Introduction

Although this text describing Eric’s story is short, the length and extent of his suffering and distress was considerable.  It is difficult not to feel frustration and even the anger that his illness was not dealt with more expeditiously.  His story well illustrates the typical treatment management failures of such illnesses — for him to be on Effexor for such a long time without benefit is clearly not good medical management.  There are other comments I could make, but perhaps an important one is to highlight the importance of not considering ECT unless you have already tried an MAOI, that was a good decision by Eric.  Here is his story in his own words.

I thought I would share a bit of my experience with antidepressants throughout the years and my journey with MAOIs.

I am 40 years old and have been on antidepressants since the age of 16. When I was 16, I went to my PCP [primary care physician, for those not from USA] to help me address anxiety because I couldn’t stand it any longer.

The doctor prescribed Effexor and I was on that medication for several years with no real improvement.

When I was 17, I was put on blood pressure medication [KG, Effexor can raise BP significantly via NRI property].  It took two different medications to somewhat control my blood pressure.  I was in the best shape I’ve ever been in and had no family history of blood pressure issues.  In my late 20s I started thinking outside the box and wondered if my severe anxiety was the culprit of my BP issues.  I mentioned this to my doctor and he was passive on the suggestion.

My PCP switched antidepressants a few times, with no improvement.  I felt stuck and was tired of trying new meds, just to be dissatisfied.

In my 30s I decided to find a psychiatrist.  My first Pdoc experimented with at least 10 different antidepressants and anxiety meds.  He was quick to prescribe me benzodiazepines and told me nothing about the ramifications of that particular class of medications.  I’m lucky I didn’t take them as he prescribed them.

At age 38 I found a different psychiatrist that actually listened to me.  He tried a few different meds, without success.  He suggested ECT therapy and I almost agreed to the treatment.

I started in depth research on antidepressants and came across MAOIs.  I spent two weeks researching Parnate and Nardil, watching Dr. Gillman on YouTube, joined MAOI support groups, and read reviews.  I decided I wanted to try Parnate.

I presented all of my research and sources to my Pdoc.  He agreed to prescribe Parnate but didn’t have much knowledge on the drug.  I took Parnate for 2-3 months and didn’t see much of an improvement.  I decided to ask if I could try Nardil and he agreed.

I made a direct switch from Parnate to Nardil and started with 30mg.  I’m currently on 75 mg and have been for over a year.  After 6 weeks of Nardil I became a totally different person.  My anxiety was GONE and my depression went from a 10 to 2 in two months, 1😀-10😩)

I’m my Pdocs only patient on an MAOI and he’s been wonderful letting me guide my own treatment and supports me [KG, anyone meeting such a doctor can consider encouraging them to join the MAOI Expert group that I convened, details on the website].  It does concern me that such a wonderful medication isn’t widely in use for patients that don’t have results with other medications.  MAOIs don’t make pharmaceutical companies rich or give incentive to physicians who prescribe them [KG, there are several commentaries giving the detailed background that fully justifies Eric’s statement].

If I didn’t look outside the box, do research and present my findings, I‘d still be a lab rat.  Dr. Gillman said that there’s outdated misinformation pertaining to MAOIs and that’s what Psychiatrists are taught in medical school.  This statement from Dr. Gillman couldn’t be more accurate.

I experienced very low blood pressure for 6 months and decided to cease my blood pressure medications without the knowledge of my PCP [KG, the failure of the medical attendants to monitor Eric’s blood pressure and adjust his treatment appropriately would have put them in and invidious position had he come to harm and they had been subject of a legal suit for damages].  I made the decision not to tell my PCP until I was off the meds for 5 months.  I had an appointment 3 weeks ago and my BP was 110/80. I informed him I’d been of the BP meds for 5 months and he agreed I no longer needed them.

I hope my story helps someone that may have some of the same experiences that I did.  My advice is to be your own advocate when pertaining to your health [KG, good advice, but that is not easy for patients with depression — I usually advise that they recruit some appropriate assertive family member or friend to assist in promoting their cause].