3 replies to this topic

[agwoodliffe]

David Wallace was a pretty well renowned American writer. He suffered greatly from depression, and was treated with Phenelzine for about 20 years. Towards the end of that period, he started noticing some issues with it, and decided to try an alternative...nothing worked, and the depression returned. He switched back to Phenelzine, only to find it had lost its effectiveness. Not only was the depression resistant to all treatment, but it got worse and worse, until finally he committed suicide. A horror story.

 

So the question is, how could a depressive illness be resistant to so many scientifically approved treatments? Even more importantly, how could a drug like Phenelzine suddenly lose its effectiveness?

I think I have an answer. It has been shown that Phenelzine also inhibits the function of Vitamin B6, which is crucial for serotonin, dopamine and GABA synthesis. This inhibition becomes more pronounced over time. So it makes sense to think that his taking Phenelzine had caused some kind of long-lasting deficit in utilising Vitamin B6. The answer is simple: supplement with the vitamin, but I don't think Wallace knew that until it was too late.

[mealz13]

Could be.  There are so many variables and honestly, we really don't know how any of the drugs work, and additionally, how they don't work.  I've always espoused the idea of supplementation of essential nutrients to help with mental symptoms, while doctors would just try to up my medication--I felt much better when changed my diet than when I was on any drug.  Wallace was a great soul; I really enjoy his writing; his suicide is just another example of how we don't understand mental illness in general; perhaps if he had known about alternative treatments, like supplements, he would still be here, but it's hard to say.

[ElixirOfLife]

Google Nardil poop-out. It's a well known effect in a lot of users (that I've also experienced). 

 

Since phenelzine is a MAOI, I think it's highly likely that homeostasis is the cause for the substance to lose effectiveness. Keep in mind that Phenelzine (and all MAOIs) effect all the monoamine neurotransmitters and the brain knows how to deal with these changes. Serotonin, NE, dopamine, and GABA are monoamines and are effectively increased by phenelzine.

 

I also think there is a placebo effect after a while - that isn't discounting the effectiveness of phenelzine (it really is capable of working wonders!). Since it works so well initially, it's easy to see how we can start to associate well-being with taking the pill. After some time, any anti-depressant will lose effectiveness. Once the body's neurochemistry has adjusted to the effects, the med will stop working, even with long breaks in between. 

 

Life changes can happen and something can tip a person over the edge where the placebo effect isn't good enough and then we have to deal with real emotions again. Without the right emotional skills (which AD's can be a hindrance to natural development of), the psyche can spiral downward.

Edited by ElixirOfLife, 27 May 2014 - 10:24 PM.

[Reformed-Redan]

I dropped phenelzine cold turkey. Shits powerful. Too powerful IMO.