MAOI Med-Bashing Isn’t Cool!

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The adage “You can’t believe everything you read” is more true than ever in the internet age. And the saying takes on a whole new meaning when it hits too close to home. 

While researching articles about people’s experiences with electroconvulsive (ECT) therapy, I found two posts written by an author — I’ll call her Madame Spuriosa — that alluded to the medication that changed my life: my MAOI.

Her posts contained misleading and/or blatantly inaccurate information about this class of medication. If you’re unfamiliar with MAOI’s and read Madame’s posts, you’d be dissuaded to try this potentially life-changing medication for treatment-resistant bipolar depression.

The experience reminded me how important it is to do your own research about medications and not blindly accept a blog, The Huffington Post or a doctor’s opinion about anything. I was stunned by what the author’s physician said about MAOI’s…I’ll get to that soon.

Simply researching a reputable site can make a profoundly helpful difference.

My doctor and I often use Mayo Clinic and Wikipedia can be very helpful, but of course it’s wise to check several sources & not just reply upon one. 

Consider calling your pharmacist if you like him/her (I’ve read some horror stories about pharmacists who could pass for Satan!). Quiz her about your meds during a slow time – don’t call at 5:20 p.m. when there’s a line ten customers deep. Many pharmacists know a great deal, and they like to share their knowledge as long as they don’t have a ton of customers. If you go this route, just ask her if she’s not super-busy when she comes to the phone.

 

Back to the MAOI Saga….

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Months ago I was contacted by a blog reader who, after reading about my experience with MAOI’s, decided to try one because she was resistant to numerous bipolar meds.

Here she shares how much an MAOI helped improve her quality of life:

“I stopped by your blog while trying to find something that worked for my depression, after failing 6 or so meds and wasting 10 years of my life with this unsettling emptiness. I learned about MAOI’s from browsing through your personal struggles. 2 months later on Parnate I think I’m beginning to feel… just fine. I like it. Thank you.”

When I read that comment, I knew my blogging wasn’t some useless hobby, as I’ve been told. It’s one thing to blog about silly things, which I often enjoy doing – it makes me happy, but it’s entirely another matter to be told your post has helped someone you’ve never met. 

Here’s another example of MAOI bashing by Dr. Julie Holland, author of Weekends At Bellevue and Moody Bitches.

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Dr. Julie Holland’s Moody Bitches is described as A groundbreaking guide for women of all ages that shows women’s inherent moodiness is a strength, not a weakness”

Here’s an excerpt of my Moody Bitches review:

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She Lost Me When She Dismissed the Medicine That Eradicated My Bipolar Depression (In 1 ignorant sentence!)

I enjoyed Dr. Holland’s first book Weekends At Bellevue and I wanted to like this one! I’m pro-medication and pro-psychiatry. I want to promote female psychiatrists whenever I can. Unfortunately I can’t do that with Dr. Holland.

In Moody Bitches Dr. Holland wrote that she was against prescribing MAOI’s (monoamine oxidase inhibitors) without providing ANY convincing reasons behind her statement; once I read that, she lost me as a fan.

An MAOI (Parnate/tranylcypromine) has been a life-changing medication for my treatment-resistant bipolar depression, especially after I combined it with lithium. 

Thanks to my psychiatrist (who thought out of the box and went with this “old-school” med combo of the MAOI and lithium) I have a good life. Before my MAOI was added to my lithium, I had no purpose for seven long, horrific years, ever since my bipolar disorder, peripartum onset was triggered in 2007.

(I wrote about how my life changed for the better…)

None of these amazing blessings would’ve taken place if not for my MAOI. So all I can emphasize in this review is that I no longer recommend this doctor’s books to anyone, and I lost every bit of respect for her professional acumen since she dissed MAOI’s.

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The following excerpts are from Madame Spuriosa’s posts. I bolded the lines in red that troubled me.

I went for a psychopharmacological consultation and was given three options: MAOI (another class of medication), transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT). I was terrified of ECT and I did not want to deal with the dietary restrictions with the MAOI.

When I read that blurb, this is what came to mind:

I don’t want to deal with a lot of things, like unsightly leg hair, gassiness, not being rich, and road ragers on meth, but if I have to give up some foods and booze in order to no longer be severely depressed, then I’ll gladly deal with those dietary restrictions, no problemo!

