Posted by chad_3 on September 9, 2002, at 11:04:03
In reply to Re: Nardil v Parnate, Klonopin, Xanax, gabaergic, SP, posted by cybercafe on September 9, 2002, at 7:58:41
Cybercafe -
>
> hmmm... if serotonin is more gooder for anxiety, why do SSRIs do so poorly and MAOIs do so much better?
>
For generalized anxiety disorder by itself, I think that Paxil and Effexor are both superior to the MAOI's, and can work very well at low doses. I agree that for significant generalized SP by itself, Nardil is far superior to SSRI's, and probably even Parnate - because although Parnate doesn't tend to increase a "friendly sociability" like Nardil - Parnate still is usually effective at reducing interpersonal sensitivity, low motivation, and most types of associated depressions. Agressivness or "anti-social" behavior around people (even while not "afraid" to do so) - is more likely with Parnate than Nardil - often people taking Parnate for primary SP are not really "afraid" to be around people - but rather find they would prefer to avoid them - and still end up alone most of the time - not particularly social - but definitely active and productive in more solitary type work or pursuits. Just IMO based on what I've heard out their so far. Perhaps your experience with Parnate has been more succesfull than the ones I've heard about ...> or theoretically... at least something like moclobemide should be much much better for anxiety than nardil if 5HT = good, and NE and DA = bad
I think 5ht, DA, and GABA agonists are they agents shown most effective for SP to date. Nardil boosts all 3. I do think 5ht plays a role - but while the SSRI's boost 5ht, then also decrease whole brain DA (maybe good for depression, but tending to increase passitivtiy at the expense of social and sexual assertivness (initiation), exploratory behavior and disinhibition). Nardil instead of depeleting dopamine rather apparently moderately boosts it, consistent with the above advantages associated with DA++.
> however doesn't evidence seem to suggest that in fact moclobemide is not better than nardil ?
>
Interesting point - but IMO I have yet to see evidence pointing to much efficacy for moclobmoide. I think the moclobomide studies are a great example of how divergent some of these studies can be in their conclusions (how does this happen?). 5 large D/B studies for moclobomide for SP (more than any other med) - 2 of them show NO efficacy, 2 of them show EXTREME (good) efficacy, and 1 shows modest efficacy. Nardil and Klonopin show robust results in all studies for SP. I have yet to hear of any individual reporting long term robust results with moclobomide for primary significant SP - in spite of the fact the this drug is widely used across the world to treat SP. I think moclobomide is a great antidepressant - with little to no side effects, and great for dysthymia as well, but my opinion is that it lacks robust efficacy for SP. Maybe someone will prove otherwise. I hope so - because the side effect profile of moclobomide is practically unsurpassed among psychotropic drugs. IMO, moclobomide does not seem to be particularly effective for the "anxiety" component associated with SP. Coincidentally there are studies that have shown also that MAOI-B + MAOI-A inhibition leads to axiolytic effect, while MAOI-A alone (eg; moclobomide) or MAOI-B alone (selegline low dose) does not.>
> yeah... but why does parnate work for me so much better than effexor or paxil?
> i find the stimulating properties agitate me, but my SP is definately much much much betterI just this part of what you wrote now - but it sounds similar to what I've heard from others and wrote about above (and similar to my experience also) with Parnate...
>
>
> maybe you can try klonopin or trazodone with parnate? ....I was able to tolerate well (still had high energy, cognition, and good sleep) - high Klonopin + Parnate (also high Klonopin + Effexor). But still axiogenic. Xanax definitely reacted differently with Parnate. IMO Xanax preferentially blunts NE over 5h2, (unlike Klonopin IMO) - and is part of what makes Xanax so effective for panic and SSRI-type antidepressant effect (can be depressive too - especially in males I think where significant NE drop can reduce energy and mood).
>
> the question is... why does nardil have worse side effects (i dunno...hypotension? anorgasma? sedation?) than parnate? ... or than an SSRI... ?
>
hypotension usually worse with Parnate (but usually goes away entirely with either MAOI after a couple months anyway). Sexual side effects with Parnate are less than Nardil at comparable dose ranges - but SSRI's (Zoloft, Paxil) - I believe are much greater at comparable doses. As with hypotension - Nardil sexual side effects reduce probably ballpark 80% on average over the first 3-4 months - where SSRI sexual side effects start bad, stay bad, end bad - they rarely if ever improve over time.Sedation - Parnate and Nardil - neither usually a problem with this - yes Parnate more activating but it's tendency to cause insomnia may result in daytime sedation. Overall I think MAOI's are activating - moreso than all SSRi's except Prozac and the SNRI Effexor, to which I think they are more comparable.
>
> i am in canada... my doc has tried moclobemide before... but like others have indicated, moclobemide does not seem to have the same effectiveness on depression or anxiety as parnate (for depression) or nardil (for anxiety)Moboclobomide is milder - I thought it was probably a pretty good antidepressant ... no? I know that when they have tried to use it for SP in studies, they always push the dose extremely high.
>
>
> > I notice however the UCLA Dr's do still like to give out Zyprexa samples though (might be a dangerously effective mix with Parnate for SP and other disorders)... ; )
>
> you may be right... but feeling happy is more important to me than a possible movement disorder (and my relationship with my doc) ...... i'm guessing that worst case scenario, dopamine agent or 5HT2A agent or aripipazole or ECT clears up ... or at least covers up.... any irreversible EPSIf you want Zyprexa - certainly you won't have much trouble in 2002....
>
>
> you're probably right that nardil is better than parnate ... i am thinking more along the lines of getting an equal anxiolytic effect and increased antidepressant effect without the side effects of nardil .....Some people report a lot of side effects with nardil - I believe that these can be managed if they are unavoidable - by reducing the dose and augmenting. Anyway - I would be interested in discussing it with you sometimes in email if you want - I have been a "human gineua pig" in earlier years - have tried different things so maybe we could learn something from each other. Anyway was great to hear you comments on SP and thanks for the input and feedback.
Chad
http://www.socialfear.com/
poster:chad_3
thread:119071
URL: http://www.dr-bob.org/babble/20020906/msgs/119369.html