![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 40. This is the beginning of the thread.
Posted by Lynne on August 7, 1999, at 20:36:10
I am going to start taking Parnate soon. I have Social Phobia and Atypical Depression. Any thoughts or information on Parnate would be deeply appreciated!
Posted by Elizabeth on August 8, 1999, at 21:42:22
In reply to Parnate information wanted, posted by Lynne on August 7, 1999, at 20:36:10
> I am going to start taking Parnate soon. I have Social Phobia and Atypical Depression. Any thoughts or information on Parnate would be deeply appreciated!
Is there something specific you'd like to know? There are many old threads on MAOIs that include discussion of Parnate.
Posted by lynne on August 9, 1999, at 9:03:32
In reply to Re: Parnate information wanted, posted by Elizabeth on August 8, 1999, at 21:42:22
> > I am going to start taking Parnate soon. I have Social Phobia and Atypical Depression. Any thoughts or information on Parnate would be deeply appreciated!
>
> Is there something specific you'd like to know? There are many old threads on MAOIs that include discussion of Parnate.I am worried about being able to sleep when taking Parnate. Can you take Trazadone with Parnate? I am also concerned about weight gain.
I will go back and check out the old threads on MAOI's. Have you tried Parnate yourself and did it help you?Thanks,
Lynne
Posted by Ruth on August 9, 1999, at 20:27:02
In reply to Re: Parnate information wanted, posted by lynne on August 9, 1999, at 9:03:32
I've taken parnate for a unipolar depression. I had a good response to it which lasted for a number of months and then it ceased to be effective. The two things to keep in mind are the need to follow the dietary restrictions (Dr. Bob has something about that) and also the chance that it will cause orthostatic hypotension (you get dizzy when you stand up- so you have to remember to stand up slowly)
As for the sleep issue I had the opposite problem to your concern which is to say that I found the parnate quite sedating and so I found myself needing afternoon naps.
But all things considered it certainly was helpful to me.
Let me know if you have more questions.> > > I am going to start taking Parnate soon. I have Social Phobia and Atypical Depression. Any thoughts or information on Parnate would be deeply appreciated!
> >
> > Is there something specific you'd like to know? There are many old threads on MAOIs that include discussion of Parnate.
>
> I am worried about being able to sleep when taking Parnate. Can you take Trazadone with Parnate? I am also concerned about weight gain.
> I will go back and check out the old threads on MAOI's. Have you tried Parnate yourself and did it help you?
>
> Thanks,
> Lynne
Posted by Elizabeth on August 11, 1999, at 13:45:27
In reply to Re: Parnate information wanted, posted by lynne on August 9, 1999, at 9:03:32
> I am worried about being able to sleep when taking Parnate.
A legitimate concern. I don't have any more problems on Parnate than off it, but (1) I take it all before 3pm, and (2) I have pretty bad sleep problems off it!
> Can you take Trazadone with Parnate?
You certainly can.
> I am also concerned about weight gain.
Never heard of anyone gaining weight on Parnate in the long run, though I did *regain* some of what I'd lost while depressed.
> I will go back and check out the old threads on MAOI's. Have you tried Parnate yourself and did it help you?
Hell yeah. I take 30mg/day with lithium. The combination has helped a great deal.
Posted by Mark on November 24, 1999, at 14:32:27
In reply to Re: Parnate information wanted, posted by Elizabeth on August 11, 1999, at 13:45:27
Has anyone taken Parnate for social phobia?
If so just a few questions: Is it better than Nardil for social phobia?
Does it generally work better than the SSRIs for social phobia? Do either Parnate or Nardil cause weight gain? Finally, how closely do you have to follow the dietary restrictions? Can I drink beer!?
Thanks.
Posted by Elizabeth on November 25, 1999, at 0:39:20
In reply to Re: Parnate information wanted, posted by Mark on November 24, 1999, at 14:32:27
> Has anyone taken Parnate for social phobia?
I don't have generalized social phobia, but I do have an anxiety disorder of some sort (overlap of panic disorder, social phobia, and generalized anxiety, maybe) and have taken Parnate.
> If so just a few questions: Is it better than Nardil for social phobia?
