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Re: Selecting an MAOI

Posted by maxime on July 17, 2003, at 19:50:36

In reply to Selecting an MAOI, posted by david maclean on July 17, 2003, at 19:29:34

Hi there. Usually a pdoc will prescribe Nardil if you have a lot of anxiety.

Parnate is more stimulating so it is good for the type of depression where you can barely get out of bed.

But there are always exceptions. Some people with high anxiety respond better to Parnate.

I guess because both Nardil and Parnate can cause high blood pressure that the stimulant effect of Parnate would raise your BP more than Nardil. But I don't know if that is true or not. I take Parnate and my BP has lowered.

Marplan isn't available in the U.S. so I really can't comment on that.

Max

> How does a psych doc go about selecting an MAOI for atypical (apathetic) depression?
>
> I have hard that Nardil is sedating and that Parnate is energising. Is that the main criterion for choosing between these two?
>
> The UK pharms guide for docs (the BNF) says this ... "Tranylcypromine (Parnate) is the most hazardous of the MAOIs because of its stimulant action. The drugs of choice are phenelzine (Nardil) or isocarboxazid (Marplan) which are less stimulant and therefore safer."
>
> Have they got it right? In what way do they mean that Parnate is dangerous on account of its stimulant action?
>
> What about Marplan (Isocarboxazid)? I don't hear much about this one. Is this because it is usually a very last choice?
>
> Is the preferred choice Nardil then Parnate then Marplan?
>
> I would welcome any info on the questions I have asked. Thank you.

 

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