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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Anna P. on October 18, 2000, at 12:55:18
Hi Cam,
As a Canadian, I'm shure you would know the answer to my question.
My psychopharmacologist said that it's possible to switch from
Moclobemide to Parnate. I'm very surprise as they are
both MAOI's, and Moclobemide as reversible MAOI act also on the serotonian
system. What do you think? Please help.Anna P.
Posted by Anna P. on October 18, 2000, at 17:25:32
In reply to Question for Cam W., posted by Anna P. on October 18, 2000, at 12:55:18
> Hi Anthony,
How are you doing on the combo Parnate-Lithium?
You've promised to let us know, remember?I recall from your previous posts that you were
adding reboxetine to Parnare (Nardil)?
How did it go?
I'm on Reboxetine now and want to switch to Parnate.
Do you think I will take a great risk if I start Parnate at 1/4 tablet?Anna P.
Posted by Cam W. on October 18, 2000, at 19:54:16
In reply to Question for Cam W., posted by Anna P. on October 18, 2000, at 12:55:18
Anna - There shouldn't be any problem switching from Manerix™ (moclobemide) to Parnate™ (tranylcypromine). In terms of a wash-out, it probably isn't necessary, as Manerix has a short half-life. If you really wanted to be safe, you could ask your doc about doing a 2 day wash-out of Manerix before starting the Parnate (ie stop the Manerix, wait 2 days and start the Parnate).
Hope this helps - Cam
Posted by Ant-Rock on October 19, 2000, at 10:06:17
In reply to Re: Parnate Ant-Rock, posted by Anna P. on October 18, 2000, at 17:25:32
> > Hi Anthony,
> How are you doing on the combo Parnate-Lithium?
> You've promised to let us know, remember?
>
> I recall from your previous posts that you were
> adding reboxetine to Parnare (Nardil)?
> How did it go?
> I'm on Reboxetine now and want to switch to Parnate.
> Do you think I will take a great risk if I start Parnate at 1/4 tablet?
>
> Anna P.Hello Anna, the reason I haven't posted about my Lithium-Parnate combo, is that today is only my 7th day on 300mg lithium, added to 40mg Parnate, 600mg Adrafanil. Tomorrow I am supposed to increase to 600mg lithium, so I figured I would post after a week at 600mg lithium to have a better idea of its efficacy. So far , no side- effects at least.
Unfortunately, after a fair trial of reboxetine/parnate combo, I didn't experience any improvement, and I went up to 8mg rebox. I was hoping the Rebox would jump-start the parnate,but it was not to be. I feel that the parnate has lost most of its effect.Over the years, each time I've taken it , it has worked to a lesser degree.
I must say, i went very slowly adding the rebox, since this was unexplored territory, and didn't incur any negative side-effects, but i would definitely let your doctor know if you decide to take this route. You probably would be fine introducing 1/4 tab parn. while also titrating down the rebox., but this is just my opinion.Hopefully the increase in lithium tomorrow will bring about some relief, but only time will tell.
I will post my parnate/lithium experience in the near future.Thank you Anna for your concern, it means a lot.
If I can answer any other questions, feel free to ask me. Good luck with any decision you decide to make.
Sincerely
Anthony
Posted by Judy on October 19, 2000, at 20:33:21
In reply to Re: Parnate Ant-Rock » Anna P., posted by Ant-Rock on October 19, 2000, at 10:06:17
I haven't visited this board for a long time but the last time I participated, Anthony mentioned a doctor from down South, I believe, who regularly prescribed the combination of Parnate and Selegiline with good results.
Anthony: Did you ever consider that combination? Do you remember the doctor's name and might he be written up on the internet somewhere?
Cam: What is your learned opinion of that combination? What's the worst case scenario.
I ask because I unsuccessfully took Selegiline for about six months, weaned off and started Parnate this past spring. The first week I took Parnate, I felt wonderful, then the bubble burst and I've been in a limbo of not-quite-depressed but definitely anhedonic ever since. I've been told that the initial mania had nothing whatsoever to do with selegeline remaining in my system, but I still can't help wondering...
