Nardil, Parnate questions

I would say generally not, or at least, no one has proven so. Some people argue that parnate/nardil
work better than SSRIs, but some people find the side effects much much worse.

I would say, that if you're happy with your SSRI (i.e. it treats you, and you can handle the side
effects), then don't change.

"ohberg" <[email hidden]> wrote in :"]news:[email hidden]:

Quoted message said:

Do these "older" anti-depressants ever work better than the newer SSRIs? Would appreciate hearing
from anyone with insight into this medication. I am thinking of switching from a SSRI, and want to
weigh the pros & cons.

In article <[email hidden]>,

ohberg said:

Do these "older" anti-depressants ever work better than the newer SSRIs? Would appreciate hearing
from anyone with insight into this medication. I am thinking of switching from a SSRI, and want to
weigh the pros & cons.

From what I have read: the tricyclics might be more effective, but also have more side-effects. The
even more troublesome MAOIs might even be generally more effective.

For example, I would personally avoid tricyclics, because of the difficulty (sometimes) in
restarting the heart.

John

ohberg said:

Do these "older" anti-depressants ever work better than the newer SSRIs? Would appreciate hearing
from anyone with insight into this medication. I am thinking of switching from a SSRI, and want to
weigh the pros & cons.

Despite all their well documented problems, these drugs have balls.

They increase the levels of all the transmitters that are metabolised about MAOs i.e. noradrenaline,
serotonin AND dopamine.

Sometimes a double barreled pharmacological shotgun works wonders.

--
Larry Brash

In article said:

Do these "older" anti-depressants ever work better than the newer SSRIs? Would appreciate hearing
from anyone with insight into this medication. I am thinking of switching from a SSRI, and want to
weigh the pros & cons.

This is rather like the argument elsewhere about Nefadozone.

These drugs are kept because some people respond to nothing else, but only as a last resort because
they are DANGEROUS and need careful monitoring.

These are called Mono-Amine Oxidase(A) Inhibitors. The (A) group of mono-amines includes
adrenaline, as well as noradrenaline and serotonin. But blocking oxidative disposal, you "cut the
brake line" that stops indefinite increase of adrenaline.

Woe betide you if you then take pro-adrenaline drugs, or even certain foods, because they will K I
L L -- very rapidly -- by runaway increase of blood pressure leading to a severe stroke.

On no account self-prescribe stuff which is sure to kill you if carelessly handled. Don't muck
around with high doses of deadly nightshade (atropine), henbane (hyoscene), or foxglove (digitalis)
for similar reasons.

-- .---. It was once believed that a million monkeys at a million { o o } keyboards would eventually
type the works of Shakespeare, _(---)_ but the Internet has since disproved this theory. / \

In article said:

ohberg said:

Do these "older" anti-depressants ever work better than the newer SSRIs? Would appreciate hearing
from anyone with insight into this medication. I am thinking of switching from a SSRI, and want
to weigh the pros & cons.

Despite all their well documented problems, these drugs have balls.

They increase the levels of all the transmitters that are metabolised about MAOs i.e.
noradrenaline, serotonin AND dopamine.

Not all of them have much effect on Mono-Amine Oxidase(B)
[i.e. on Dopamine]. Selegiline is better for this.

Quoted message said:

Sometimes a double barreled pharmacological shotgun works wonders.

Yes, but I wouldn't suggest messing with them outside professional supervision.

--

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
8====3 (O 0) GROETEN --- PRINTZ XEMU EXTRAWL no real OT has |n| (COMMANDER, FIFTH INVADER FORCE)
ever existed ................................................................. A society without a
religion is like a maniac without a chainsaw.

Dave Bird said:

Quoted message said:

Sometimes a double barreled pharmacological shotgun works wonders.

Yes, but I wouldn't suggest messing with them outside professional supervision.

Indeed, and it needs a psych who knows MAOI's. Most of my colleagues under 40 have no experience
using them. There are many traps for young players. Also, most of them don't have many clues about
tricyclics either. They, too, still have their role.

--
Larry Brash

In article said:

Dave Bird said:

Quoted message said:

Sometimes a double barreled pharmacological shotgun works wonders.

Yes, but I wouldn't suggest messing with them outside professional supervision.

Indeed, and it needs a psych who knows MAOI's. Most of my colleagues under 40 have no experience
using them. There are many traps for young players. Also, most of them don't have many clues about
tricyclics either. They, too, still have their role.

I agree. If SSRIs have bad high-serotonin effects e,g, the patient cannot bear being totally
anorgasmic, or worse things like intestinal bleeding, headache, etc, then the next recourse is
trucyclics. SSRIs are NO MORE EFFECTIVE THAN TRICYCLICS, but are better tolerated and have fewer
side-effects.

For reference, those side effects are usually one or more of: --(M1 block) dry mouth, dry stool
--(H1 block) slight drowsiness --(a1 block) light-headed when you stand up, blood pressure cannot
track up quickly. They are more irritating than distressing IMO.

