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Attempting med washout after decades of crazymeds.. So DONE... with SSRIs, SNRIs, tricyclics, A/Ps, mood stabilizers, been cycling through 2nd & 3rd trials of same damn meds I've already tried... Ritalin officially pooped out on me and I can't get out of bed in the morning.

They helped with affective symptoms of depression, but at what cost?  I've been (barely) existing in this anhedonic blah wasteland for YEARS. I want to just rip off the band-aid... I'm stable, but can't continue like this..

I feel drained 24/7, doesn't matter what activity. I lack pleasure/motivation/drive to do anything but lay around staring at the wall. My cognition is mush, memory poor, I can't multitask.... I cannot do anything productive (work/maintain job), engage in leisure stuff (sex, read books, enjoy music, socialize) or creative tasks... It all makes me TIRED...

Is this my baseline?  I'm afraid my brain is permanently disabled from longterm psych meds..  Blood tests, checkups indicate I'm in perfect health.

I expect to have sh&tty withdrawals for awhile, but once dust settles - if I do go back on any psych med I want to try an MAOI... I know they are old school (with diet restrictions) but I've read they're proven 100x more effective than SSRIs & SNRIs (particularly for anhedonia, they hit dopamine + serotonin + epinephrine)

 Can anyone shed light as to WHY no one here mentions/or is taking MAOIs?  Pdoc said there aren't many being produced bc they are considered "old" and never prescribed? I've heard loads of testimonials that the no-Tyramine diet is really NO BIG DEAL... So I skip red wine (gives me awful migraines) and stinky old goat cheese (hate it anyway!)

Any feedback/ thoughts?  I just want to function like a normal human being!

Many say Parnate is the only thing that helped lifelong, suicidal depression (after taking all other meds & ECT...) https://www.drugs.com/comments/tranylcypromine/parnate-for-depression.html?sort_reviews=most_helpful

 

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5 hours ago, Blahblah said:

Attempting med washout after decades of crazymeds.. So DONE... with SSRIs, SNRIs, tricyclics, A/Ps, mood stabilizers, been cycling through 2nd & 3rd trials of same damn meds I've already tried... Ritalin officially pooped out on me and I can't get out of bed in the morning.

They helped with affective symptoms of depression, but at what cost?  I've been (barely) existing in this anhedonic blah wasteland for YEARS. I want to just rip off the band-aid... I'm stable, but can't continue like this..

I feel drained 24/7, doesn't matter what activity. I lack pleasure/motivation/drive to do anything but lay around staring at the wall. My cognition is mush, memory poor, I can't multitask.... I cannot do anything productive (work/maintain job), engage in leisure stuff (sex, read books, enjoy music, socialize) or creative tasks... It all makes me TIRED...

Is this my baseline?  I'm afraid my brain is permanently disabled from longterm psych meds..  Blood tests, checkups indicate I'm in perfect health.

I expect to have sh&tty withdrawals for awhile, but once dust settles - if I do go back on any psych med I want to try an MAOI... I know they are old school (with diet restrictions) but I've read they're proven 100x more effective than SSRIs & SNRIs (particularly for anhedonia, they hit dopamine + serotonin + epinephrine)

 Can anyone shed light as to WHY no one here mentions/or is taking MAOIs?  Pdoc said there aren't many being produced bc they are considered "old" and never prescribed? I've heard loads of testimonials that the no-Tyramine diet is really NO BIG DEAL... So I skip red wine (gives me awful migraines) and stinky old goat cheese (hate it anyway!)

Any feedback/ thoughts?  I just want to function like a normal human being!

Many say Parnate is the only thing that helped lifelong, suicidal depression (after taking all other meds & ECT...) https://www.drugs.com/comments/tranylcypromine/parnate-for-depression.html?sort_reviews=most_helpful

 

Honestly I think it’s partially a pdoc thing. I had a pdoc once who was comfortable enough to just suggest one to me after ECT unprompted. I think there are some that are totally fine with it, and some that are uncomfortable with “old” meds in general. Two of my pdocs weren’t even that old, but had experience in settings (one with long term schizo ward and one in a jail ward) that required them to use the older/cheaper stuff… and I was only like 17 or 18 when it first came up. I think it’s kind of like clozaril. My first pdoc said it wasn’t even on the table, so I got scared because it’s all talked up for being dangerous, but if it’s managed well and you get into a routine it can really be not a big deal. 
 

idk about them not being produced but i feel like if you have a pharmacy you go to regularly they would be able to get it on monthly (or whatever) order for you once you jumped the hoops for the first fill 

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18 hours ago, Blahblah said:

Any feedback/ thoughts?  I just want to function like a normal human being!

