Posted by Vincent_QC on November 22, 2008, at 8:32:54
I'm new on this board. So I will explain my case...that's a big one...
To do a short medical history, I'm 32 yo and I do social phobia with agoraphobia, panic attack, generalised anxiety and depression since i'm 19yo. I also have to mention that I was a fat kid and I endup at 18 yo with a morbid obesity problem...All my problems come from my chilhood and my low self-esteem and my body perception "image".
I try everything, I mean all the SSRI's, SNRI's, remeron, wellbutrin, TCAs, anticonvulsive drugs(Lyrica, gabapentin, topomax and others to not mention all...) and of course all the newer antipsychotics like Zyprexa, seroquel, risperdal...All I get was always a BIG weight gain (60 pounds on paxil years and years ago) but no improvement of my anxiety or my social phobia or even depression.
What is unusual in my case is that I had a gastric by-pass in 2001 (not the one very popular in the USA),it work more with the malabsorbtion (fat especially), they by-pass the first part of the intestine, so now I don't ingest fat and some others things. I go from 445 pounds to 180 in less than 1 year. I stay at this weight for a couple of years but since the begining of 2007 and the re-introduction of antidepressants in my life, I begin to gain weight again.
So you can understand that now I fear to a gain more pounds since i'm now at 220 pounds (40 more than in 2006). That weight gain give me a lot of extra anxiety and I feel more bad than before. I fear to not be able to return to a normal weight like before (180 will be ok).
So now here the problem... My new psychiatrist put me on "Parnate"...20mg/day for the first 2-3 weeks and a possible increase after...
By experience, I know that regular diet will not be effective, since the by-pass already do a good job...It's why I want to do a proteine "diet". But proteine whey powder or white eggs proteine powder are not safe with an MAOI...I try to find all the informations about that on the internet, I ask also my doctor and a lot of pharmacists and nobodies seem to know if it's dangerous or not. Some people say that's ok, others say to avoid all proteine podwer... I'm now confuse a lot.
In the begining of 2007, I was put for the first time on a MAOI...It was my last ressort, since that's hard to find a good doctor (in canada) who will prescribe them now. I'm lucky, my familly doctor is very open minded. So I begin the Nardil and I increased my dosage until I reach the 90 mg goal. After 1 1/2 months, I had to stop because I had a very bad hypotension problem and trust me a very bad one. I was not able to climb stairs without having problems with my vision and vertigo...so I just drop out the Nardil...I don't had the chance to see if it was good for all my problems or not. They only thing I remember is that I had less social phobia problems issue but I also remember that I gained weight on it. At the time, I was also on a "high" dose of Rivotril (8 mg day)...I'm now just on a 15-20 mg of Valium...Since I had a bad experience switching from long acting benzo to shorts acting ones (Xanax, Ativan, Serax)...I ended up at the hospital last summer because of them. Now i'm stable at a low dose of Valium and I don't want to increase my dosage again.
After that experience, I try others kind of mix , cipralex with ritalin to get more energy, because the cipralex dry up all my energy...so we encounter a side effect with another pill to give more energy but it was a big mistake... I also try cipralex with wellbutrin, prozac and remeron at the same time...But I ending with no improvement at all. I was always tired with no energy, no motivation and also a lot of anxiety especially on the social side of my life who is now non-existent.
Last week (18 november 2008), I had an appointment with a new psychiatrist and a very good one. We do a list of what I try...and we had only 3 pills that I don't try...So he decide to put me on the "Parnate" at 20 mg/day. He say that it have a more activating profile (but I don't feel it after 5 days...)...
So I have a lot of questions about that drug: Is it has effective than Nardil for social phobia and anxiety? I gain 40 pounds on the cipralex, can I will be able to loose it on the Parnate or I will continue to gain weight? Do you think that a 30 mg/day goal is really effective or I will have to take more? Also, for all what I read about the Parnate on the internet, it seem to take less time do have a benefict effects, so should I will have to wait 2 months before I see if it works or not? I already lost too much time trying pills so I that normal that I want to see some improvements soon. I also begin a cognitive therapy next week (CTB) for anxious problems...It's a 20 weeks therapy, based on my own profil and problems.
My last question is already mentionned somewhere on this board but nobodies seem to know the real answer...
I read that it's dangerous to take proteine powder, is that true? I know everything about the dangerous effect of tyramine, I follow the diet very well, since it's not a big deal for me...but I ask a pharmacist about that, he say that he was not sure. I know that soy proteine are to avoid...but whey proteine??? We try to take a look on the nutritional facts of a couple of brands and we found that a lot of them have some tyrosine or things like that, who seems to be a danger if I use it with an MAOI...
In fact, no one seem to know if it's dangerous or not. My psychiatrist don't know either. So i'm confuse now...I really want to loose weight rapidly, since I can't do a regular diet because I try it last year and I don't loose weight (maybe because of the by-pass)...The only way is to do a strict proteine diet.
Last spring, after the "Zoloft" experience (2 months on that), I gain another 20 pounds, so I do a proteine diet and I go down from 230 to 175 pounds in 2 months. I Was really happy like that. At the end of August, my old psychiatrist put me on "cipralex" and in less than one montht, I gain more than 20 pounds, after 2 months I gain another 20 pounds...it's why now i'm at 220 and it's also the reason why I want to return to a normal weight...so the proteine diet is the only real option I have. Yeah, I can eat just fresh meat, but the powder option is more easy to follow. On the other side, I want also to really make a try with the Parnate. After 5 days on it, I seem to tolarate it very well, normally I just feel all the bad side effects after the first dose I take (cipralex was the worst of them). They only side effect I have for now is a little headache, but I do regular migraine so i'm use to it. I also have my own machine for blood pressure, so I can take it regulary to see if my headache come from food I eat (tyramine content) or just a regular migraine.
I know, it's a long post, with a lot of questions, but i'm confuse a little bit.
Someone here take proteine powder with MAOI without having a hypersensitive crisis???
I know I can do a "try", mean that I can take a spoon...wait a couple of hours, take my blood pressure and see what happen (it can take more than 12 hours to have a reaction to tyramine)...but at the same time, I don't want to end-up at the hospital again...
What can I do?...
All good comments or experience is weelcome ;-)
Thanks in advance!!!
poster:Vincent_QC
thread:864607
URL: http://www.dr-bob.org/babble/20081114/msgs/864607.html