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Hi everyone. I’ve been dealing with unbearable symptoms for over 4 years. Insomnia, racing thoughts (OCD), derealization, irritability, brain fog and depression. 

I have tried so many medications, but none help. My insomnia and anxiety are through the roof and I have 24/7 derealization. Years ago, 2007, when I was struggling with depression, my psych talked about starting an MAOI, but we instead we added geodon to Zoloft and it worked (for awhile) 

Long  story short, I developed sudden onset ruminating thoughts (in form of OCD), insomnia and Anxiety  in 2009. After many trials of meds (I’m adverse and paradoxical to most) I finally was put on remeron which got me sleeping again and in turn helped my other symptoms. 

From 2010-October 2014 I did relatively well, that is until remeron stopped working and all my symptoms came back. 

Since I have been inpatient several times trying every sleeping med , bipolar med, SSRI etc with no relief. 

Mom wondering if an MAOI could help me? Can MAOI’s treat anxiety? Racy brain? I’ve read they can make insomnia worse, which I don’t need. 

Symptoms: severe insomnia, lucid dreams/nightmares, 24/7 derealization, severe anxiety and panic, major depression, brain fog, dizziness, migraines. 

I believe, like in 2009-2010, many of my symptoms are from sleep deprivation. I am very desperate to get control over my anxiety and sleep. I’m at the end of my rope. 

Could an MAOI help me as a last ditch effort to get some kind of quality of life back? 

Current meds: weaning off Zoloft, weaning off remeron, geodon 20 mg X2, Ativan 5 mg per day (please don’t jump down my throat about this, it will give me a panic attack. I know it’s a high dose and I need to taper this too), prazosin 2 mg. 

TIA

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Has ur doc brought it up again? I would say that it is at least worth a conversation...especially if depression is a really big issues. Yes they can help with the anxiety too...but you would have to come off of your ads for at least 14 days first. There are a couple options some more activating (parnate) some calming/sedating (Nardil) and others. Of course Ud need to follow the diet and some other restrictions, but if you really need relief bringing it up can't hurt. Just as an aside.... Have you tried any more antipsychotics? 

P.S. I was a Ativan 5 mg a day too and I was able to figure it out over time without many issues...don't panic about it, it'll be ok 

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On 1/14/2019 at 2:05 PM, Iceberg said:

Has ur doc brought it up again? I would say that it is at least worth a conversation...especially if depression is a really big issues. Yes they can help with the anxiety too...but you would have to come off of your ads for at least 14 days first. There are a couple options some more activating (parnate) some calming/sedating (Nardil) and others. Of course Ud need to follow the diet and some other restrictions, but if you really need relief bringing it up can't hurt. Just as an aside.... Have you tried any more antipsychotics? 

P.S. I was a Ativan 5 mg a day too and I was able to figure it out over time without many issues...don't panic about it, it'll be ok 

Thank you for your response♥️ I have tried SO many antipsychotics, but they make my symptoms so much worse. I have never tried an MAOI. 

The doctor has no brought up MAOI’s again. She has no idea what to do with me. She actually wants me to cold turkey everything for a “med vacation” she has no clue. I’m seeing a new doctor in March 

I am almost off Zoloft and remeron. I’m on about 2-3 mg Zoloft and about 4 mg remeron. Would I have to cold turkey these for at least 2 weeks? 

Depression is very bad, but anxiety, derealization and insomnia are killing me. 

Were you able to get off Ativan? 

Edited by Britton777

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19 minutes ago, Britton777 said:

Thank you for your response♥️ I have tried SO many antipsychotics, but they make my symptoms so much worse. I have never tried an MAOI. 

The doctor has no brought up MAOI’s again. She has no idea what to do with me. She actually wants me to cold turkey everything for a “med vacation” she has no clue. I’m seeing a new doctor in 2 weeks. 

I am almost off Zoloft and remeron. I’m on about 2-3 mg Zoloft and about 4 mg remeron. Would I have to cold turkey these for at least 2 weeks? 

Depression is very bad, but anxiety, derealization and insomnia are killing me. 

Were you able to get off Ativan? 

1) you'd need some sort of med vacation for MAOIs anyway, and I guess it couldn't hurt if nothing works- but glad ur getting another opinion...try to be as open minded as possible if they want to go in a new or unusual direction

2) u said u tried aps but have u tried the older typicals? They aren't meant for depression but can help ruminations and panic/anxiety...but not all doc's use them cuz of a more serious side effect profile. A commonly discussed one on this site is stelazine as well as loxapine and Thorazine sorry NVM THIS- FORGOT UR PREVIOUS THREAD!!

3) yep got off ativan. Switched to Valium and was able to work my way down on things 

Edited by Iceberg

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Britton..maybe your username is actually the answer, but are you in the US? EU?

Your choice of MAOI is quite a bit better if you're not in the US. Reversible MAOIs (RIMA), could be a consideration as there are less blood pressure, diet and cardiovascular concerns.

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56 minutes ago, Iceberg said:

1) you'd need some sort of med vacation for MAOIs anyway, and I guess it couldn't hurt if nothing works- but glad ur getting another opinion...try to be as open minded as possible if they want to go in a new or unusual direction

2) u said u tried aps but have u tried the older typicals? They aren't meant for depression but can help ruminations and panic/anxiety...but not all doc's use them cuz of a more serious side effect profile. A commonly discussed one on this site is stelazine as well as loxapine and Thorazine sorry NVM THIS- FORGOT UR PREVIOUS THREAD!!

3) yep got off ativan. Switched to Valium and was able to work my way down on things 

Ya, I tried Thorazine and another older antipsychotic, but not loxapine. Neither helped. 