Madame’s other post states:

My doctor was calm and cool while he presented my options. The first was to try a different class of medication, pretty much the only medication I had not yet tried…there were dietary issues, such as certain cheeses and chocolate that cannot be consumed. I looked at my doctor with a straight face and told him there was no way I could cut out chocolate. Luckily, he smiled and offered me a second option. (Dyane’s note: Madame opted for ECT rather than try an MAOI.)

When I read that section, I was flabbergasted!!!

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Astonished!

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Gobsmacked!

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Flummoxed!

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You get the idea.

No medication fits everyone – believe me, I know that, and I certainly don’t mean to give anyone false hope about MAOI’s. 

But the truth is that lithium and MAOI’s work, and not only do they work, but they work for treatment-resistant bipolar depression remarkably well. Studies done in the ancient 1970’s (the decade I was born) found that MAOI’s seem to work best when combined with lithium.

What I want to emphasize is that MAOI’s dietary restrictions are totally, completely do-able, and they’ll actually make you a healthier person. There are many different lists in circulation of MAOI dietary do’s and don’ts.

While some of those lists mention cutting out or reducing chocolate, I’m here to say that you CAN have chocolate, a.k.a. the most important food in the world. I’m living proof that it’s perfectly safe to eat chocolate and take an MAOI because I’m fairly sure I’m composed of about 90% chocolate.

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This is me.

My friends, if you’ve read this far please give yourself an “A+” for being a great blog follower and a kind reader. I appreciate you so much!

You probably can guess that along with postpartum bipolar disorder, I’m going to keep mentioning the existence MAOI’s until the cows come home to…chew their cud, I guess.

Maybe I’ll write a song about it.

End of sermon.

Well, for now. 😉

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Unless it’s from the Weekly World News of course!

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Have a good Thursday!

love,

Dyane

Read my debut Huffington Post article Postpartum Bipolar Disorder: The Invisible Postpartum Mood Disorder here! 

Dyane’s memoir Birth of a New Brain – Healing from Postpartum Bipolar Disorder will be published by Post Hill Press in Fall, 2017.

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48 thoughts on “MAOI Med-Bashing Isn’t Cool!

  1. Thank you for your post! I started on Parnate in January for treatment resistant depression (not bipolar) and that with zyprexa and klonopin have saved my life. I cut out red wine, cured meats, and I didn’t like aged cheese anyway. I do still have chocolate and other alcohols. I’m trying to cut back though. My biggest problem is I gained about 50 pounds on the zyprexa and another 20 on the Parnate. Not fun. I’m a work in progress I guess. Thanks for sticking up for MAOIs! They can be a life saver if people weren’t so afraid. For me, the diet is not a big deal. (Strangely though I was at a restaurant last night that had fava beans on the menu!)
    Good luck to you and your writing career! I think it’s great 🙂

    1. Sorry for the late reply; it has been hectic since we were out of town without internet access the past 2 weeks and then (stupidly) returned here the day before the girls started school.

      Anyway, I hear you on the med weight gain.:( I took Zyprexa and gained some weight, but nowhere as much as when I took Seroquel! Yuck!!!!

      It’s refreshing to hear you agree that the MAOI diet isn’t a huge to-do —-it’s worth it if we feel less rottten. That’s too weird that you were @ a restaurant that serverd fava beans, LOL! 😉 T I’m rooting for you too – you’ll lose weight when the time is right. It took me a long time to be ready to try losing weight while on the meds – talk about procrastination. But it’s okay, like you wisely said, we’re works in progress. You rock! Be good to yourself! ake care, and thanks for the lovely encouragement. Xo Dy

    1. Darling one, I’m finally getting around to replying to various comments. I’ve been distracted (and drained) by Spring Break and taking care of two energetic little girls who like to put the poor chicken on the trampoline, as you might have noticed! (They weren’t cruel to Malena – they just hung out there with her!)

      Anyway, I’m sorry that Depkaote killed your hair – what a relief you are off it and that your hair is growing back!!!

      Sending you lots of love as always,
      Your Sassy Honey Pot

  2. Really great post! I read all the way to the end lol. Very interesting. I’m glad you have found a meds combo that works for you. I have treatment resistant depression and my psychopharmacologist went old school adding Nortriptyline to my Effexor with a small amount of Adderall which keeps my meds working. Took 7 years and over 35 different combos but I got my life back. Been on same meds over 12 years. I definitely agree that just because one med does or doesn’t work for me doesn’t mean it won’t work for you. Hugs to u!

