They've tried every other class of anti-depressant. Only the MAOI remain. Today I started the first 10mg titration round of tranylcyprom (generic of Parnate), after a two-week "washout" period wherein all other anti-depressants (Pristiq, in my case) had to be out of my system.
The washout wasn't as bad as I'd feared. Maybe two weeks wasn't enough to fling me into the pit of despair that landed me into BryLin and ECT over the summer when I foolishly attempted a cold-turkey quit. There were the usual SNRI withdrawal symptoms. Well, I suppose there's just the one, colloquially dubbed "brain zaps" by its sufferers. For me, it manifested itself as a kind of whooshing when I moved my eyes laterally. It's actually still happening, but far less severely than when I first went off.
The worst thing about an MAOI, and why they don't prescribe drugs of its class more often, is the dietary restrictions. My doctor downplayed them, saying most of the things on the restricted list "we don't eat much of in America." He was highlighting Chianti and fava beans and banana peels, glossing over the star criminals of aged meats and cheeses. That means sausage, cheddar, and pepperoni.
What happens if you ingest one of these verboten items while taking an MAOI? If you're lucky, nothing, but you'll probably have a "hypertensive crisis." That is, your blood pressure will skyrocket. Your head will feel like it's being split apart. For that, he prescribed nifedipine capsules. I break one of them in my mouth, wait fifteen minutes, break another, and if that doesn't cause the symptoms to go away, I go to the ER.
But, hell, if the drug makes me happy, I'll give up pepperoni pizza, and cheesesteak pizza, and sausage pizza, etc.
If that were all, if it were just some small list, it wouldn't be so bad. However, when you start Googling MAOI dietary restrictions, you get a whole hell of a lot of stuff. Caffeine. Aspartame and phenylalanine. That's my beloved Pepsi Max right there.
So, today I woke up, took the single square red pill (along with Simvastatin and a 0.5mg Klonopin), left the house without breakfast. Once at work, I had a Smores Pop Tart and maybe three cups of coffee through the day. At least that much caffeine didn't have an effect. I had my usual 300mg of Provigil at noontime, but with water rather than Pepsi Max. I didn't want to push it. Add in a handful or four of shredded wheat. I figured a box of it would be a cheap and relatively healthy snack.
Someone on the Intarwebs had written that an MAOI heightened the effects of their cigarettes. Nothing for me with my RYO Drum sticks. Indeed, nothing really "good" at all, but it's the first day on the lowest dose, so one can't expect much.
For dinner, the wife made spaghetti and meatballs. It was very good, and nothing in it seemed to bother me. I had some salad, but skipped all the dressings, as they were creamy and certain creamy things are on the restricted list, so why take chances?
With luck, I'll lose weight just because I'm afraid to eat anything.
That brings us to now, with me sitting down after finally getting the girls to sleep, and figuring it was my duty to chronicle my own run with this exotic class of anti-depressants. In another four days I go to two pills a day, and four days after that, the full three daily. Unfortunately, that's one each morning, noon and night, not just three at once.
I think I'll have a peanut butter sandwich and some milk, then go to bed.
Speaking of going to bed -- that may be different tonight. I'll say no more lest I jinx what could be the happiest development since 2009.