No, in my experience Nardil was definitely better for general and social anxiety.
> Does it generally work better than the SSRIs for social phobia?
They haven't been compared directly, but my hunch is yes.
>Do either Parnate or Nardil cause weight gain?
Nardil: yes, very frequently.
Parnate: no.
I just started taking a third one, Marplan, to see how it will do; so far no sugar cravings.
>Finally, how closely do you have to follow the dietary restrictions? Can I drink beer!?
I've posted my standard rant about MAOI diets a number of times and won't repeat it here -- look in the old MAOI threads if you're interested. (Not trying to blow you off, but it's rather long.)
Posted by carole on November 29, 1999, at 2:05:16
In reply to Re: Parnate information wanted, posted by Elizabeth on November 25, 1999, at 0:39:20
> > Has anyone taken Parnate for social phobia?
>
> I don't have generalized social phobia, but I do have an anxiety disorder of some sort (overlap of panic disorder, social phobia, and generalized anxiety, maybe) and have taken Parnate.
>
> > If so just a few questions: Is it better than Nardil for social phobia?
>
> No, in my experience Nardil was definitely better for general and social anxiety.
>
> > Does it generally work better than the SSRIs for social phobia?
>
> They haven't been compared directly, but my hunch is yes.
>
> >Do either Parnate or Nardil cause weight gain?
>
> Nardil: yes, very frequently.
>
> Parnate: no.
>
> I just started taking a third one, Marplan, to see how it will do; so far no sugar cravings.
>
> >Finally, how closely do you have to follow the dietary restrictions? Can I drink beer!?
>
> I've posted my standard rant about MAOI diets a number of times and won't repeat it here -- look in the old MAOI threads if you're interested. (Not trying to blow you off, but it's rather long.)I have taken parnate for 3 yrs. consider it a wonder drug. Have heard similar from others as well. curious about sugar cravings. have had intense sugar cravings, mostly at night. I've certainly considered parnate could be cause. would like more info on experiences with this side effect and/or others regarding metabolism changes, (carbohydrate, insulin resistance anything anecdotal re; side effects possibly linked to parnate) Also, any info on lupus -like symptoms associated w/ MAOi's noted. Also, I get such a profound reaction by non-psych doc's when I tell them I take Parnate. Recently in hospital w/ severe pneumonia and M.D.s afraid to treat me for fear of interaction w/ parnate. Albuteral breathing treatments stopped when pulmonary doctor
got hospital pharmacists' drug interaction sheet.This was straightened out after I explained that I had never had a reaction before and suggested we monitor BP during tx's. Dose of albuterol still decreased. This was upsetting as I was having quite a hard time breathing and was exhausted from effort. I was given so much info and lecture after lecture by every medical person treating me in the hospital that I have decided to stop the medicine. I am afraid I will be denied medical treatment in the future by uninformed physicians who are scared to death of the MAOi's. I am a psychiatric nurse myself and have great faith in the physician who prescribed the parnate for me. I have read much on the drug and have carefully determined what meds to stay away from. Unfortunatly, it is a source of much concern for the doctors presently treating me for the pneumonia and working to diagnose what appears to be some sort of auto-immune thing going on . If anyone knows of a possible connection - parnate and hyper-immune, lupus like symptoms, please let me know. There are a number of people here in Florida ready to smugly "I told you that was a bad drug" me to death. Thanks.. CT
Posted by Mark on November 29, 1999, at 3:47:48
In reply to Re: Parnate information wanted, posted by carole on November 29, 1999, at 2:05:16
Carole, was Parnate good for your social anxiety, if you have it?
Posted by carole on November 29, 1999, at 21:49:24
In reply to Re: Parnate information wanted, posted by Mark on November 29, 1999, at 3:47:48
> Carole, was Parnate good for your social anxiety, if you have it?
