precisely fk all

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you mean the people who know facts as opposed to slang fiction?