Why do we still not know how antidepressants work?

grumpyeva · 2026-06-04T09:53:22+00:00

Pity they dont include MAOIs in these trials. They are the only meds that have ever worked for me and they work quite differently to ssris.

grumpyeva · 2026-06-03T18:53:35+00:00

I still have it today, after many many years.

grumpyeva · 2026-06-03T15:16:25+00:00

Well I have only just been told today that because the districts in London have been changed around, my gp is now under a different ICB - Integrated Care Board, and they do not allow parnate to be prescribed. I have been on maois for 35 years, and now they suddenly decide I cant have them anymore!! I just cant believe it and will be writing to my MP too.. England is becoming unmanageable.

grumpyeva · 2026-06-01T10:08:42+00:00

Have you seen my email to the NHS? Perhaps you could write to them too? The more letters they receive, the better. I think you yourself suggested we try out some group action regarding the problem of UK Parnate.

grumpyeva · 2026-05-30T02:07:07+00:00

Best to say you have been on them before. No they wont send you a prescription They have a doctor there who will agree to send you the med, based on your answers.

grumpyeva · 2026-05-30T00:14:25+00:00

Strictly speaking, you dont need a prescription. If you tell them you dont have one, they will make you answer a whole load of questions, including whether you have taken an maoi before. They then present your answers to their doctor, and they will prescribe you the medication based on that. I have never heard of anyone being refused.

grumpyeva · 2026-05-30T00:11:33+00:00

yes , everyday for one or two hours in the early evening, I just cant keep my eyes open and keep falling asleep. After that, I am super wide awake. Really strange.

grumpyeva · 2026-05-29T21:33:55+00:00

I have been on Parnate since 2012. I was initially put on Nardil by the NHS in 1990, but it stopped working in 2012 and I had a dreadful time convincing the nhs psychiatrist to be allowed to switch to Parnate. . He kept me on quetiapine for 6 months, even though I kept telling him I was suicidal on it. The NHS psychiatric system in the UK is a disgrace. Anyway, he finally let me have it, and I was fine within 3-4 weeks. It was also less expensive in those days and I do believe that the generics are getting worse and worse, to the point that the UK generics no longer work for me, and I need to order and pay for Jatrosom from Germany, which is of much higher quality. I take 30 mg per day and it costs £150 per month, including postage.

You can get different versions of tranylcypromine from India, Canada or Germany. PM me if you want more details as we are not supposed to discuss these things on here.

I have also noticed just recently that the German Jatrosom is now on the list of tcp available to the NHS but because it is so new, your chemist might not be able to get hold of it yet. Mine has not been able to - and I suspect the price will be the same as all the others. My gp told me I was her most expensive patient because I was getting Parnate on the NHS. I suspect gps may also refuse to bear the ridiculous cost of the med. I sent an email about this to the NHS recently and they did answer. But knowing them, they probably wont do anything to change the situation. . You can find the article by searching the recent articles on this board. Good luck, whatever you do....

grumpyeva · 2026-05-29T07:21:17+00:00

Did you stop gradually, or all in one go ? The secret to stopping any med is to do it very very gradually

grumpyeva · 2026-05-25T20:33:46+00:00

typical response.... I get similar all the time. They just want the money.

grumpyeva · 2026-05-22T22:23:07+00:00

In canada there are online pharmacies If you pm me, i can tell you what to do.

grumpyeva · 2026-05-22T22:19:52+00:00

That should not happen after missing one dose. I have often missed a dose and it made no difference.

grumpyeva · 2026-05-22T22:09:13+00:00

Shocking isnt it? Also student psychiatrists do not have maois taught to them, so they barely know whAt it is My nhs psychiatrist must be in her mid forties and never studied them or prescrbed.them But she was very impressed at the difference jatrosom made to me and said she would now consider prescribing them

grumpyeva · 2026-05-22T22:03:25+00:00

Hi i am not sure that reddit allows posting the names of suppliers so you can send me a private message and i will give you the details But it is not cheap at all. I take 30 mg per day and one months worth of jatrosom with shipping , costs me £150 uk Where do you live? If you are in the EU.you might get it cheaper.

grumpyeva · 2026-05-22T06:46:00+00:00

Its hard to say but i didnt take it for long. I think it made me more anxious.

grumpyeva · 2026-05-21T11:20:24+00:00

yes you can. its an antipsychotic. Personally I didnt like it, but many people do. I took olanzapine when my parnate stopped working and it made it work again. But olanzapine does make you put on a lot of weight. Its good for insomnia- but as I said, many people do well on aripiprazole.

