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Mental Health Never used antidepressants, need advice

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I'll add that an SSRI doesn't make a lot of sense, to me, given they have the lowest success rate of any class (countered with the lowest adverse events) and the amount of time required to have any effect at all, means you'd spend a month to feel relief when you'd feel better in hours with a different medication. It's just my experience, but I think SSRIs don't really treat anxiety so much as they dampen all emotions.
Exactly! They turn you into an apathetic indifferent zombie...

Better: https://www.socialanxietysupport.co...dard-when-it-comes-to-depression-and-2148482/
 
I will point to this ranking here: https://slatestarcodex.com/2015/04/30/prescriptions-paradoxes-and-perversities/

These numbers are based on aggregated patient ratings. Top 4 drugs:
Nardil 1.25
Parnate 1.23
Chlomipramine 1.22
Emsam/selegeline 1.07

The top 3 drugs are pretty close to neck-and-neck, then there is a huge dropoff to the next tier of drugs (Emsam is also an MAOI, sorta, like an attempt to make a "diet" MAOI)
 
I will point to this ranking here: https://slatestarcodex.com/2015/04/30/prescriptions-paradoxes-and-perversities/

These numbers are based on aggregated patient ratings. Top 4 drugs:
Nardil 1.25
Parnate 1.23
Chlomipramine 1.22
Emsam/selegeline 1.07

The top 3 drugs are pretty close to neck-and-neck, then there is a huge dropoff to the next tier of drugs (Emsam is also an MAOI, sorta, like an attempt to make a "diet" MAOI)

What really bums me out about MAOIs is that RIMAs aren't available in the US. Moclobemide and Toloxatone would be my first choices if they were available.
 
Yeah. they're both available. But I'm not trying to mess with avoiding a tyramine induced hypertensive crisis.

Why do you believe RIMAs to be useless? I've done a sizable amount of research in various venues, and the picture i get is better efficacy than ssris, low side effect profile, and of course no dreaded "cheese effect".

The only maoi we have here that I'm considering is Emsam.
 
Yeah. they're both available. But I'm not trying to mess with avoiding a tyramine induced hypertensive crisis.

You can add Nortriptyline which inhibits tyramine uptake and thus lessens or abolishes the tyramine pressor response.

Don't let horror stories scare you...

Why do you believe RIMAs to be useless? I've done a sizable amount of research in various venues, and the picture i get is better efficacy than ssris, low side effect profile, and of course no dreaded "cheese effect".
There are some biased pharma-studies, but no reputable doctor in clinical practice found them useful...
 
For me moclobemide was a see-saw of daytime somnolence and night-time stimulation. I had to end treatment as I can't function for long without deep sleep.
 
You can add Nortriptyline which inhibits tyramine uptake and thus lessens or abolishes the tyramine pressor response.

Don't let horror stories scare you...


There are some biased pharma-studies, but no reputable doctor in clinical practice found them useful...

Horror stories aside, I don't want to cut out a bunch of foods from my diet, all of which I love, or worry every time i eat out. Food is one of few things i somewhat reliably enjoy.

I wouldn't entertain trying an MAOI and adding nortriptylene because I'm trying to take as few meds as possible, and my psychiatrist agrees that's the best approach for me as well. I'm very uncomfortable putting one drug in my body, much less two, lol.

As to the efficacy of RIMAs, there are biased pharma studies on every drug out there. As far as no reputable doctor finding them useful, it sounds like anecdotal evidence. If you can point me to a reliable resource that echoes your sentiment, I'd certainly be interested!
 
For me moclobemide was a see-saw of daytime somnolence and night-time stimulation. I had to end treatment as I can't function for long without deep sleep.

Interesting! I can see why you stopped, sounds awful. Did you vary the time of day you took it in an attempt to address the issue? Thanks for sharing your experience with that drug.
 
As to the efficacy of RIMAs, there are biased pharma studies on every drug out there. As far as no reputable doctor finding them useful, it sounds like anecdotal evidence. If you can point me to a reliable resource that echoes your sentiment, I'd certainly be interested!
This is common wisdom...
 
This is common wisdom...

While I'm familiar with common wisdom such as "buspirone(buspar) is a useless medication", and can verify that all over the internet, I can't do the same with your statement on RIMAs. If you can point me to ANY resources that back up this common wisdom, as you put it, that would be awesome. Otherwise it's just the opinion of one person.
 
^As is this whole thread, largely. Gonna close this. We might need a sticky: no recommending drugs, medication or otherwise.
 
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