 

Like @Iceberg said, I think it does partially depend on the pdoc,  and how comfortable they are with prescribing MAOIs.....

That being said, none of my pdocs (young or old) have ever suggested an MAOI for my treatment-resistant depression.

There's no harm in asking your pdoc about trying an MAOI....But it's impossible to predict what their reaction might be.

Edited by CrazyRedhead
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@Blahblah off the cuff here but two other fringe ideas. 1 is cytomel (T3) which has been studied in BP depression for those who don’t tolerate ADs. Didn’t help me much but I think it’s pretty safe if you don’t have a screwy thyroid. The other are dopamine agonists often used for Parkinson’s and restless legs. Like ropinirol and pramipexole This is pretty out there but I know a few people on here have trialed it, and I think one said it’s been the best med for anhedonia. Idk if pdoc would go off the trail like that if they won’t do MAOIs but just a mention 

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4 hours ago, CrazyRedhead said:

Like @Iceberg said, I think it does partially depend on the pdoc,  and how comfortable they are with prescribing MAOIs.....

That being said, none of my pdocs (young or old) have ever suggested an MAOI for my treatment-resistant depression.

There's no harm in asking your pdoc about trying an MAOI....But it's impossible to predict what their reaction might be.

Have you ever wanted to try an MAOI? or have the other meds or combos usually done the trick? My pdoc isn't opposed to me maybe trying it, they just said that here, it is usually only prescribed for patients in the hospital and just seen as "inferior" for some reason.

But if the other med classes aren't really helping symptoms, I don't get it. He also said that MAOIs are not as widely produced (because more of the newer meds have replaced them)

 

3 hours ago, Iceberg said:

@Blahblah off the cuff here but two other fringe ideas. 1 is cytomel (T3) which has been studied in BP depression for those who don’t tolerate ADs. Didn’t help me much but I think it’s pretty safe if you don’t have a screwy thyroid. The other are dopamine agonists often used for Parkinson’s and restless legs. Like ropinirol and pramipexole This is pretty out there but I know a few people on here have trialed it, and I think one said it’s been the best med for anhedonia. Idk if pdoc would go off the trail like that if they won’t do MAOIs but just a mention 

I've tried Cytomel and Levothyroxine (both did nothing). And No way would my psych prescribe a med for a non-psych condition (like Parkinsons)

I've tolerated A/Ds, but my issue is that they all cause anhedonia longterm and now that Ritalin pooped out, that was the only med that noticeably helped my main symptoms.... A/Ds treat anxiety/ dysphoria / emotional lability,  which i no longer have.... but I need something to treat this lack of motivation/interest/apathy symptom. They do not prescribe Adderall or other stims here, or Vyvanse, so those are definitely off the table.

I feel like an MAOI is the only viable & different option to try...They have a completely different mechanism of action from all the inhibitors..

I really don't get why no one takes MAOIs... I've heard the diet is really not difficult, there are certain foods/ meds that are no-nos, but a lot of the foods are just "restricted" (meaning you don't want to eat them every other day or anything) usually for most types of "danger" foods (like cheeses) there are a bunch that pose no problem...

 

 

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31 minutes ago, Blahblah said:

Have you ever wanted to try an MAOI? or have the other meds or combos usually done the trick? My pdoc isn't opposed to me maybe trying it, they just said that here, it is usually only prescribed for patients in the hospital and just seen as "inferior" for some reason. But if the other med classes aren't really helping, I don't get it. He also said that MAOIs are not as widely produced (because more of the newer meds have replaced them)

My current meds bring no real relief at all....Pdoc wants me to stay on them, because they could be keeping me from suicide, but that's about it......**SIGH**

I can no longer work, have no motivation to do anything, and I'm a hermit most of time, because I can't leave my house, except when roommate takes me to a doc appt.....I can no longer drive or go to grocery store, so grocery shopping is done by roommate....i can no longer cook or clean either, so roommate does that, too.

Didn't mean to sidetrack by telling my story, but yes, I have actually mentioned trying an MAOI to a few of my docs.......They all said MAOIs are very risky, one doctor said they're too dangerous, one doctor said, we don't prescribe them here, etc.......Just my personal experience.

Edited by CrazyRedhead
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Being cynical it's big pharma being unable to make money off of them. All I can say is go read the MAOI guru (according to smarter people than I) himself at https://psychotropical.com/ . He has done so much work on MAOI's and is very, very blunt about their efficacy, why they're not more prevalent and so on. 

Personally I've been on Nardil 3 times and Parnate once. Only once did they help (and yes, I got up to way past therapeutic dose for way longer than necessary each time) and that was when I took Nardil with Adderall. However I am extremely, extremely treatment-resistant as you know @Blahblah .

