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Re: Marplan compared to Parnate. Which one? Tom2228

Posted by SLS on February 20, 2020, at 1:03:10

In reply to Re: Marplan compared to Parnate. Which one?, posted by Tom2228 on February 18, 2020, at 18:15:46

Hi, Tom.

> Ive taken all 3 at varying times in the past decade, always returning to Marplan...until the crushing shortage. Rechallenge of Nardil worked for a little bit until the honeymoon wore off then it just drove me crazy for about a year until I went back to Parnate. My life has invaluably changed for the better and have experienced several months (Im severely rapid cycling) of stability, remission from depression (a *real* feat), anxieties, you name it and no need to look back despite Marplan newly available.

I'm glad it was life-changing for you. That's what I'm looking for, too.

Do you have any plans to go back to Marplan? Is Parnate now as effective for you as Marplan was in the past?

> IME Marplan is a very effective drug. It is often underdosed, however. I would suggest not giving up until you have spent adequate time on at least 80-90mg, which is the dose that worked best for me for years.

I hope I can convince my doctor to go that high if needed. I emailed him the 2007 Marplan company drug monograph that recommends a maximum dosage of 60 mg/day - as compared to the old recommendation of 30 mg/day.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011961s039lbl.pdf

> N.B. Last time I was on 90mg Marplan I required 50-75mg desipramine, 80mg methamphetamine, and 1.25mg pramipexole. Now with 100-120mg Parnate Ive dropped the TCA in favor of 15mg dextroamphetamine + the methamphetamine, and seem to be okay without the dopamine agonist.
>
> Of course its highly individual, but bottom line, I believe Marplan is highly underrated (and underdosed for those who need it. My doctor had someone on 175mg Marplan + 45mg Dexedrine). Just dont give up on it; it mixes very well with adjuncts too since it itself has few if any side effects (barring some weight gain).

If I were to take 60 mg/day, how many weeks should I give it to work? Do you know of any literature that suggests going higher than 60 mg/day? How do you know when it makes sense to go higher?

> Desoxyn is another adjunctive option that I believe you have not trialed. It is a very gentle med, relatively free of side effects, and most importantly has been found at lower/ therapeutic doses to be *neurotrophic*. The toxicity we all know about is associated with recreational doses. Where does the fine line exist? Who knows, but MAOIs are neuroprotective so.. IMO its worthy of serious consideration for those who are so recalcitrant. Id probably be dead without it. 10yrs and sharp as a tack.

Woohoo!

So, what are you taking now, Tom?

Currently, I take:

nortriptyline 100 mg/day
Lamictal 300 mg/day
Lithium 300 mg/day

300 mg/day is an ideal dosage of lithium for me. Going higher flattens me out and makes me feel apathetic and more depressed. It helped a bit with depression when I first added it to Parnate. I decided to stay with it, even it no longer contributes to reducing depression as a preventative for Alzheimer's Dementia.

My doctor will likely switch from nortriptyline to trimipramine if I don't respond to the addition of Marplan. I still profit from taking Lamictal. I tried to reduce the dosage a few weeks ago and felt an abrupt increase in depression.

Stay well...


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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