I did not have a social anxiety. More of a situational "misery". A combination of "sorry Life Events" left me feeling very sad and hopeless. Parnate took me from feeling like "I hate the world, why me?" to "this is pretty cool, I really love people after all!!" in a matter of a week! Not what you normally see with antidepressants. The "euphoria" leveled off however, and I just felt damn NORMAL again. Less emotional, more energy. I expect that my "kiss-my-butt-confidence" is boosted by the "wonder drug". The med had same effect on my brother who had suffered serious clinical depression complete with the expected social "phobia" that one developes after years living with a chronic disableing disease. He turned his life around. BUT... the drug seemed to lose it's effectiveness after 4-5 years and he slid back into a severe depression with some psychotic features.Parnate IS a wonderful medication. Much education is needed so that clinicians will not avoid trying patients on it when other meds just dont work. The benefits FAR outweigh the risks in many cases!We dont withhold the toxic cancer drugs from patients who need them as the only treatment available to extend life. Mental illness requires the same aggressive treatment sometimes.
Posted by JAIME on December 7, 1999, at 8:27:36
In reply to Parnate information wanted, posted by Lynne on August 7, 1999, at 20:36:10
>IN response to the original questions:
1. Yes for me works against social phobia
2. if is better than nardil I can say that are different. Because Parnata acts as a Anphetamine and Nardil not. I prefer Nardil because it works better for me.
3. Yes both cause weight gain.
4. I dont follow any dietary resatriccions and I am on nardil + parnate.
5. I use NARDIL + Parnate and really are fantastic combined.I am going to start taking Parnate soon. I have Social Phobia and Atypical Depression. Any thoughts or information on Parnate would be deeply appreciated!
Posted by Scott L. Schofield on December 12, 1999, at 12:27:31
In reply to Re: Parnate information wanted, posted by JAIME on December 7, 1999, at 8:27:36
> 4. I dont follow any dietary resatriccions and I am on nardil + parnate.
> 5. I use NARDIL + Parnate and really are fantastic combined.
You have taken Parnate and Nardil at the same time? I have never heard of this, but I have often thought of it. My doctor feels that it is necessary to allow two weeks between discontinuing one and beginning the other.1. How did you go about beginning the combination treatment?
Did you begin both at the same time or add one while already taking the other?
2. Do you know if this combination has been used by others?
3. Why did you discontinue it if it was working so well?This seems like an exciting treatment option for those of us who are treatment-resistent. It would be greatly appreciated if you could provide any documentation or other sources to support the safety of this combination.
Much Thanks.
- Scott
Posted by Zeke on December 13, 1999, at 6:27:06
In reply to Re: Parnate information wanted, posted by lynne on August 9, 1999, at 9:03:32
Parnate is structurally related to amphetamine. You may experience some sleep difficulty transiently at first (or at first at a certain dose). This is reportedly the most common side effect. You should become tolerant to that if it happens. Re weight gain, the med may cause some weight gain but also by virtue of being an amphetamine-cogener also weight loss effects.
A adverse effect of both medications is orthostatic hypothension -- dizziness or fainting when for example going from laying to standing. Since it is a side effect of both drugs, that may be more likely to occur. Because of that and other MAOI interatcions (in general, not necessarily with Desyrel per se) your doc will likely be more cautious than in using Parnate alone.
You might wish to look at: http://www.mentalhealth.com/drug/p30-p01.html
Also see the section on monoamine oxidase inhibitors in the Merck Manual: http://www.merck.com/pubs/mmanual/section15/chapter189/189b.htmHad you previously taken any SSRIs?
Posted by Zeke on December 13, 1999, at 7:28:00
In reply to Re: Parnate information wanted, posted by carole on November 29, 1999, at 2:05:16
Between being lectured and being a nurse, I'm certain you've heard about the Serotonin Syndrome -- a sudden buildup of serotonin in the body. This syndrome is a special hazard from MAOI interactions and has reportedly caused 15 deaths (eg, Libby Zion: phenelzine and meperidine). This syndrome may be easily overlooked in diagnosis. Combined with the fact that MAOIs are much less used, since the SSRIs etc have become available, most physicians are inexperienced in treating patients taking MAOIs, though academically aware of the potential dangers. I imagine the role of serotonin in the Phen-Fen matter, also increases the concern. So from a doctor's perspective, the Hippocratic Oath as well as malpractice suits (eg, Libby Zion again), must come to bear.
That doesn't make your situation easier, but it's an explanation!
