Mental Health Irreversible MAOIs - Opinions

[plumbus-nine]

Seems the only available here are selegiline or rasagiline but I'm also asking about tranylcypromine etc.. What are your experiences, are these chems as effective as people say? How bad is the thing about diet, seemingly one can titrate it and some don't even need to watch their diet..

I'm considering MAOIs because S/NRIs failed, augmentation failed, moclobemide failed. Am hooked on venlafaxine just to reach some weird anhedonic restless baseline. Memantine seems to have stopped working too.

 

[CFC]

They are consistently rated as the most effective antidepressants, some more than others.

But as I'm sure y'all know, doctors are incredibly averse to prescribing nowadays due to what are actually extremely rare and manageable tyramine reactions.

I haven't had the opportunity to try them personally though. It was hard enough convincing a doctor to prescribe harmless low-risk moclobemide - so you can imagine how difficult it would be to get risk-averse professionals to agree to these, whether you're suicidal or not

 

[plumbus-nine]

Prescription isn't the problem around here, selegiline/rasagiline are sold without as are most medicines except benzos/z-drugs/opiates but the classical ones, trancylpromine and the other whose name I forgot seem not to be available.

Moclobemide is available but failed in past so I'd rather try selegiline. Read some report of an individual even adding fluvoxamine on top of 50mg(!) of selegiline but of course I don't trust that report, it sounds like a ticket for serotonin syndrome.. Problem is that years ago I tried 5mg selegiline from India (thus possibly adulterated even when the other meds were ok) and got problems with aggression, led to a police record and me living with afraid of jail for like 2 years.. in the end it didn't happen but they nearly ejected me from Germany.. don't wanna run into this again. It was weird because stims even meth have in lower doses a more calming effect to me and 5mg aren't supposed to act on NE.

 

[CFC]

There's a decent website which has a nice discussion of the various MAOIs used as antidepressants and has collected various reports and opinions. You should certainly give it a read. I'll see if I can find the link later when I have some time to check my bookmarks.

Also, I know you're only joking, but you should probably edit out the stuff about online pharmacy and prices, as it's generally against the forum rules here (y)

 

[HOOH]

They are consistently rated as the most effective antidepressants, some more than others.

After psilocybin and ketamine, of course

 

[plumbus-nine]

After psilocybin and ketamine, of course

Well K didn't do it in past (DXM did tho, but many many years ago, also effects lasted only around a week or so - ever since I wasn't able to get any more lasting AD effects out of a dissociative) and my tolerance to psychedelics is abnormally high due to the venlafaxine, (1cP-) LSD was the only one which was able to break through it, guess DMT should be too, that's definitely on my list but dunno whether it is too short lasting for effects as an antidepressant. For shrooms I'd have to go through venla withdrawal first, which I don't tolerate at the moment ... :/

 

[telepathetic]

Can someone define "reversible" in this regard? Or say, with tyrosine kinase inhibitors, etc?

 

[HOOH]

Well K didn't do it in past (DXM did tho, but many many years ago, also effects lasted only around a week or so - ever since I wasn't able to get any more lasting AD effects out of a dissociative) and my tolerance to psychedelics is abnormally high due to the venlafaxine, (1cP-) LSD was the only one which was able to break through it, guess DMT should be too, that's definitely on my list but dunno whether it is too short lasting for effects as an antidepressant. For shrooms I'd have to go through venla withdrawal first, which I don't tolerate at the moment ... :/

Do SSRIs cause tolerance to psychedelics?

 

[plumbus-nine]

Do SSRIs cause tolerance to psychedelics?

At least venlafaxine does a robust job at down? / up? (always confuse them) regulating 5ht2a to the point of eg shrooms becoming unusable because overshadowed by secondary effects. Early into my treatment with venla I tried it and got nothing but a weird anxiogenic brain fog with like 7g cubensis, when before 2g gave a beautiful mild visual trip..

It's pretty common for people being unable to trip or at least losing all the visuals and euphoria when on SSRI.

 

[VerbalTruist]

Do SSRIs cause tolerance to psychedelics?

The answer is that YMMY. I have been on various SSRIs and have noticed no effect with psychedelics. When I was taking Effexor, psychedelics weren't a class of drugs that was on my radar. There have been some reports of serotonin syndrome in some people when they are taking venlaflaxine and decide to take stimulants, empathogens, and/or psychedelics. My recommendation is to always conduct thorough research before you decide to take a substance. Look at trip reports for counter indications, check on the various wikis that are out there, etc.

I know that I eventually landed on Wellbutrin because there aren't any sexual side effects for me and it allows for the occasional psychedelic or stimulant without worrying about it.

 

[AlphaMethylPhenyl]

Irreversibles take two weeks to dissociate from MAO.

