Posted by Questionmark on July 8, 2006, at 22:58:44
In reply to Moving from Nardil to Emsam., posted by sanshin on July 2, 2006, at 22:12:21
Nardil is significantly more serotonergic (and less catecholaminergic) than selegeline/Emsam, and you may be having extremely reduced serotonin transmission and a possible catecholamine overload (esp dopamine?), which can make your emotions much more unstable and sensitive and can result in a return of depression. Can you try some 5-HTP (or, possibly even better, tryptophan [if you can get it]) along with it? I would try this. And/or try to get some tryptophan. (Under your doctor's supervision, preferably, of course.)
If he/she would be willing, maybe you could even maintain low doses of Nardil and Emsam, while gradually reducing the former and raising the latter. However, my personal theory is that those who do well with Nardil will not do as well with Parnate or selegeline, and vice versa. But hopefully I'm wrong about this.
In any case, good luck.> Hi,
>
> I've used 60 mg/day of Nardil since approx 1985. Overall, it worked for my atypical depression. I do believe the formulary change in '03 compromised the quality of Nardil.
>
> Three wks ago, my excellent pdoc suggested I try Emsam. I did a very abbreviated withdrawl from the Nardil (going to nil in about 5 days) but stuck on the patch the same day I heard about Emsam; therefore running both at once for a few days. I checked my BP during this dual drug therapy and it was lower than normal (101/71). I am hypertensive and take Atenelol.
>
> With the 20/6 patch and a couple of Nardil, I felt great. However, I am now only using the Emsam. Things are unwinding rapidly and I am getting back into some heavy depression.
>
> The Emsam (or rapid Nardil withdrawl) has brought some extreme fatigue and constant need for sleep. However, sleep brings disturbing dreams similar to other Nardil withdrawls.
>
> Any ideas? I honestly wish I'd just stuck with the Nardil. The phenelzine was consistently helpful. Perhaps I need a heavier load of the Emsam. I wonder if someone who needed 60 mg of Nardil can really get enough MAO inhibition with this patch.
>
> Other meds I use: Ambien, Xanax. (And Atenelol).
>
> Thanks for any thoughts.
poster:Questionmark
thread:663682
URL: http://www.dr-bob.org/babble/20060701/msgs/665289.html