See:
http://www.hospitaldoc.com/serotoni.htm
http://www.vh.org/Providers/Lectures/EmergencyMed/Psychiatry/MedEmergSerotonin.html
http://www.ozemail.com.au/~ouad/SERO0001.HTM
http://www.ozemail.com.au/~ouad/MONA0001.HTM
Posted by Elizabeth on December 13, 1999, at 7:36:24
In reply to Parnate: sleep & weight, posted by Zeke on December 13, 1999, at 6:27:06
> Re weight gain, the med may cause some weight gain but also by virtue of being an amphetamine-cogener also weight loss effects.
AFAIK Parnate has *never* been reported to cause weight gain in the literature.
Posted by Zeke on December 13, 1999, at 7:52:39
In reply to Re: Parnate information wanted, posted by carole on November 29, 1999, at 21:49:24
> Much education is needed so that clinicians will not avoid trying patients on it when other meds just dont work. The benefits FAR outweigh the risks in many cases! We dont withhold the toxic cancer drugs from patients who need them as the only treatment available to extend life. Mental illness requires the same aggressive treatment sometimes.
Since it works for you witout severe untoward reaction, it's a wonderful drug.
No we don't withhold (some) toxic compounds in cancer therapy. But we are cautious about using them. We also withdrawl some drugs that have non fatal toxicities: thalidomide and fenfluramine.
I know you're venting, but just playing the devil's advocate...
Besides, have all other meds failed? Have all the SSRIs been tried? other newer antidepressants? Have they been augmented with Synthroid or pindilol or stimulants or... This may or may not be safer than an MAOI but sounds like it would cause less physician anxiety and hassle for you (in the long run).
Posted by Zeke on December 13, 1999, at 8:28:53
In reply to Re: Parnate: sleep & weight, posted by Elizabeth on December 13, 1999, at 7:36:24
> > Re weight gain, the med may cause some weight gain but also by virtue of being an amphetamine-cogener also weight loss effects.
>
> AFAIK Parnate has *never* been reported to cause weight gain in the literature.I beg to disagree -- see references. (I have to refrain from saying, "not in the literature, just in people.")
However since we're speaking of Parnate, note that the weight gain seems to occur much moreso with Nardil than Parnate. As Bernstein says, "...an amphetamine-like structure of tranylcypromine may explain its lesser ability to stimulate appetite and weight gain than the appetite and weight effects observed with phenelzine."
Bernstein JG
Induction of obesity by psychotropic drugs.
Ann N Y Acad Sci 1987;499:203-15
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2886102&form=6&db=m&Dopt=bRemick RA, Froese C, Keller FD
Common side effects associated with monoamine oxidase inhibitors.
Prog Neuropsychopharmacol Biol Psychiatry 1989;13(3-4):497-504
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2748873&form=6&db=m&Dopt=bCantu TG, Korek JS
Monoamine oxidase inhibitors and weight gain.
Drug Intell Clin Pharm 1988 Oct;22(10):755-9
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3068037&form=6&db=m&Dopt=bOn the otherhand, some evidence exists for a weight loss effect from Parnate(tranylcypromine).
Dulloo AG, Miller DS
Thermogenic drugs for the treatment of obesity:
sympathetic stimulants in animal models.
Br J Nutr 1984 Sep;52(2):179-96
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=6477859&form=6&db=m&Dopt=b(Importantly, this article also rejects the common notion that stimulant type drugs reduce weight purely through reducing appetite.)
So its a mixed bag...
Posted by Adam on December 13, 1999, at 9:32:08
In reply to Liz: Parnate: weight gain, & the literature, posted by Zeke on December 13, 1999, at 8:28:53
> I have to refrain from saying, "not in the literature, just in people."Why refrain? Individual responses to ADs can diverge quite dramatically from the average response.
'Not to say "the literature" has no value, it just doesn't account for everything.
Posted by Zeke on December 13, 1999, at 10:00:58
In reply to Re: Liz: Parnate: weight gain, & the literature, posted by Adam on December 13, 1999, at 9:32:08
> Why refrain? Individual responses to ADs can diverge quite dramatically from the average response.
> 'Not to say "the literature" has no value, it just doesn't account for everything.I was being more sarcastic than literal. I didn't want to be hurtful to Elizabeth however. (Literally, weight gain is documented in (Parnate in) the medical journals.)