I hope this helps and good to hear from you too.

Pete

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  • 2 weeks later...
On 3/25/2022 at 9:46 PM, CrazyRedhead said:

My current meds bring no real relief at all....Pdoc wants me to stay on them, because they could be keeping me from suicide, but that's about it......**SIGH**

I can no longer work, have no motivation to do anything, and I'm a hermit most of time, because I can't leave my house, except when roommate takes me to a doc appt.....I can no longer drive or go to grocery store, so grocery shopping is done by roommate....i can no longer cook or clean either, so roommate does that, too.

Didn't mean to sidetrack by telling my story, but yes, I have actually mentioned trying an MAOI to a few of my docs.......They all said MAOIs are very risky, one doctor said they're too dangerous, one doctor said, we don't prescribe them here, etc.......Just my personal experience.

@CrazyRedhead I'm sorry to hear they aren't providing relief. 😞  I'm in nearly the exact same boat - I can't sustain a real job, no motivation to do anything, exhausted all the time, and since Covid i've been a complete hermit. I still force myself to go out for small errands, grocery shop, clean...the necessities, but that's it. It's not "living" But I guess since I'm not leaping off the edge of a building, pdoc doesn't offer up any new suggestions, tried most everything anyway!

She is open to MAOIs (as I've tried everything)...but they are usually only given to patients in-patient via hospital prescription 😞 So I fear that even if my pdoc is OK prescribing it, since she is not associated with a hospital I will need to jump through a bunch of hoops to get it approved!

 

On 3/26/2022 at 4:01 PM, sming said:

Being cynical it's big pharma being unable to make money off of them. All I can say is go read the MAOI guru (according to smarter people than I) himself at https://psychotropical.com/ . He has done so much work on MAOI's and is very, very blunt about their efficacy, why they're not more prevalent and so on. 

Personally I've been on Nardil 3 times and Parnate once. Only once did they help (and yes, I got up to way past therapeutic dose for way longer than necessary each time) and that was when I took Nardil with Adderall. However I am extremely, extremely treatment-resistant as you know @Blahblah .

I hope this helps and good to hear from you too.

Pete

@sming 

Yeah actually I became a bit more interested in MAOIs after reading that guys website.... and then saw loads of testimonials that the "awful" food interactions are totally exaggerated, majority of people do not have a problem.

Did either Nardil or Parnate make you tired? Or cause weight gain? did you have any noticeable/intolerable side effects?  I heard that Parnate is usually more activating. Anyway...we'll see how desperate I get.

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20 hours ago, Blahblah said:

@CrazyRedhead I'm sorry to hear they aren't providing relief. 😞  I'm in nearly the exact same boat - I can't sustain a real job, no motivation to do anything, exhausted all the time, and since Covid i've been a complete hermit. I still force myself to go out for small errands, grocery shop, clean...the necessities, but that's it. It's not "living" But I guess since I'm not leaping off the edge of a building, pdoc doesn't offer up any new suggestions, tried most everything anyway!

She is open to MAOIs (as I've tried everything)...but they are usually only given to patients in-patient via hospital prescription 😞 So I fear that even if my pdoc is OK prescribing it, since she is not associated with a hospital I will need to jump through a bunch of hoops to get it approved!

 

@sming 

Yeah actually I became a bit more interested in MAOIs after reading that guys website.... and then saw loads of testimonials that the "awful" food interactions are totally exaggerated, majority of people do not have a problem.

Did either Nardil or Parnate make you tired? Or cause weight gain? did you have any noticeable/intolerable side effects?  I heard that Parnate is usually more activating. Anyway...we'll see how desperate I get.

Yes. Nardil made me tired and had significant weight gain, about 40lb. I also got Orthostatic hypotension really badly. I'd nearly faint going up merely 1 flight of stairs. 

Parnate just didn't work out for me at all but yes that's what I've read. 

I'd give them a go ASAP. What do you have to lose? Are you happy with how things are right now? No! 🙂

Pete

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Thanks for the support @sming & @CrazyRedhead  Every time I try a new strategy (psychologically or health-wise) or build my hopes up, I am crushed when it fails. Nothing helps long term (not without enduring negative side effects that outweigh benefit, eventually, and having to stop....) Failed efforts just trigger suicidal ideation, like why bother trying?  Fighting it like this just makes me stressed, anxious & feeling worse...but laying down & "accepting it" doesn't help much either!

Reality is, I will always have major depression, no matter what I do, where I go/ live/ work, who I am with.... I will never be able to sustain my dream of psychological "wellness."  I've been living so long like this, it's all I know... I've become such a hermit I don't speak to anyone. I feel toxic... I am literally terrified about getting older or having to manage this for the rest of my life, burdening others.....