Posted by Cam W. on October 20, 2000, at 19:35:48
In reply to Re: CAM W. / Ant-Rock Questions, posted by Judy on October 19, 2000, at 20:33:21
> I haven't visited this board for a long time but the last time I participated, Anthony mentioned a doctor from down South, I believe, who regularly prescribed the combination of Parnate and Selegiline with good results.
>
> Anthony: Did you ever consider that combination? Do you remember the doctor's name and might he be written up on the internet somewhere?
>
> Cam: What is your learned opinion of that combination? What's the worst case scenario.
>
> I ask because I unsuccessfully took Selegiline for about six months, weaned off and started Parnate this past spring. The first week I took Parnate, I felt wonderful, then the bubble burst and I've been in a limbo of not-quite-depressed but definitely anhedonic ever since. I've been told that the initial mania had nothing whatsoever to do with selegeline remaining in my system, but I still can't help wondering...Judy - As a caveat I'd like to say that I have limited experience with MAOIs, as they are seldom used in the population of people that I fill prescriptions for (actually, I don't think that I even carry Parnate in the store). Others on this board have much more experience with MAOIs than I do.
At therapeutic doses (no more than 10mg/day) selegiline (Eldepryl™) is a selective, irreversible inhibitor of MAO-B. Parnate™ (tranylcypromine) is an irrevesible inhibitor of both MAO-A and MAO-B. Other than perhaps being able to use lower doses of each when given together, I can't think of any reason to do so (but again, I lack real-life experience with MAOIs). Maybe the southern doc has fewer problems with the "tyramine effect" with this combination; I don't know.
Hopefully someone else can shed light on your question - Cam
Posted by Judy on October 22, 2000, at 11:09:22
In reply to Re: CAM W. / Ant-Rock Questions, posted by Judy on October 19, 2000, at 20:33:21
Thanks, Cam. There's something about my writing to this board that makes it automatically go into archive mode! (Just like cash registers break down when I'm next in line at the market. I think I exude a magnetic field or something!!!)
I was hoping someone would be able to tell me what the actual risk would be of taking a low dose of Eldepryl - 10 mg maybe (I was taking up to 80 mg when trying it as an AD until my doctor became uneasy exploring such uncharted territory combined with a lower dose of Parnate than I'm taking now - 70 mg/day). I'm not seeking anyone's blessing to try this. I'd just like an educated guess on what the reaction might be to mixing the two rather similar drugs. Hypotension? What?
Judy
Posted by Ant-Rock on October 22, 2000, at 16:26:27
In reply to Re: CAM W. / Ant-Rock Questions, posted by Judy on October 22, 2000, at 11:09:22
Hi Judy,
Actually i did try this combo awhile back with out any problems. I didn't notice any improvement but in retrospect I may not have used the deprenyl at a high enough dose. I might be of some help regarding the initial mania to Parnate. I had this exact same feeling when i began my 1st parnate trial. Wonderful mental and physical energy for about a week. Unfortunately it faded and each time I've gone back on Parnate it seems to be less effective, leaving me with anhedonia/fatigue. In my opinion ,the deprenyl didn't cause your reaction, but this is only my opinion.
I have been hearing that there is a liquid deprenyl thats stronger/better than the pill. Do you know if there's any truth to this? Maybe someone else could comment.
Anyway, the Dr I mentioned is James Mcknight, with a very avant garde research group (Biobehavioral Associates) in Atlanta. Phone # 404-294-9773. The person I corresponded with was maintained on 30mg parnate/20mg eldepryl.
The Dr. stated he has used this combo with several of his refractive patients with good results.
Good luck Judy, and please let me know how you make out.
Sincerely,
Anthony
Posted by shellie on October 22, 2000, at 18:38:13
In reply to Re: Parnate Ant-Rock » Anna P., posted by Ant-Rock on October 19, 2000, at 10:06:17
Hi Anthony. Just curious if you have ever tried to jump-start parnate with pindolol?
I'm back on nardil (having a first good week--which I know doesn't mean much). I considered adding pindolol to activate it quicker; instead I am going to be adding serzone. But curious if you ever tried an MAOI with pindolol since it's supposed to be a good jump-starter and maybe a good augmenter for MAOIs.