Posted by Adam on December 13, 1999, at 10:53:49
In reply to Adam: My sarcasm missed!, posted by Zeke on December 13, 1999, at 10:00:58
I seem to have a special talent for failing to recognise sarcasm, or even mild irony. You didn't miss, I did.
> > Why refrain? Individual responses to ADs can diverge quite dramatically from the average response.
> > 'Not to say "the literature" has no value, it just doesn't account for everything.
>
> I was being more sarcastic than literal. I didn't want to be hurtful to Elizabeth however. (Literally, weight gain is documented in (Parnate in) the medical journals.)
Posted by Elizabeth on December 13, 1999, at 13:06:51
In reply to Liz: Parnate: weight gain, & the literature, posted by Zeke on December 13, 1999, at 8:28:53
> > AFAIK Parnate has *never* been reported to cause weight gain in the literature.
>
> I beg to disagree -- see references. (I have to refrain from saying, "not in the literature, just in people."):-) Well I *did* say "AFAIK." You can't argue that I knew of documented weight gain with Parnate! :-)
> However since we're speaking of Parnate, note that the weight gain seems to occur much moreso with Nardil than Parnate.
Tell me about it! (50 lbs - more than 40% of my original weight - on Nardil, none on Parnate.)
> As Bernstein says, "...an amphetamine-like structure of tranylcypromine may explain its lesser ability to stimulate appetite and weight gain than the appetite and weight effects observed with phenelzine."
I *really* wonder about the stimulant-like properties of Parnate (a psychopharm consultant first mentioned this to me in 1997 and I was intrigued).
> Bernstein JG
> Induction of obesity by psychotropic drugs.
> Ann N Y Acad Sci 1987;499:203-15
> http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2886102&form=6&db=m&Dopt=bI can only view abstracts at this time, but I saw no reference to any specific case of Parnate-associated weight gain.
Also as an aside, remember there is a big confound in the claim that Parnate might "cause" weight gain: Parnate has been used, historically, mainly for atypical depression in which weight gain is already a feature of the depression!
> Remick RA, Froese C, Keller FD
> Common side effects associated with monoamine oxidase inhibitors.
> Prog Neuropsychopharmacol Biol Psychiatry 1989;13(3-4):497-504
> http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2748873&form=6&db=m&Dopt=bOkay, here is a specific report. However, the abstract, at least, doesn't document the cases adequately to convince me the weight gain was *caused* by the Parnate (were they on other drugs? were they already gaining weight prior to taking the Parnate? etc.).
> Cantu TG, Korek JS
> Monoamine oxidase inhibitors and weight gain.
> Drug Intell Clin Pharm 1988 Oct;22(10):755-9
> http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3068037&form=6&db=m&Dopt=bUhh... "There are no cases of tranylcypromine-induced weight gain in the literature that are clearly associated with the drug." (This was after the drug had been approved in this country for nearly 30 years.)
> On the otherhand, some evidence exists for a weight loss effect from Parnate(tranylcypromine).
>
> Dulloo AG, Miller DS
> Thermogenic drugs for the treatment of obesity:
> sympathetic stimulants in animal models.
> Br J Nutr 1984 Sep;52(2):179-96
> http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=6477859&form=6&db=m&Dopt=b
>
> (Importantly, this article also rejects the common notion that stimulant type drugs reduce weight purely through reducing appetite.)No doubt the appetite reduction helps, though my appetite increased on Parnate (probably secondary to remission of depression!).
Posted by Zeke on December 14, 1999, at 1:39:09
In reply to Parnate: weight gain, & the literature - Zeke, posted by Elizabeth on December 13, 1999, at 13:06:51
> > > AFAIK Parnate has *never* been reported to cause weight gain in the literature.
> >
> > I beg to disagree -- see references. (I have to refrain from saying, "not in the literature, just in people.")
>
> :-) Well I *did* say "AFAIK." You can't argue that I knew of documented weight gain with Parnate! :-)
>You're a tough sell -- probably from Missouri -- but I respect that!
