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Mental Health (Expert Forum)
Reboxetine or MAOI's?
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
Reboxetine or MAOI's?
by Lynn, Oct 26, 1999 12:00AM
I have been diagnosed with atypical depression, atypical manic depression, dysthymia and DDNOS. This has been going on for 8 years now. Kind of abnormal in the abnormal. :-( Basically I overeat, oversleep, little energy and motivation is lagging at this point. It has gotten worse over the years. At the beginning of this EEG,MRI,blood work etc was done and everything was normal. Thyroid levels are borderline but have never been prescribed meds for that. I am kind of disappointed in the mental health field because I do everything that is asked of me (I do question however) with little or no relief. I basically cannot remember what happened to me so therapy also lags behind.
However...I never give up hope. :-)
I am seeking out a new therapist who's spirituality is greater than mine and will not only work with my mind... but my body and spirit also. Seems like most of them in past have got caught up in the mind maze.
Plus will seek out a new psychiatrist also. This will make it my 4th psychiatrist in 8 years. I have been on about every class of drugs available when it comes to the treating of depression and its cousins. Lots of combinations also.
Question is..I have been on MAOI(Both Parnate and Nardil) and seemed to be working when I developed severe hypotension. I asked doc to give me something to raise the BP and he refused to do so. That was 5 years ago and I knew it was a possible to do from reading. Yet he did not think it would be safe due to his lack of knowledge on the subject more than what I would do with medications being taken wrong. I am very responsible when it comes to meds.
Today I am really not looking forward to the diet restrictions of an MAOI and was wondering if it would be better to try the Reboxetine first before trying the MAOI again with treatment of hypotension if needed. I know I can obtain Reboxetine from overseas with a prescription until it becomes available in USA. I have done this with Aurorix in past (which did not help my depression) I guess it is a toss up. I just hate to go on a MAOI if Reboxetine might work. I don't know that Reboxetine will be a strong enough drug. Comments welcome.
However...I never give up hope. :-)
I am seeking out a new therapist who's spirituality is greater than mine and will not only work with my mind... but my body and spirit also. Seems like most of them in past have got caught up in the mind maze.
Plus will seek out a new psychiatrist also. This will make it my 4th psychiatrist in 8 years. I have been on about every class of drugs available when it comes to the treating of depression and its cousins. Lots of combinations also.
Question is..I have been on MAOI(Both Parnate and Nardil) and seemed to be working when I developed severe hypotension. I asked doc to give me something to raise the BP and he refused to do so. That was 5 years ago and I knew it was a possible to do from reading. Yet he did not think it would be safe due to his lack of knowledge on the subject more than what I would do with medications being taken wrong. I am very responsible when it comes to meds.
Today I am really not looking forward to the diet restrictions of an MAOI and was wondering if it would be better to try the Reboxetine first before trying the MAOI again with treatment of hypotension if needed. I know I can obtain Reboxetine from overseas with a prescription until it becomes available in USA. I have done this with Aurorix in past (which did not help my depression) I guess it is a toss up. I just hate to go on a MAOI if Reboxetine might work. I don't know that Reboxetine will be a strong enough drug. Comments welcome.
Doctor's Answer
by HFHS.MD-AJ, Oct 31, 1999 12:00AM
Lynn,
I can understand your concern and frustration that your depression has not responded to treatment thus far. However, it is good to note that you remain optimistic. Atypical depression is characterized by over-eating/over-sleeping, and often responds to treatment with MAOI's. You state that MAOI's were helpful but caused hypotension. Hypotension associated with MAOI's may respond to increased salt intake, hydration, support stockings, and taking the medication in divided daily doses. There are studies which suggest that best treatment results are obtained with a combination of medications and cognitive-behavioral/interpersonal therapy.
Consideration should also be given to treatment with Electroconvulsive therapy (ECT), which is a often a safe and effective treatment for medication-resistant depression. Reboxetine is an antidepressant that is not approved by the Food & Drug Administration (FDA). It would be unethical for any physician in the U.S. to encourage the prescription and/or use of medications that are not approved by the FDA.
I can understand your concern and frustration that your depression has not responded to treatment thus far. However, it is good to note that you remain optimistic. Atypical depression is characterized by over-eating/over-sleeping, and often responds to treatment with MAOI's. You state that MAOI's were helpful but caused hypotension. Hypotension associated with MAOI's may respond to increased salt intake, hydration, support stockings, and taking the medication in divided daily doses. There are studies which suggest that best treatment results are obtained with a combination of medications and cognitive-behavioral/interpersonal therapy.
Consideration should also be given to treatment with Electroconvulsive therapy (ECT), which is a often a safe and effective treatment for medication-resistant depression. Reboxetine is an antidepressant that is not approved by the Food & Drug Administration (FDA). It would be unethical for any physician in the U.S. to encourage the prescription and/or use of medications that are not approved by the FDA.