@sming yikes the weight gain is really discouraging (at least I am thin & not overweight, just about the only thing I've got going for me!) Next time I check in with pdoc I'll continue to ask about Parnate. (I've heard it's often less sedating than Nardil & always causes insomnia).. but worse comes to worse, I just go off it....

 

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1 hour ago, Blahblah said:

Thanks for the support @sming & @CrazyRedhead  Every time I try a new strategy (psychologically or health-wise) or build my hopes up, I am crushed when it fails. Nothing helps long term (not without enduring negative side effects that outweigh benefit, eventually, and having to stop....) Failed efforts just trigger suicidal ideation, like why bother trying?  Fighting it like this just makes me stressed, anxious & feeling worse...but laying down & "accepting it" doesn't help much either!

Reality is, I will always have major depression, no matter what I do, where I go/ live/ work, who I am with.... I will never be able to sustain my dream of psychological "wellness."  I've been living so long like this, it's all I know... I've become such a hermit I don't speak to anyone. I feel toxic... I am literally terrified about getting older or having to manage this for the rest of my life, burdening others.....

@sming yikes the weight gain is really discouraging (at least I am thin & not overweight, just about the only thing I've got going for me!) Next time I check in with pdoc I'll continue to ask about Parnate. (I've heard it's often less sedating than Nardil & always causes insomnia).. but worse comes to worse, I just go off it....

 

As I've mentioned before @Blahblah, you are one of the few people I've met, ever, who truly experiences what I experience. Everything,**everything** fails. Always. 

However if you've not tried MAOI's, you can't honestly say to yourself that you've tried everything, right? I implore you to try them. So what if it gives you insomnia! Take Ambien! Take Trazodone! Be exhausted and much less depressed! Potentially...

have you done ECT and TMS yet? I can't remember. What about VNS or DBS? You have to give those a go, surely. 

Should VNS fail for me, which I'm sure it will, I am clocking out. Well, I plan to at any rate. I can't tolerate this any more. 

sorry, this was a weird message. Feel free to disregard. 

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  • 4 weeks later...
On 4/9/2022 at 5:14 AM, sming said:

As I've mentioned before @Blahblah, you are one of the few people I've met, ever, who truly experiences what I experience. Everything,**everything** fails. Always. 

However if you've not tried MAOI's, you can't honestly say to yourself that you've tried everything, right? I implore you to try them. So what if it gives you insomnia! Take Ambien! Take Trazodone! Be exhausted and much less depressed! Potentially...

have you done ECT and TMS yet? I can't remember. What about VNS or DBS? You have to give those a go, surely. 

Should VNS fail for me, which I'm sure it will, I am clocking out. Well, I plan to at any rate. I can't tolerate this any more. 

sorry, this was a weird message. Feel free to disregard. 

Hi there! I was scanning through the depression forums, I come here kind of sporadically but the "everything fails" caught my eye so I thought I'd just say hi! Everything fails for me too.

My signature isn't fully updated, but I finally made a spreadsheet of all the meds, etc. that I've tried and I think it's about 40+ now? 

Most meds I take do absolutely nothing, no side effects, nothing. I've done every psych med that made sense to try, all kinds of off label stuff, all forms of ketamine, TMS, psilocybin (microdosing; considering giving a macro dose a go)... all did absolutely nothing.

I don't have any answers on the MAOIs actually, just thought I'd throw in a hello from another treatment-resistant sad sack. CHeers!

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  • 1 month later...

I have tried most ADs two, maybe three times, save some of the newer ones, which I have only tried once. A few of the older ones I have tried four times, or even more. The only ADs I haven’t tried are Pristiq, Luvox, and maybe Zoloft (I honestly forget). But my pdoc said the likelihood of any of those helping me is essentially less than zero, based on my past experience, so don’t bother. BUT there is one major exception: all of the MAOIs. I refuse to take them for a variety of reasons, but primarily because of the dietary limitations.
 

As someone who loves food, and who, when depressed, can often ONLY get any minor joy in life from from food in such a time, there is no way in hell that I’m gonna take an AD that removes that one joy from my life. It’s not worth it. Of course, I also sincerely doubt they will work. I know a few peeps who have had success with them, and suggested that the dietary stuff isn’t so awful. But then again, I’m a foodie with a global palate who has a particularly special affinity for East and Southeast Asian cuisines, which are particularly problematic for MAOIs. That said, if the depression was so overpowering, idk. But then my pdoc rates my post-crash anhedonialand depression as severe, whereas I only rate it moderate at most. (dips here and there into hell notwithstanding).

Edited by Goofball
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