General references like the PDR and the Merck Manual (and especially the watered down popular books) tend to generalize the MOAIs and use the same profile for all. What we can certainly agree on is that while Parnate and Nardil are similar, they have important differences. This is true of others, my pet peeve being the 'sameness' attributed to Ritalin and Dexedrine (the amphetamines in general). For example, there has been reluctance to treat epileptics with ADD because of Ritalin's proconvulsant effect, and this then is assumed for amphetamine. But the literature demonstrates an antiseizure property of amphetamines. But somehow this has been all but forgotten aboutand replace with the simple notion that amphetamines were used just to offset the sedative effects of phenobarbital. Fortunately, the therapeutic differences in stimulants is becomeing more appreciated by those who treat ADD.
> > However since we're speaking of Parnate, note that the weight gain seems to occur much moreso with Nardil than Parnate.
>
> Tell me about it! (50 lbs - more than 40% of my original weight - on Nardil, none on Parnate.)
>
> > As Bernstein says, "...an amphetamine-like structure of tranylcypromine may explain its lesser ability to stimulate appetite and weight gain than the appetite and weight effects observed with phenelzine."
>
> I *really* wonder about the stimulant-like properties of Parnate (a psychopharm consultant first mentioned this to me in 1997 and I was intrigued).Well among other things, the DEA is keeping an eye on Parnate and its derivatives for abuse potential.
http://rhodium.lycaeum.org/chemistry/future_drugs.html
(Interestingly, is the Surgeon General's report documenting people not seeking help for psychiatric disorders. Gee guys, we take away the tools and what do you expect. We've already removed the promising application of MDMA in psychotherapy because of morally biased research.)>
> > Bernstein JG
> > Induction of obesity by psychotropic drugs.
> > Ann N Y Acad Sci 1987;499:203-15
> > http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2886102&form=6&db=m&Dopt=b
>
> I can only view abstracts at this time, but I saw no reference to any specific case of Parnate-associated weight gain.
>
> Also as an aside, remember there is a big confound in the claim that Parnate might "cause" weight gain: Parnate has been used, historically, mainly for atypical depression in which weight gain is already a feature of the depression!That's a good point. Further confounding is the fact that SSRIs are more frequently used in atypical depression with efficacy. Conversely here, weight loss is reported in the atypicals.
IMHO Parnate is also mainly for refractory depression:
"Tranylcypromine in high doses (20 to 30 mg po bid) is often effective for depression refractory to sequential trials of other antidepressants; it should be administered by physicians experienced in the use of MAOIs."
--The Merck Manual>
> > Remick RA, Froese C, Keller FD
> > Common side effects associated with monoamine oxidase inhibitors.
> > Prog Neuropsychopharmacol Biol Psychiatry 1989;13(3-4):497-504
> > http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2748873&form=6&db=m&Dopt=b
>
> Okay, here is a specific report. However, the abstract, at least, doesn't document the cases adequately to convince me the weight gain was *caused* by the Parnate (were they on other drugs? were they already gaining weight prior to taking the Parnate? etc.).Don't know - just pointing to evidence in the literature.
>
> > Cantu TG, Korek JS
> > Monoamine oxidase inhibitors and weight gain.
> > Drug Intell Clin Pharm 1988 Oct;22(10):755-9
> > http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3068037&form=6&db=m&Dopt=b
>
> Uhh... "There are no cases of tranylcypromine-induced weight gain in the literature that are clearly associated with the drug." (This was after the drug had been approved in this country for nearly 30 years.)With emphasis on the word 'clearly.'
>
> > On the otherhand, some evidence exists for a weight loss effect from Parnate(tranylcypromine).
> >
> > Dulloo AG, Miller DS
> > Thermogenic drugs for the treatment of obesity:
> > sympathetic stimulants in animal models.
> > Br J Nutr 1984 Sep;52(2):179-96
> > http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=6477859&form=6&db=m&Dopt=b
> >
> > (Importantly, this article also rejects the common notion that stimulant type drugs reduce weight purely through reducing appetite.)
>
> No doubt the appetite reduction helps, though my appetite increased on Parnate (probably secondary to remission of depression!).Remember that increased appetite (especially carbo cravings) are a symptom of atypical depression, just as weight gain is!
