These accounts are from people with whom I have recently interacted via my web site. This first gentleman’s account illustrates vividly how rapidly Parnate can be effective, despite treatment failure of, among many things:
The usual ‘guideline-recommended’ regimes with various additions and combinations
- ‘38 ECT treatments
- six weeks of daily transcranial magnetic stimulation treatments
- multiple (and very expensive) IV ketamine doses’.
- Mono-therapy with new super Asenapine (sarcasm)
- But … no MAOI, ever suggested, at all, not one tablet
Understanding, or justifying, doctors’ pathological avoidance of Parnate, illustrated by the above peregrinations prior to Parnate, is quite beyond my understanding — I hope this story demonstrates why!
In my ‘Guidelines’ commentary I discuss why RCTs and statistics mis-direct doctors. These RCTs are all about a few rating-scale-points improvement — not complete remission of a prolonged illness within 3 or 4 weeks, like this man experienced. When you have seen a number of examples of responses such as these below — I have seen a great many — you may be inclined to re-assess your evaluation of RCT data and use Parnate more often, and sooner in the course of the illness.
Just think for a minute about the suffering, the wasted time, the expense, the distress to family, the damage to career, the deterioration of general health, that this man endured. This is the nightmare you have nightmares about.
Just contemplating this will, I hope, pain you as much as it pains me, and may make you wish you could ‘turn-down’ your capacity for empathy. And, ‘lest we forget’, for every story like this, there are the ones we will never know of, because those people did commit suicide.
Remind yourself of that, next time you are blathering like a blithering idiot about some trivial SE, like low or elevated blood pressure, or whatever***.
I should also repeat that this story is not exceptional: I am contacted by many patients with similar stories, many of whom respond dramatically and quickly to tranylcypromine. Not everybody either wants, or finds it easy to, revisit such traumatic experiences and write an account of them. Indeed, this gentleman took some months to do it because it was a process that aroused powerful memories and emotions.
*** One can ‘blather’, or ‘blither’, but only properly be a ‘blithering idiot’: the vagaries of English are so delightfully quixotic. That may be because the vowel order is jarring; one says ‘tic, tac, toc, or tick-tock (sound of a clock). To say ‘toc, tic’ just sounds wrong — native English speakers follow this ‘rule’ without even being conscious of it. Perhaps that is why ‘blathering idiot’ never came into use?
In so far as this story is not exceptional, and one cannot say that without thinking of Dr Osheroff, recently deceased, and his legal case against the infamous ‘Chestnut Lodge’ hospital around 1980, there is an uncanny parallel to this first case report story. I will not go into the Osheroff-case in detail, comment is plastered all over the Internet, and it is a standard part of the teaching of doctors in training. For those who are interested I suggest using the search terms: Osheroff, Chestnut Lodge, Bernard Carroll, Gerald Klerman, and Mickey Nardo.