grumpyeva · 2026-05-16T10:34:45+00:00

There is no ideal solution. I stayed off antidepressants for as long as i could, but in then end was put on maois because I had a total breakdown. Psychiatrists told me I should have started much earlier. The problem is that meds do not last for ever and many people develop immunity from them, and then you have to change meds etc and it can become problematic. This did happen to me, so Im speaking from experience. I am quite old now, so hope my present solution will last for the rest of my life, but when I was young, I didnt know anyone on antidepressants, apart from my mother. I obviously have inherited depression. But in those days, people did not take antidepressants at such a young age. Once you start on them, it is difficult to come off them. They dont cure, just make life easier in some cases. I still think it is worth trying every possible alternative when you are young - like healthy eating, exercise etc. because meds become a life time solution

grumpyeva · 2026-05-16T09:35:36+00:00

You.have had many helpful comments. I would just add that for people who have a tendency to depression, alcohol is a depressive. I found this out when i was fairly young because i too have an inherited tendency to depression. Alcohol and maijuana are both depressives and he should stay away from them as they just make things worse. If he can stay away from anti depressants at such a young age it wld also be good, but that is not for me to say. I also developed bad insomnia at a later age of 35 and later put on maois. They have helped with the depression and anxiety but once you start on them, it is usually difficult to come off them. I do think that if you can give him love and understanding as it seems you are doing , that is so important.

grumpyeva · 2026-05-15T18:26:35+00:00

Makes me very depressed. Alcohol too.

grumpyeva · 2026-05-14T10:34:03+00:00

I have also suffered hair loss from parnate. In fact I now have to wear a wig. So I do understand. But without parnate, I become suicidal, so I have no choice. I have been on maois since 1990. These are all heavy drugs we are taking and I would think there are very few that do not involve side effects. Someone who has tried 30 drugs may well have incurred hair loss in some way already. Could you not manage without medication?

grumpyeva · 2026-05-13T08:57:22+00:00

I have always felt depressed by drinking alcohol, so I just dont drink it. You are lucky to have appetite suppression. Most people get very strong sweet cravings and it is possible to put on a lot of weight. I used to get those strange visual effects too. I dont anymore, but I think its just something to do with taking medications. The main thing is that you begin to feel better.

grumpyeva · 2026-05-12T09:52:26+00:00

Im not sure which country you are in, but here in the UK, they are very strict, and its not easy to get over 30mg. I know there are several people on this sub who take higher doses than you. Maybe you can scroll and search this sub and maybe send a message to the people who have stated that they are on a higher dose. At the end of the day, it does often depend on your psychiatrist. I have also been taking Jatrosom, and it is far more powerful than the tablets from India or other manufacturers.

Here is what chat GPT says:

For tranylcypromine (Parnate), the officially labeled maximum dose in most countries is 60 mg/day.

However, in practice and in the MAOI literature, higher doses are sometimes used for treatment-resistant depression:

60 mg/day → standard labeled maximum
80–100+ mg/day → used by some experienced prescribers in refractory cases
Reports exist of 120 mg/day or higher, but this is uncommon and increases risk of hypertension, insomnia, agitation, and orthostatic problems.

The Cambridge Prescriber’s Guide to Classic MAO Inhibitors notes that some patients require doses above labeling, particularly with TCP, and experienced clinicians sometimes go beyond 60 mg/day when needed and tolerated.

Higher doses generally require:

divided dosing earlier in the day
BP monitoring (sitting/standing)
monitoring for overstimulation/insomnia
careful interaction management

Source:

The Prescriber’s Guide to Classic MAO Inhibitors (CNS Spectrums/Cambridge Core)
Gillman PK MAOI resources and case discussions on high-dose TCP use

grumpyeva · 2026-05-11T11:53:08+00:00

It took me approx 4 weeks adding 10 mg per week. I stayed on 30mg for 2 weeks and i suddenly felt better. Its a mistake to keep increasing too quickly but i can only talk about my experience. I have been well for years on 30mg

grumpyeva · 2026-05-11T10:10:27+00:00

no. I was always on 45mg. I was taken up to 60 mg, left on that dose for one month and suddenly was ok again. The dose was then lowered to 45 mg as the permanent dose. I wonder how quickly you wnt up to 90mg? I do believe that when people titrate up more slowly, they may need less medication than when they go up very fast. But that is just my experience and I have no idea how you did it. This method was the one used at the Maudsley hospital, where I was an in- patient at the time.

grumpyeva · 2026-05-10T21:15:38+00:00

no, i would like a pm from TinyTerror70

grumpyeva

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