You might find this one interesting
Richard J. Wurtman and Juidith J. Wurtman
Carbohydrates and Depression
SCIENTIFIC AMERICAN January 1989
http://www.sciam.com/0189issue/0189wurtman.html
Posted by Elizabeth on December 14, 1999, at 4:44:22
In reply to Re: Parnate: weight gain, & the literature - Liz, posted by Zeke on December 14, 1999, at 1:39:09
> > :-) Well I *did* say "AFAIK." You can't argue that I knew of documented weight gain with Parnate! :-)
> >
>
> You're a tough sell -- probably from Missouri -- but I respect that!Not even close - Boston. :)
> General references like the PDR and the Merck Manual (and especially the watered down popular books) tend to generalize the MOAIs and use the same profile for all.
Yeah, I know. Among my many flames about such references. :)
> Well among other things, the DEA is keeping an eye on Parnate and its derivatives for abuse potential.
I guess they wonder about it too. There *have* been reports of that in the literature (and in people, too!).
> http://rhodium.lycaeum.org/chemistry/future_drugs.html
> (Interestingly, is the Surgeon General's report documenting people not seeking help for psychiatric disorders.
I can't find this...happen to have a URL?
>Gee guys, we take away the tools and what do you expect. We've already removed the promising application of MDMA in psychotherapy because of morally biased research.)
You know, I really don't think that opposing use oof certain types of drugs has anything to do with morality. Maybe that's just my own moral bias, though!
> IMHO Parnate is also mainly for refractory depression:
>
> "Tranylcypromine in high doses (20 to 30 mg po bid) is often effective for depression refractory to sequential trials of other antidepressants; it should be administered by physicians experienced in the use of MAOIs."
> --The Merck ManualTrue, that's what I use MAOIs for (haven't given tricyclics an adequate trial due to side effects, though).
> > Uhh... "There are no cases of tranylcypromine-induced weight gain in the literature that are clearly associated with the drug." (This was after the drug had been approved in this country for nearly 30 years.)
>
> With emphasis on the word 'clearly.'I think that's what I'd require to consider it real evidence that Parnate "causes" or "induces" weight gain.
> > No doubt the appetite reduction helps, though my appetite increased on Parnate (probably secondary to remission of depression!).
>
> Remember that increased appetite (especially carbo cravings) are a symptom of atypical depression, just as weight gain is!Well yeah, I thought that was where the weight gain came from! Eating junk food, especially at night.
> You might find this one interesting
>
> Richard J. Wurtman and Juidith J. Wurtman
> Carbohydrates and Depression
> SCIENTIFIC AMERICAN January 1989
> http://www.sciam.com/0189issue/0189wurtman.htmlOh god, not the Wurtmans!
Posted by Zeke on December 14, 1999, at 11:25:55
In reply to Re: Parnate: weight gain, & the literature - Liz, posted by Elizabeth on December 14, 1999, at 4:44:22
> > (Interestingly, is the Surgeon General's report documenting people not seeking help for psychiatric disorders.
>
> I can't find this...happen to have a URL?
>http://www.nytimes.com/library/politics/121399mental-health.html
> >Gee guys, we take away the tools and what do you expect. We've already removed the promising application of MDMA in psychotherapy because of morally biased research.)
>
> You know, I really don't think that opposing use oof certain types of drugs has anything to do with morality. Maybe that's just my own moral bias, though!
>I'm not talking about people taking ecstasy every weekend at the local rave -- though that's the reason it's schedule 1. I'm talking about limited clinical use to augment therapy just as pindolol augments Prozac. When I say morality, I mean the government passing along research that supports its view and withholding research that doesn't, or even preventing research in the first place. I get upset when they rant that 'MDMA destroys serotonin neurons," but never mention that administration of an SSRI four hours later will block the uptake and damage. I'm sorry, I just get upset when moral prejudice strongarms block scientific discovery. And remember that many of these folks would like to cast all psych meds in to the sea -- ' and by God, you should just pull yourself up by your bootstraps!'
> > IMHO Parnate is also mainly for refractory depression:
> >
> > "Tranylcypromine in high doses (20 to 30 mg po bid) is often effective for depression refractory to sequential trials of other antidepressants; it should be administered by physicians experienced in the use of MAOIs."
