Expert: Ivan Goldberg, M.D. - 2/16/2010

Question
I have treatment resistant depression and live in an area where I can't find a physician who will treat me with an MAOI, only SSRIs, which have never worked for me. I have read everything available on Parnate and believe that I understand the dosages and food restrictions.
I can get a prescription for parnate and take it myself, although I would like to have a doctor who could advise me.  I feel in a bind.
If I am judicious and careful, do you think it is safely treat one's self.
Do you know anyone who is available for long distance consultation?

Answer
Hi Lisa . . .

Many younger psychiatrists have never prescribed MAOIs even once and this trend is very unfortunate for those with hard-to-treat depressions. MAOIs are often useful as an initial antidepressant when it comes to people who have so called "Atypical Depression" and work much better than SSRIs.

You might look at the list of expert psychiatrists at http://www.psycom.net/depression.central.psychiatrists.html and see if anyone listed there is close to you.

I don't think that any responsible physician will prescribe an MAOI for you to self regulate, as MAOIs can be very tricky st times. For example, everyone is aware that there are many foods that, when taken with MAOIs, can cause hypertension, but in practice, hypotension is a much larger problem.

Best regards . . .

Ivan
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