[strangegecko]

May I ask which are you taking and for how long?

I had the best few weeks of my life when I started Parnate. Unfortunately the effect petered out, and upping the dosage wasn't an option.

The US is one of the few countries in the world where you can get adequate MAOI therapy, I think, which is unfortunate for the rest of the world. The only thing I can get where I am now is Selegiline, and even that made the doctor uncomfortable.

[WalterSear]

Ouch. The first few days on MAOIs was eye-opening: I realized what it was like for 'other people', and realized why I had felt so misunderstood for so long - I was being misunderstood :) Other people had had no reference to my distress, and I had had no reference of life without it.

I tried all the MAOIs, and ended up on EMSAM - it's Selegilene in a patch form. The other (oral) MAOIs caused such profound drop in blood pressure and pulse pressure that I would frequently get the mid-low 'roaring' tinnitus that is evidence of an event causing permanent hearing damage. I also collapsed several times. I'm getting the roaring now from time to time with the EMSAM, but I really don't have any option but to suffer the hearing loss at this point.

(Fyi: doctors - even ENT specialists aren't aware that low blood pressure - even extremly short term, acute episodes - causes hearing damage, despite a significant body of academic literature on the matter.)

I have been taking it in combination with a modest amount of Provigil and caffeine, under my psychiatrists guidance. Caffeine is a much more powerful stimulant when combined with an MAOI. IMHO, it's the combination of the three that is helping me. If I stop taking either of the stimulants, I start feeling worse after a few days. I'm not cured by any means - yet, however I'm better than I have in memory. My SO concurs, too.

(I've been on EMSAM since ~September. I spent the rest of last year going on and off all the others)

IMHO, you may want to try it in combination with other drugs. Stimulants worked for me, but I'm on the ADHD spectrum, which may have something to do with it.

[strangegecko]

I had the same experience when I started Parnate - I really thought I was cured. It was a night and day difference. I still remember just walking down the street and feeling like things are overall pretty ok and I'm gonna figure everything out over time. I remember thinking how impossible my previous state was and how it was no wonder I hadn't made any progress all that time.

I also seem to respond to stimulants only. I have tried to get provigil but that's also impossible without a sleep study and a diagnosis for narcolepsy. I have access to Ritalin but it's a bit too intense when I use it occasionally, and I'm scared of long term side effects for dopamine receptors.

I'm currently taking Wellbutrin, which works (I know because I tried to stop a few months ago and I went from depressed to suicidal), but it's clearly not enough. I could take Selegiline intermittently on top of that, but it's a dangerous game to combine these. I also take a ton of supplements which seem to do something, but the problem is a lack of consistency. I think the consistency is probably the big theme overall - I also have positive effects from caffeine if I go over my standard daily dose, but I don't see anything that requires dosage escalation as a long term solution.

Are you taking Selegiline at standard doses? I've thought about trying it again with a higher dosage into a range where it stops being selective.

[WalterSear]

12 mg patch - it's non-selective at this point. ( Fwiw, due to it being the patch, I haven't been watching my diet at all. In a post market study of ~40,000 people over and extended period, there were two hypertensive crises reported, which IMHO, are more likely to be misdiagnoses than anything else.)

Fwiw, you may want to try it with 1-3 cups of coffee next time - it may make the difference for you. Ritalin is, well, crunchy. I don't like it either. It's less unpleasant than adderral, I suppose.

The downside of the patch? The US is the only country where a drug invented in the 60s, and a delivery system invented in the 90s, that would have cost $250/month out-of-pocket in 2014, costs $250/month after insurance. The out-of-pocket would be $2300/month. Obscene.

[strangegecko]

Yeah,I just checked again and I can't even get the patch here. They only have the 5mg tablets.

Anyway, thanks for the info.