Several years ago I did some research on all the Makarov ammo that I could find, and there is still one manufacturer that makes some good defensive ammo: Hornady. Their specs for it are: 95 grain JHP, 1000 fps, 211 ft/lbs at the muzzle. It can be ordered from Cheaper Than Dirt or Natchez Shooters Supplies. I usually just buy it at the monthly gun show.
Cor-Bon made some +P Makarov ammo at one time, but I think it has been discontinued. Cheaper Than Dirt also lists a couple of different versions of Glaser Safety Slugs for the Mak, if that's your thing. The Hornady XTP is what mine is loaded with, although I don't carry it anymore.