Can MAOI’s help anxiety and panic too? Is it possible it could help insomnia even though that’s a major side effect? Can it help OCD ruminating thoughts? And songs looping in my head? 

17 minutes ago, argh said:

Britton..maybe your username is actually the answer, but are you in the US? EU?

Your choice of MAOI is quite a bit better if you're not in the US. Reversible MAOIs (RIMA), could be a consideration as there are less blood pressure, diet and cardiovascular concerns.

No, I’m in the US :( we don’t have RIMA in the US? 

Edited by Britton777

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Britton- yes I would think there's a possibility of helping but ur symptoms seem quite complicated so you'd have to get that opinion from your new doc. I think Nardil can be quite sedating but keep in mind that if the MAOIs somewhat works there are still some add on options although they are more limited 

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How long have you been on prazosin? I suffered derealization on a beta blocker. Maybe alpha blockers work similarly. 

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Yeah i'd agree with Iceberg, this is definitely doc territory. I'm remembering your other thread and your case is quite complex.

Curious if you went through all the typical APs already? I remember there was a 2nd one they gave you on that other thread, but don't remember if you ended up taking it or for how long.

In theory, an MAOI can help, though anxiety is said to be a possible side effect. Keep in mind however, just because it could, doesn't mean it will. Your issues as a whole is nothing but paradoxical side effects anyways.

Anecdotally...my dx is depression with anxiety. Wellbutrin is known to exacerbate anxiety. For me at least, I found wellbutrin to actually calm me down and improved my anxiety. Sample size of 1. Take that as you will.

If you could refresh our memory, 2010-2014 it was remeron, geodon and zoloft? Or remeron + something else entirely?

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37 minutes ago, Iceberg said:

Britton- yes I would think there's a possibility of helping but ur symptoms seem quite complicated so you'd have to get that opinion from your new doc. I think Nardil can be quite sedating but keep in mind that if the MAOIs somewhat works there are still some add on options although they are more limited 

Do you know if geodon and Ativan are ok with MAOI? I’m thinking Nardil from what I’ve read. It’s nice to hear that they can be sedating as insomnia is one of my biggest problems 

28 minutes ago, argh said:

Yeah i'd agree with Iceberg, this is definitely doc territory. I'm remembering your other thread and your case is quite complex.

Curious if you went through all the typical APs already? I remember there was a 2nd one they gave you on that other thread, but don't remember if you ended up taking it or for how long.

In theory, an MAOI can help, though anxiety is said to be a possible side effect. Keep in mind however, just because it could, doesn't mean it will. Your issues as a whole is nothing but paradoxical side effects anyways.

Anecdotally...my dx is depression with anxiety. Wellbutrin is known to exacerbate anxiety. For me at least, I found wellbutrin to actually calm me down and improved my anxiety. Sample size of 1. Take that as you will.

If you could refresh our memory, 2010-2014 it was remeron, geodon and zoloft? Or remeron + something else entirely?

It was Zoloft, remeron, geodon and Ativan. I’m almost off Zoloft and remeron since they weren’t helping at all. Still on 20 mg geodon X2 and Ativan. I also take prazosin for night terrors (doesn’t really help) 

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1 hour ago, cakepop said:

I have 24/7 derealization too for 3 years now. It’s my most bothersome symptom. I’m trying to find meds that work as well and so far, Clomipramine combined with Klonopin is what brings me relief from the derealization. 

I have been considering an MAOI as well.

I haven’t found anything to help the derealization:( 

what have you heard/read that has you thinking MOAI too? 

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8 minutes ago, Britton777 said:

Do you know if geodon and Ativan are ok with MAOI? I’m thinking Nardil from what I’ve read. It’s nice to hear that they can be sedating as insomnia is one of my biggest problems 

It was Zoloft, remeron, geodon and Ativan. I’m almost off Zoloft and remeron since they weren’t helping at all. Still on 20 mg geodon X2 and Ativan. I also take prazosin for night terrors (doesn’t really help) 

Every doc has their own level of caution regarding the MAOI interactions, but geodon does get flagged with Nardil. Like I said tho, doc's are different and can play with doses and stuff so there's not always a definitive answer

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Sounds like Nardil would be your best first go-to MAOI based on your symptomology.

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I know shit about shit for benzos..but I wonder..do benzos lose their effects over time? Either an AD like poop out or just tolerance? Maybe mikl can chime in.

Not jumping down your throat or anything, but I wonder if that was what really held you together back then.

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Just now, argh said:

I know shit about shit for benzos..but I wonder..do benzos lose their effects over time? Either an AD like poop out or just tolerance? Maybe mikl can chime in.

Not jumping down your throat or anything, but I wonder if that was what really held you together back then.

Honestly, I know it was the remeron they helped me as it got me sleeping again. It was after I started sleeping, but before I started reeping the benefits of sleep that I was put on Ativan. I would give my limbs to go back in time and not have started Ativan. 

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26 minutes ago, Britton777 said:

Honestly, I know it was the remeron they helped me as it got me sleeping again. It was after I started sleeping, but before I started reeping the benefits of sleep that I was put on Ativan. I would give my limbs to go back in time and not have started Ativan. 

One thing at a time tho you can't expect yourself to solve it all at once 

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50 minutes ago, Iceberg said:

One thing at a time tho you can't expect yourself to solve it all at once 

Thank you... so you thinks it’s possible Nardil could help me? Sorry, broken, worried, ocd record here. I’ve been reading up on it all day and it seems possible to me. I just don’t know. 

Edited by Britton777

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