    1. Thanks a million for your comment, and I apologize for the late reply!
      I was very honored & impressed that you read the entire post! (You get an A+!)

      How awesome that your psychiatrist also thought out of the box and went old school! I ***love*** reading about your kind of experience, although I don’t love the fact that it took over 7 years and 35 combos to feel better. Of course I completely relate to that….I’m thrilled you got your life back and that you found my post to share your experience with others. Sending you back lots of (((hugs))) too – all my best to you & your family! Xo Dyane

      1. It did derail my life for a while but my parents and my doctor never let me give up. I’m so very lucky to have a life and my husband is extremely loving n supportive. It’s funny because I’m actually a pretty happy-go-lucky person when I’m not depressed lol! Hope u are well. Hugs xo!

  3. Yay for your efforts and Huff Post article. My husband forwarded it to me. People (doctors) have often looked at me like “riiiiightt” when I tell them my bipolar I was w postpartum onset. It definitely was. I thought women didn’t sleep in the months after childbirth because they felt like they were electrocuted and driven to staring at their baby and pacing the nursery for hours at a time. But MAOI–it saved my soul! I take Marplan, an unusual drug in the other chemical arm from Parnate. I was crippled with terrible depression and anxiety and my world was getting smaller and smaller. The maoi was so swift and assertive in my body, like a very long overdue stealth anxiety missile. It was unnerving. I would have given up air for it but have found, over time, that for all kinds of different reasons I can enjoy most foods on the “no foods” list in moderation. An SSRI was not an option for me (crazy times) and with Tegretol it got me off the couch…in the dark.

    Thanks for this post and your work. By the way, my brilliant and life-loving sister-in-law was also struck with pp bipolar disorder a few years after me (mine was in 2008). It was clear and not a misdiagnosis. She ran out of time finding her way and suicided when my niece was 14 months. I strongly suspect with time research will bear out that this illness is not so rare.

    1. Hi Emily!

      I’m finally writing back and thanks so much for your comment – I apologize for taking so long to reply. That’s fantastic that an MAOI saved you just like me! I haven’t heard of Marplan, so I appreciate your letting me know about it. Your line “I would have given up air for it” was brilliant!
      I get it!

      I can eat some of the “no no’s” on the list, but I’m still pretty conservative as I’m a worry wort.

      My heart goes out to the loss of your sister-in-law; no mother should have to suffer in such a way. I hope that research *cures* bipolar disorder – I keep saying that if we can send people to the moon, surely we can find something to stop this insidious illness from taking more lives.

      Thanks again for writing – it was wonderful to hear from you!
      take care,
      Dyane

  4. Another amazing and amazingly detailed post! I am so glad that Parnate helped you! Hopefully if the need arises, people will at least try MAOI’s and I’m sure your post will help them make that decision. XXXXOOOO

  5. Yes! A+. Well I’m afraid honestly of hitting that drug-resistant bipolar depression. Cheese and chocolate are my lifeline and I’m a real wine connoisseur so that’s pretty much half my existence. I’ll keep them in mind and it won’t kill me to change my diet but I’d have to say that this post was a little depressing for me. Idunno. Maybe because I’m SO lacking in self-control. Oh well. Glad that your Lithium/MAOI combo works!!! Love you my dear!! XOXOXO

    1. Girl, I used to INHALE cheese & wine on a daily basis. You could give those up – I know you could. But I don’t want you to!!!!!

      You have ginormous POTENTIAL and (dare I say it again) GUTS OF STEEL! Once you give up something, yeah, it’s not easy at first, but then it’s no big deal.

      I had to give up my BLOOD (a.k.a. coffee) during 2 pregnancies, so that was 18 months holy mother of Zod, and also I gave up SUSHI (although that probably wasn’t necessary) I didn’t think I’d be able to do any of that. But I surprised myself. You would too.

      And you…..you could pretty much fly if you wanted to, Jess. So don’t worry about this shit too much ,and know that I love ya!

      And if I had to resort to doing something drastic if evil depression returns, I keep hearing great things about ketamine shots for bipolar depression so I’d consider that or ECT again- it sounds like there are more options coming down the pipeline. If you hear of anything, let me know! XOXOXOXOOXOXOX

  6. I just gotta say: your blog is NOT a waste of time. At all. You’re sharing your life and helping others be brave enough to follow you. Anyone who tells you that should receive a polite smile and a kick in the shins. Or, I could send you one of my twins for you to sic on them. They’re more effective as a team, but that’ll cost you extra. 🙂

    1. Awww – ***thank you*** so much! I really needed to read your comment today. I might have to shell out the big bucks for those twins pretty soon! Have a great weekend & thanks for putting a big smile on my face.;)))))) p.s. for an additional fee, does Daniel Craig come as part of the Twins package?