Diet it essential to stick to at least until you know how you'll react to small amounts of tyramine-containing substances.

If all of those have failed you with a decent trial period (a few months or a significant side effect) then it might be indicated.

Wellbutrin is a unique and interesting antidepressant.

 

[plumbus-nine]

There have been some reports of serotonin syndrome in some people when they are taking venlaflaxine and decide to take stimulants, empathogens, and/or psychedelics. M

Which is pretty weird imho, but also leaves the interesting possibility of psychedelics actually restoring natural serotonergic activity - 5ht2a agonism shouldn't lead to serotonin syndrome(?) and ant/-inverse agonism of this receptor doesn't induce brain zaps either.

Yeah, the point about diet is worrying but I continue to read that it were overblown, the cases of death are just a handful and some people say they didn't get the tyramine sensitivity entirely.
Weird that we don't have any irreversible, selective MAOA inhibitors.

Wellbutrin was pretty inactive for me at 150mg/d unless combined with DXM which gave an effect which imho could be described as the real "rocket fuel" stuff. Was just 75mg XR DXM + 150mg bupropion but the most stimulating effect I've ever experienced, had to stop because it grew into uncomfortable strength, made me do some socially weird shit (yet nowhere as bad as with selegiline) and strongly potentiated tinnitus to the extent of fearing ototoxicity. Very possibly tachycardia/hypertension but strangely no insomnia.
Definitely recommendable for lethargic depression but I'm worried about cardiovascular stuff, and the tinnitus..

 

[YoungS]

I take 20mg for suicidal ideation and it helps. Can't up my dose because of positive symptoms of psychosis.

 

[VerbalTruist]

Wellbutrin was pretty inactive for me at 150mg/d unless combined with DXM which gave an effect which imho could be described as the real "rocket fuel" stuff. Was just 75mg XR DXM + 150mg bupropion but the most stimulating effect I've ever experienced, had to stop because it grew into uncomfortable strength, made me do some socially weird shit (yet nowhere as bad as with selegiline) and strongly potentiated tinnitus to the extent of fearing ototoxicity. Very possibly tachycardia/hypertension but strangely no insomnia.
Definitely recommendable for lethargic depression but I'm worried about cardiovascular stuff, and the tinnitus..

Can you go into the effects of that combination a but more? That isn't a very high DXM dose. Was it stimulating, sedating, would you talk more about that? I am interested.

 

[plumbus-nine]

Can you go into the effects of that combination a but more? That isn't a very high DXM dose. Was it stimulating, sedating, would you talk more about that? I am interested.

It was strongly stimulating, in a different quality than anything else I knew - pretty physical but without any anxiety as far as I remember (it's like 10 years ago) Rather that any fears were abolished. Or even sedating AND stimulating at the same time but with a definite plus on the stim side. I talked to some strangers in train, which I would never have done sober. Caffeine was a lot stronger, and brought the effects back full force when I was tired. Somehow managed to sleep regularly, though the possibility is that I had some milder sleep aid. The effects were like a very stimulating dissociative maybe, so instead of the confusion and robowalk you get stimulation. Dissociation was definitely noticeable but much less "stoning" than from DXM alone / DXO.

Would say the mechanisms are: Potentiation and prolongation of DXM, inhibition of DXO, modification of bupropion's metabolism so that it becomes slightly active as a DRI. Much NE on top.

Yeah, I was surprised by that low dose being so effective but very probably the fact that it was time released will have contributed much. So if possible get the polistirex variant (or if available, DXM XR capsules like Pulmofor).
Currently I'm trying to re-create this effect because most other antidepressants failed.. the pharmacies here didn't have bupropion so I went for fluoxetine + DXM. It's not the same by far but there is some potentiation. DXM is the only rhing so far which fully substitutes for venlafaxine and takes away any and all withdrawal effects (fluoxetine alone did nothing at up to 40mg).

Most annoying side effect I remember was tinnitus. It requires some time to adjust to the mental changes if you get it as strong as me. I'd suggest to start with 100mg bupropion and 50mg XR DXM or 2x 25mg.. and then taper up.

 

[n3ophy7e]

Wellbutrin is a unique and interesting antidepressant.

Indeed. I tried it many years ago while I was trying to find the right antidepressant for me. It's not even registered for use as an antidepressant here in Australia so I had to sweet talk my doctor in to prescribing it to me off-label. Stupid doctor honestly had no fucking clue what I was talking about, using it as a DRI. (It's only registered for use as a nicotine-cessation drug here in Aus).

I take 20mg for suicidal ideation and it helps. Can't up my dose because of positive symptoms of psychosis.

20mg Wellbutrin? I'm glad that it helps you. Have you tried other meds for your suicidal thoughts? Wellbutrin increases the amount of free dopamine in your brain which is why it would increase your positive psychosis symptoms.