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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by bleauberry on January 23, 2008, at 17:42:18
I am ready to make the sales pitch to my doc for a trial of nardil. I need help from you good folks in making my case. History = depression, tons of meds, ECT.
The doc is a GP. He says he does not know any psychiatrists in my entire State that use maois. I don't want a pdoc anyway. Too expensive, not any better than a real good GP. Actually I like a good GP better because they see more of the whole picture. If I needed a pdoc for nardil it would literally be a walk through the Yellow Pages phone book calling everyone one at a time until I found one who has patients on nardil. I want to stick with the GP.
The GP is cool. He is well experienced with tricyclics, antipsychotics, lithium, ssris, benzos, and stimulants. He is not a run of the mill SSRI GP.
He is up to the task of new things if the evidence and sales pitch I present him are convincing. It was I would convinced him to add zyprexa to prozac. He didn't even know what zyprexa was back then. This was years before the combination became popular, and years before antipsychotics were used as mood stabilizers or antidepressant augmentors. I showed him the early studies from pubmed and made my case. I was the first patient he ever had on zyprexa. Now 10 years later he prescribes zyprexa like most docs do ssris, like candy. But it was he and I as a partnership that ventured into uncharted waters at the time. That is why I have the faith there is a good chance I can sell him on nardil. He does not have any other patients on nardil and never has. So again, just like zyprexa, this would be a first for both of us.
Whatever you can think of to help me make my case would be SSSOOOO much appreciated. I am well versed on nardil. It will probably be me telling him what I can't eat, what side effects I can expect, etc, rather than him telling me.
Thank you in advance your time. Long posts, short posts, I'll take them all gladly, the more the better.
Posted by tecknohed on January 23, 2008, at 20:24:52
In reply to Help Me Make the Case for Nardil, posted by bleauberry on January 23, 2008, at 17:42:18
I'll try a few suggestions...
Remind him that they used to be just as widely prescribed as SSRIs, before those darn things came along.
Take as much printed SOLID data with you as poss, old & new. You probably already plan to do that anyway, but make sure its totally relevant to your symptoms/diagnosis.
Explain that Nardil is where YOUR faith lies (with meds) at the moment & that you're fed up with trying all these newer meds which dont work or last. Remind him of its solid background for TRD, etc. Maybe add that you should have been given a trial YEARS ago.
Say you know all the risks & know the diet like the back of your hand! As well as all the med interactions. Show him the list - probably best to actually show him an outdated list which will include many foods that are actually ok. Otherwise he might disagree with the list.
Dont take no for an answer.(?)
I'll try & think of some more. What is your diagnosis by the way?
teck
Posted by stargazer2 on January 24, 2008, at 8:41:21
In reply to Re: Help Me Make the Case for Nardil » bleauberry, posted by tecknohed on January 23, 2008, at 20:24:52
BB, you can babble me if you would like. I have been on Nardil twice, and it along with Marplan are the only meds that have really helped me as a monotherapy. I tried most every other med (for TRD) alone and in combination and always felt that it was just a piece meal approach to my condition.
My doctor doesn't have any other patients on Nardil now either, but since I have seen him for close to 20 years, he knows my history pretty well. I think I have avoided being hospitalized by trying so many medications.
I can't explain it but Nardil, despite it's reputation, feels much safer to me than any other meds which made me worse in many times or more zombie like. Nardil has never done this which is one reason I feel comfortable with MAO's.
It did take a long time this year to get it right, but I'm finally stabalized at 60 mg with relatively few side effects, the worse being gas and weight gain, but I feel both are in control right now. Side effects in the beginning are usually much more difficult and then they subside to a more manageable level.
It still is worth trying Nardil, in my opinion. No better or worse than anything else you have tried. I am more afraid of the atypical AP's like Zyprexa, regarding long term effects, like TD.
I think drug companies hide the truth about side effects during the initial years of a drug's release, since that is when they make their billions. After that, you get the real story of what kind of damage results from these highly used "new" treatments.
You're better with something that has been around like Nardil than many of the newer drugs, with unproven and unpublished long term effects.
Stargazer
Posted by Phillipa on January 24, 2008, at 11:31:44
In reply to Nardil trial, posted by stargazer2 on January 24, 2008, at 8:41:21
Stargazer that's interesting what you say about the atypicals never looked at it like that before. Makes sense. I knew a pdoc who got time shares and stuff like that from drug companies but he was a good pdoc. But you have me thinking now. Thanks Phillipa
Posted by Polarbear206 on January 24, 2008, at 14:25:52
In reply to Help Me Make the Case for Nardil, posted by bleauberry on January 23, 2008, at 17:42:18
> I am ready to make the sales pitch to my doc for a trial of nardil. I need help from you good folks in making my case. History = depression, tons of meds, ECT.
>
> The doc is a GP. He says he does not know any psychiatrists in my entire State that use maois. I don't want a pdoc anyway. Too expensive, not any better than a real good GP. Actually I like a good GP better because they see more of the whole picture. If I needed a pdoc for nardil it would literally be a walk through the Yellow Pages phone book calling everyone one at a time until I found one who has patients on nardil. I want to stick with the GP.
>
> The GP is cool. He is well experienced with tricyclics, antipsychotics, lithium, ssris, benzos, and stimulants. He is not a run of the mill SSRI GP.
>
> He is up to the task of new things if the evidence and sales pitch I present him are convincing. It was I would convinced him to add zyprexa to prozac. He didn't even know what zyprexa was back then. This was years before the combination became popular, and years before antipsychotics were used as mood stabilizers or antidepressant augmentors. I showed him the early studies from pubmed and made my case. I was the first patient he ever had on zyprexa. Now 10 years later he prescribes zyprexa like most docs do ssris, like candy. But it was he and I as a partnership that ventured into uncharted waters at the time. That is why I have the faith there is a good chance I can sell him on nardil. He does not have any other patients on nardil and never has. So again, just like zyprexa, this would be a first for both of us.
>
> Whatever you can think of to help me make my case would be SSSOOOO much appreciated. I am well versed on nardil. It will probably be me telling him what I can't eat, what side effects I can expect, etc, rather than him telling me.
>
> Thank you in advance your time. Long posts, short posts, I'll take them all gladly, the more the better.
If you are going to present him with literature on MAOI's, make sure you get it from a scholarly site such as pubmed.gov MAOI's are superior to other AD's and there has been a steady increase with the use of these drugs with good results for tx. resistant depression. Here is a link for MAOI users. They probably can really give you some pointers. http://health.groups.yahoo.com/group/maois/Good Luck.
PB
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