Tricyclics described as 'secondary amine' or 'less sedating' have less affinity for these other
receptors e.g. use nortriptyline instead of amitryptaline.

--
Dave Bird, an official ARS HakeMonger ><_'> <_" (licensed to mung pelagic fish and clams of all
kinds upon the Internet) "If turbot be the food of hate, Lay on MacErrel and, by damn, Cry HADDOCK
and let loose the cods of war!" Wm Skatesfin

In article said:

Dave Bird said:

This is rather like the argument elsewhere about Nefadozone.

I know more people who respond to MAOI's than do to Nefadozone.

I'm not sure what nefadozone is good for :-) but I am sure it is good for something. In theory, I
suppose, someone who responds well to a serotonin drug but needs a stronger 5HT2-block than mere
SSRIs could give.

Quoted message said:

Quoted message said:

These drugs are kept because some people respond to nothing else, but only as a last resort
because they are DANGEROUS and need careful monitoring.

Very true. One the problems that I am encountering is the older person, well on MAOIs for years,
who is now getting medical problems that make the use of these drugs more tenuous, and inevitably
you have to stop them. I see a similar problem with lithium in the elderly whose renal function is
dropping.

Reducing renal function hits ability to tolerate a whole host of drugs, and does make life very
difficult.

Quoted message said:

Quoted message said:

These are called Mono-Amine Oxidase(A) Inhibitors. The (A) group of mono-amines includes
adrenaline, as well as noradrenaline and serotonin. But blocking oxidative disposal, you "cut
the brake line" that stops indefinite increase of adrenaline.

The older MAOIs destroy the A and B enzymes. Moclobemide, a reversible inhibitor of A, is safe, but
has placebo-level efficacy (IMHO).

I stand corrected.

Quoted message said:

Quoted message said:

Woe betide you if you then take pro-adrenaline drugs, or even certain foods, because they will K
I L L -- very rapidly -- by runaway increase of blood pressure leading to a severe stroke.

I have seen it first hand a few times over the years (more then 10 years since the last time).
Blood pressures reach spectacular levels, but deaths are rare.

Of interest, only a small proportion of people on MAOIs who break their diet actually experience
hypertensive crises. Most people get away with it, but I don't ever recommend tempting fate.

True. What the punters get told is "better safe than sorry" (it CAN happen, and the result CAN
kill, so don't risk it).

Quoted message said:

Quoted message said:

On no account self-prescribe stuff which is sure to kill you if carelessly handled. Don't muck
around with high doses of deadly nightshade (atropine), henbane (hyoscene), or foxglove
(digitalis) for similar reasons.

Cup of Datura tea, anyone?

A comparable situation is Clozapine. Nobody is going to ban clozapine as a last resort drug,
because it is too useful. It is safe enough if you have the hospital resources for careful
monitoring. Without that, about 1% die.

I've swallowed all sorts of things on my own resposibility, but not MAOIs or Clozapine. Not safe
without supervision.

Quoted message said:

--

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
8====3 (O 0) GROETEN --- PRINTZ XEMU EXTRAWL no real OT has |n| (COMMANDER, FIFTH INVADER FORCE)
ever existed ................................................................. A society without a
religion is like a maniac without a chainsaw.

Dave Bird said:

This is rather like the argument elsewhere about Nefadozone.

I know more people who respond to MAOI's than do to Nefadozone.

Quoted message said:

These drugs are kept because some people respond to nothing else, but only as a last resort
because they are DANGEROUS and need careful monitoring.

Very true. One the problems that I am encountering is the older person, well on MAOIs for years,
who is now getting medical problems that make the use of these drugs more tenuous, and inevitably
you have to stop them. I see a similar problem with lithium in the elderly whose renal function
is dropping.

Quoted message said:

These are called Mono-Amine Oxidase(A) Inhibitors. The (A) group of mono-amines includes
adrenaline, as well as noradrenaline and serotonin. But blocking oxidative disposal, you "cut the
brake line" that stops indefinite increase of adrenaline.

The older MAOIs destroy the A and B enzymes. Moclobemide, a reversible inhibitor of A, is safe, but
has placebo-level efficacy (IMHO).

Quoted message said:

Woe betide you if you then take pro-adrenaline drugs, or even certain foods, because they will K
I L L -- very rapidly -- by runaway increase of blood pressure leading to a severe stroke.

I have seen it first hand a few times over the years (more then 10 years since the last time). Blood
pressures reach spectacular levels, but deaths are rare.

Of interest, only a small proportion of people on MAOIs who break their diet actually experience
hypertensive crises. Most people get away with it, but I don't ever recommend tempting fate.

Quoted message said:

On no account self-prescribe stuff which is sure to kill you if carelessly handled. Don't muck
around with high doses of deadly nightshade (atropine), henbane (hyoscene), or foxglove
(digitalis) for similar reasons.

Cup of Datura tea, anyone?

--
Larry Brash