  7. Love this post Dyane. Sometimes we have to be our own advocate. We ALWAYS need to be present (mentally) when medication is discussed. If I hadn’t been my own advocate, pdoc never would have tried tegretol and the hypo high I’ve been riding would have been far far worse.

    1. Thanks so much for your comment, lovely Leslie!
      I know we can’t expect doctors to be perfect. (Nor bloggers or journalists!)
      But it seems that there’s a lot of room for improvement….much more room for improvement than this naive gal thought, anyway. 😉

      I’m SO SO SO glad you advocated strongly for yourself so that your symptoms weren’t as severe as they could have been. That’s truly awesome! 👍 💗 take care & I wish you a great Friday & weekend, Leslie!

      1. And I’m so glad that you advocated for YOURself and that you corrected someone who had the capacity to hurt people with her opinions.

    2. I’m actually paranoid she may somehow read this and write a nasty comment – but I’m not slandering her by name or anything. I just think she could have done so much better. Then again, I could see myself making her mistake too. But I won’t from now on! ;)))

  8. Good job on this post, Dyane. This is a wonderful reminder that we need to be proactive in researching our illnesses and exploring our different options for treatment, and that we need to use our God-given brains to find reputable sources! I wish I’d done that earlier in my illness. It’s hard when I’m severely depressed, though, so I have to rely a lot on my husband and mom, who adores research. (When i came home from college my freshman year and was diagnosed with bulimia and anorexia, she checked out every book from the library about eating disorders. Every. Single. One.)

    1. Laura makes some key points.

      1. Use only reputable sites
      2. Read info from multiple sites
      3. Discuss findings w/your doc

      Only then can you make some educated and informed decisions.

    2. Dear Laura,

      Your Mom? AMAZING! I love what she did for you when you were dx’d w/anorexia/bulimia. I’ll never forget that.

      When I’m depressed I hide in bed and do nothing. The thought of simply getting out of bed is unthinkable, and I’m sure many, many of us with bipolar understand that state firsthand….so it’s imperative to have supportive family members/friends who can help us research anything that can help us feel better.

      I grew up with a family of doctors and teachers and I was taught to put them on pedestals. They could do no wrong! I’ve had to unlearn that type of thinking, which you can tell I’ve done for the most part. Agent Fox Mulder’s words just came to me “Trust no one” except (as I shared with Vic) “The Weekly World News” which I recently learned is the “World’s Only Reliable News Source”! I think it’s safe to say that we can trust a news publication that headlines the news we need to know, i.e. “Yowie Spotted In London”!

      http://weeklyworldnews.com/headlines/56628/yowie-spotted-in-london/

  9. Thanks for your post 🙂 I think that everyone is different some people are happy to be on medications while others are not. I think as individuals it’s important to pursue whatever avenue we personally feel will help us most. A big part of it for me is in how we frame our “illness.” Many people look at bipolar and other psychotic related disorders through the western medical model but that isn’t the only way to understand these experiences. Most import for me is being able to be free to live the way you want whether that means taking medication or not. It is equally important to respect other patients decisions to follow their own path. Just because they choose to do things their own way doesn’t mean you are more wrong or right in your choices, they are just that your choices and just as they will live with their own consequences so will you (for better or worse) 🙂

    1. Everything you wrote is true!
      (And thanks so much for reading/commenting!)

      I tried living without meds for a while and explored non-western options. I live in a mecca (Santa Cruz) where there are so many holistic and non-western medical model options. Some people with bipolar can live well without meds, and/or through alternative supplements/modalities. I respect anyone who follows her own path wholeheartedly, but (as you know by now since I wrote about it over and over and over again! 😉 I can’t condone the actions of a writer who fails to properly research her subject before writing articles for a large- (or small!) scale readership. Of course people are allowed to make mistakes too, but if someone is a hotshot New York psychiatrist I’m gonna call her on it! 😉 Sorry to digress – please take care Hell’e Chante!!! have a great rest-of-your-week, Dyane

  10. My wife took MAOIs for a long time, they helped her treatment resistant bipolar better than any other antidepressant before. She did have to stop for some reason (likely they stopped working, that’s how her bipolar is, something works a while, then stops). That was a few years before I started dating her, so I’m not sure what happened. When we do speeches on mental illness, she always says, about the cheese issue, “Pizza with goat cheese just isn’t the same!” 🙂 She’s a big proponent of MAOIs as well, it’s nice seeing someone elses who agrees that the dietary restrictions can be so worth it.

