Mental Health Monoamine Oxidase Inhibitors (MAOI's)

[Jktm]

Hey all. For background information (and I'll try to make this brief). I'm a longtime sufferer of severe major depression, ADHD, OCD, and severe anxiety. I've also got a host of GI problems, endocrine problems, and chronic pain, so let's just say I'm on a first name basis with my pharmacist. As far as my medications go, I'm prescribed:

alprazolam (anxiety) - 6mg/day
temazepam (insomnia) - 30mg/day
hydrocodone (pain) - 30mg/day
tizanidine (muscle pain/spasms) - 8mg/day
amitriptyline (depression/nerve pain) - 100mg/day
ondansetron (nausea) - 24mg/day PRN
promethazine (nausea) - 75mg/day PRN
hyoscyamine (stomach spasms) - .375mg/day
and dexlansoprazole (GERD) - 60mg/day.

I will soon also be on testosterone replacement therapy. The reason I mention this is I know that a hormonal imbalance such as low testosterone can have dramatic effects on one's affect, so I don't know if I should speak with my psychiatrist about making changes in the depression department before I get in to see my endocrinologist or see how that pans out.

Just the past week or so my depression has been a lot worse than normal. I'm having suicidal ideation again, I'm engaging in old-habits that can and will compromise my current treatment, and I'm in a constant state of melancholic apathy. I've dirtied my piss by smoking weed a couple times (which makes me nervous these days, I don't even know why I try anymore), I've been using methamphetamine intravenously (which makes me anxious, paranoid (usually), and in the end exponentially more depressed), and some other things I'd rather not mention here.

I don't know why I do this shit. I start to climb out of the grave I've dug for myself just to cease progress and start burying myself again. It's like I just get into such a strong state of apathy long enough to start fucking up again, and then lament over it. I really don't want to come off of the amitriptyline, because it helps quite a bit with my nerve pain. I can't supplement with a new-generation SSRI/SNRI, as they have paradoxical effects on me as far as depression and anxiety go.

I don't know, however, if it would be safe for me to start an MAOI. I've avoided these like the plague sense I started seeking pharmaceutical tools to help with depression, but I feel like it's the only option I have left. If anyone has any suggestions or anecdotal reports of experiences with MAOI's, they would be greatly appreciated.

 

[red22]

I tried Nardil and I was unimpressed with it. Initially it gave me a numbness/mania (not too bad). But it seemed to stop working. And the withdrawal effects were scary, e.g. consistent nightmares and fainting (and not in a pleasant way, i.e. nodding out). The side effects were bad too including hunger, my body became noticeably bloated, and frequent gas.

The only MAOI I would be interested in medicating with is the harmala alkaloids. I talked to someone on another forum who self-medicated using harmala alkaloids. I told him the beneficial efects I got from Nardil and he said he got the same thing from harmalas.


DOS Harmala Tek!


I don't currently have the money to experiment with harmalas. Other things I'm enthusiastic about include low dose DMT,* hydergine,** herbs,† and kratom. I'm also enthusiastic about testosterone as I've heard the same things you mentioned and a health advocate I recently got into, Dave Asprey, advocates taking it from what I hear (I still need to look at his info on it) (http://www.bulletproofexec.com/)


*http://www.bluelight.ru/vb/threads/300006-The-Rebirth-of-the-low-dose-DMT-appreciation-thread!?p=7400739&viewfull=1#post7400739


**http://www.bluelight.ru/vb/threads/266623-The-Low-Dose-LSD-Appreciation-Thread?p=6441905&viewfull=1#post6441905
http://www.bluelight.ru/vb/threads/296712-The-Big-amp-Dandy-Nootropics-Thread?p=7590522&viewfull=1#post7590522
http://www.bluelight.ru/vb/threads/653785-Hydergine-as-psychedelic-and-mental-booster-and-drug-addiction


†http://www.bluelight.ru/vb/threads/680794-The-Herbalism-Thread?p=11763774&viewfull=1#post11763774

 

[Abject]

Haven't seen you around much doug, hope you're holding up alright.
I was just on Moclobemide, a RIMA (reversivle inhibitor of MAOI-A). I don't think it's available in the states, and it did nothing for me, but it could be useful to you.
If you're looking to do one of the old MAOI's I'd suggest tranylcypromine as it's not a hydrazine derivative.
They have a small therapeutic index so OD'ing isn't very hard.
Best of luck.

PS moclobemide has a study showing it greatly increases testosterone production in depressed males.
yeah i double posted what of it

 

[sekio]

Don't start a MAOI, of all things. What you need to do is stop taking meth, smoking pot, etc. and let your body return to some sort of homeostasis. Then get your testosterone levels checked and fixed. Then, re-evaluate your medicines with a doctor if you need to.

The reason I say not to start a MAOI is because so many of your drugs could be causing this, as well as your testosterone deficiency. Adding a MAOI is just adding another possibility for drug interactions, and is really just adding another band-aid to everything.

You are on a handful of medications that could cause depression/apathy:

6mg/day of alprazolam is a lot of short acting benzo to be taking. Benzos are known to have effects like inducing apathy, dperession, and causing wierd rebound anxiety, so maybe tapering down the dose might help some.

Tizanidine is an a2 adrenergic agonist which works like clonidine, which will reduce motivation somewhat by reducing norepinephrine/adrenaline release.

The hyoscamine/promethazine combo could also make you feel pretty cloudy. Hyoscamine is basically atropine, and promethazine is a fairly strongly sedating antihistamine with mild antipsychotic activity.

Diminished sleep quality from overuse of sedatives can also lead to depression, feeling un-rested in the morning, and the like.

Also, if you are testosterone deficient, starting test therapy will definitely make you feel much better - even at low doses. If you are testosterone deficient it can be a severe cause of depression, apathy, etc. I don't know how much T uppression you're getting from the 30mg of hydrocodone, though.

I suggest you see your endocrinologist. Then talk to your doctor. (You probably should leave out the bits about smoking pot and meth.)