> > --The Merck Manual
>
> True, that's what I use MAOIs for (haven't given tricyclics an adequate trial due to side effects, though).Despite all the bliss, I think the side effects of SSRIs cause many to drop those too. I can't deal with higher doses of Luvox but use a lower dose and pindolol.
>
> > > Uhh... "There are no cases of tranylcypromine-induced weight gain in the literature that are clearly associated with the drug." (This was after the drug had been approved in this country for nearly 30 years.)
> >
> > With emphasis on the word 'clearly.'
>
> I think that's what I'd require to consider it real evidence that Parnate "causes" or "induces" weight gain.
>OK, with emphasis on no case being clear to this particular researcher.
> > > No doubt the appetite reduction helps, though my appetite increased on Parnate (probably secondary to remission of depression!).
> >
> > Remember that increased appetite (especially carbo cravings) are a symptom of atypical depression, just as weight gain is!
>
> Well yeah, I thought that was where the weight gain came from! Eating junk food, especially at night.
>
> > You might find this one interesting
> >
> > Richard J. Wurtman and Juidith J. Wurtman
> > Carbohydrates and Depression
> > SCIENTIFIC AMERICAN January 1989
> > http://www.sciam.com/0189issue/0189wurtman.html
>
> Oh god, not the Wurtmans!If I'd only know you were from Boston! (Besides, RW's a good guy -- Now if I'd have said John Mack... Beam me up Scotty!)
Posted by Adam on December 14, 1999, at 22:06:45
In reply to Re: Parnate: weight gain, & the literature - Liz, posted by Zeke on December 14, 1999, at 11:25:55
>
> I'm not talking about people taking ecstasy every weekend at the local rave -- though that's the reason it's schedule 1. I'm talking about limited clinical use to augment therapy just as pindolol augments Prozac. When I say morality, I mean the government passing along research that supports its view and withholding research that doesn't, or even preventing research in the first place. I get upset when they rant that 'MDMA destroys serotonin neurons," but never mention that administration of an SSRI four hours later will block the uptake and damage. I'm sorry, I just get upset when moral prejudice strongarms block scientific discovery. And remember that many of these folks would like to cast all psych meds in to the sea -- ' and by God, you should just pull yourself up by your bootstraps!'
>
I had the opportunity to take MDMA not too long ago which I thankfully declined. Anyway, what I read lead me to believe that it takes very high doses of MDMA or chronic use to kill
brain cells. However, axonal damage might still be a problem at lower doses, and even though axons can grow back, it's tough to know how they will grow back, and in the mean time
the cell is out of comission. MDMA also stimulates excessive dopamine release, and reactive oxygen species produced during metabolism of dopamine by MAO have been implicated in
neurotoxicity. Addition of an SSRI might offer some protection, but its difficult to know how much and what neurons.This may all be really nitpicky, though. I've become very casually aquainted with a couple fairly regular users, and it's hard to tell if "Adam" (gotta love _that_ nickname) is doing
them any real harm or not.> > > IMHO Parnate is also mainly for refractory depression:
> > >
> > > "Tranylcypromine in high doses (20 to 30 mg po bid) is often effective for depression refractory to sequential trials of other antidepressants; it should be administered by physicians experienced in the use of MAOIs."
> > > --The Merck Manual
> >
> > True, that's what I use MAOIs for (haven't given tricyclics an adequate trial due to side effects, though).I wonder what it takes before some people decide you are "refractory" enough and insist you consider an MAOI. I had one doctor keep me on Serzone for more than two months even though
I knew it wasn't working and started rapidly spiraling the drain while on it. I guess a quivering, weeping, suicidal state of frenzy is "refractory.">
> Despite all the bliss, I think the side effects of SSRIs cause many to drop those too. I can't deal with higher doses of Luvox but use a lower dose and pindolol.
> >I never got anywhere near bliss on an SSRI, but had a couple fun side effects for my troubles: a spare tire around the waist, anorgasmia, and loss of libido. Perhaps if I had
tried Prozac I could have been thin, asexual, and depressed. Will MAOIs never be a first or even second-line treatment again?
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