    1. What an awesome comment!!! Thank you so much for sharing this information about your wife. I’d be so curious to know what happened with her MAOI (which one and if it “pooped” out).

      As far as pizza goes, I live in a pizza-freak household, but I can eat fresh mozzarella (the contraindicated cheeses are aged cheeses) and my husband loves to make pizza. It works out!

      Good for the two of you to make speeches on mental illness. That’s wonderful! If you find out anything more about her MAOI experience please don’t hesitate to let me know. Thanks again and give me best to your other half! 🙂

  11. Thanks for sharing this. The thing is, everyone is different. I used to rely heavily on autistic advocacy sites for getting information on meds and treatments (I’m autistic) and most were pretty much anti-treatment. A few of these sites said never ever go on an antipsychotic as an autistic person. This information is based on first-person accounts, like one woman who had a terrible reaction to a low dose of Phenergan (a low-potency neuroleptic). Well, Abilify as a daily medicationa nd Phenergan PRN saved my sanity. I have no experience with MAOIs but my point is, anecdotal evidence doesn’t say much about how you will do unless it’s based on you.

    1. Hi Astrid!

      You’re absolutely right about anecdotal evidence not holding much water for any of us unless it’s based UPON us!

      Another issue I’d like to explore at some point (it’s connected to this one) was the topic of older meds vs. the newer meds. Many doctors are pressured by sales reps and patient expectations to prescribe the new, glitzy meds with names I can’t pronounce properly. They don’t want to prescribe one of the older MAOI’s when there are newer, pricier drugs on the market.

      If you want a chuckle, visit my “NEW CONTEST! Your Suggestions for Big Pharma Names” – it’s one my favorite posts, but it’s very silly – and read the comments if you want more chuckles!)

      https://proudlybipolar.wordpress.com/2015/09/26/new-contest-your-suggestions-for-big-pharma-med-names/

      Thanks for your insightful comment. You’re a voice of reason!!!

    1. You get an A+ and a chocolate bar and sushi if you haul yourself up here – check out this short clip when you can:
      Our wonderful mountains don’t get on the 6 o’clock news very often, but Monday Ben Lomond was not just on the 6 o’clock news they were on KPIX 5, CBS’s San Francisco Bay Area channel. Ben Lomond has been declared the Rain Capital of the Bay Area with 62 inches of rain so far.

      Video and article from Monday 3/21/2016 at 6:00pm, KPIX/CBS Channel 5 News

      http://sanfrancisco.cbslocal.com/2016/03/22/ben-lomond-rain-el-nino-santa-cruz-mountains/

      Rilla & I actually watched the guy filming this news segment from across the street! he interviewed Massood, who owns “my” lotto ticket outlet/corner store. Too bad Lucy wasn’t with us as I would have had him interview her!

      1. And today it’s sparkling and sunny – you’d never know the San Lorenzo River was raging and the Loch Lomond reservoir was almost at its limit so recently!!!

    1. Your comment is music to my ears and it made me so happy, beautiful Mary!

      I had fun writing this post/novel once I took some “chill pills” –
      a Green & Black’s milk chocolate bar and
      some DoTerra grapefruit essential oil (not to eat – just dabbed a bit on my wrists!)

      Love you too!!!!
      XOXO
      Dy

  12. thanks for this post. Do you mind sharing any side effects you had from the MAOI? Its never been offered to me. I am already on Lithium. I’m so leary as I’ve had my hair fall out(resulting in needing to cut about 6 inches off), and a skin rash and….
    So happy for you that you found the right combo!!!

    1. I had hair fall out too from lithium (they had me at 1575!!! Jeez!) I’m at 900 mg now. My only big side effect is that when I first took it I had heavy afternoon fatigue. It sucked. But it lifted within a month (I know that’s long, but it’s still so worth it – sorry to sound like a cult member!) Others don’t have that happen. I read anecdotal evidence of fellow Parnate poppers on…where else….the internet. And, gulp, I believed them! XO

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