Posted by SLS on August 5, 2009, at 6:26:40
In reply to MAO's: why do doctors avoid them?, posted by floatingbridge on August 4, 2009, at 22:53:22
> Hi,
>
> Is it because after a round on an MAO, other meds don't work? (My doc seems to project it as an end of the line type of treatment.)
>
> Are liability issues at play, too?
>
> puzzled by my mao resistant pdoc,
>
> fb
Perhaps they don't trust their patients to adhere to the contraindications. Why risk the liability? Also, I think today's middle-aged doctors had the crap scared out of them in medical school. However, interest is now growing in medical schools to return to the MAOIs. They are no longer seen as demons, but as legitimate tools.My doctor is scared of Parnate because one of his patients reported developing a headache at some point during their initial titration. There was no indication that it was the classic occipital headache due to tyramine ingestion. I believe I was his first patient to break the 60mg barrier. It's funny because he was already aware of Jay Amsterdam's work with dosages of 120+mg.
Education of doctors and patients is critical. I think doctors also need to evaluate the functional level and personality of the patient so as to feel comfortable with patient adherence to the contraindications.
In 1982, the Columbia University depression program wanted to make an MAOI their very first drug to try on me. My, how things have changed.
- Scott
poster:SLS
thread:910315
URL: http://www.dr-bob.org/babble/20090801/msgs/910349.html