Always happy to see you posting, Shellie
Posted by Anna P. on October 23, 2000, at 14:05:56
In reply to Re: Parnate Ant-Rock » Anna P., posted by Ant-Rock on October 19, 2000, at 10:06:17
> > >
> >
>
> Hello Anna, the reason I haven't posted about my Lithium-Parnate combo, is that today is only my 7th day on 300mg lithium, added to 40mg Parnate, 600mg Adrafanil. Tomorrow I am supposed to increase to 600mg lithium, so I figured I would post after a week at 600mg lithium to have a better idea of its efficacy. So far , no side- effects at least.
>
> Unfortunately, after a fair trial of reboxetine/parnate combo, I didn't experience any improvement, and I went up to 8mg rebox. I was hoping the Rebox would jump-start the parnate,but it was not to be. I feel that the parnate has lost most of its effect.Over the years, each time I've taken it , it has worked to a lesser degree.
> I must say, i went very slowly adding the rebox, since this was unexplored territory, and didn't incur any negative side-effects, but i would definitely let your doctor know if you decide to take this route. You probably would be fine introducing 1/4 tab parn. while also titrating down the rebox., but this is just my opinion.
>
> Hopefully the increase in lithium tomorrow will bring about some relief, but only time will tell.
> I will post my parnate/lithium experience in the near future.
>
> Thank you Anna for your concern, it means a lot.
> If I can answer any other questions, feel free to ask me. Good luck with any decision you decide to make.
> Sincerely
> AnthonyHi Anthony,
Most of all, thank you for your advice and assurance - it means a lot to me too.
Somehow it calmed me down. I talked with my doctor and he advised me to do a washout with Moclobemide, or start Parnate at 1/4 tablet at my own risk.
He is one of the best psychopharmacologists, and he said he had cases with Parnate-Reboxetine interactions. Well, for me restarting Moclobemide didn't make any sense as the last time I was on it, it barely worked.
I started Parnate at 1/2 tablet last Friday. On Saturday evening my BP went up to 130/90, and I was scared. I took some Lorazepam and I was fine. I want to increase Parnate further now.Now another topic. Anthony, you've wrote that you expect some relief from the higher dose of Lithium.
Can you explain what does it mean to you?
Does Lithium increase your energy?I will tell you about my Li experience. I took Li for 10 days with Reboxetine that doesn't work for me anymore. I hoped that Li will bring back some of my response to Reboxetine. Well, it did nothing at 300 mg, and I kept slowing down. No good or bad side effects. After 10 days I started to cry for 2 days, and be extremely nervous. I stopped Li immediately. I need a medicine that helps, not getting me worse.
Like my old combo Moclobemide + Revia: controled anxiety and gave me 100 % self control. So I don't know how Lithium works. Maybe it works better with Parnate?Anthony, is Adrafinil helpful?
Best wishes,
Anna P.
Posted by Anna P. on October 23, 2000, at 15:33:04
In reply to Re: Question for Cam W. » Anna P., posted by Cam W. on October 18, 2000, at 19:54:16
> Anna - There shouldn't be any problem switching from Manerix™ (moclobemide) to Parnate™ (tranylcypromine). In terms of a wash-out, it probably isn't necessary, as Manerix has a short half-life. If you really wanted to be safe, you could ask your doc about doing a 2 day wash-out of Manerix before starting the Parnate (ie stop the Manerix, wait 2 days and start the Parnate).
>
> Hope this helps - CamCam, yes, this helps - thank you for reassuring me. Had I known these information one year ago, I wouldn't loose my career. I was on Moclobemide at that time, and I was affraid to switch to Parnate. Also, nobody in my state knew how to switch, and I wasn't able to go through 2 weeks without meds. Anyway, thank you again.
Anna P.
Posted by Ant-Rock on October 23, 2000, at 18:22:28
In reply to Re: Parnate Ant-Rock » Ant-Rock, posted by shellie on October 22, 2000, at 18:38:13
> Hi Anthony. Just curious if you have ever tried to jump-start parnate with pindolol?
>
> I'm back on nardil (having a first good week--which I know doesn't mean much). I considered adding pindolol to activate it quicker; instead I am going to be adding serzone. But curious if you ever tried an MAOI with pindolol since it's supposed to be a good jump-starter and maybe a good augmenter for MAOIs.
>
> Always happy to see you posting, ShellieHi Shellie,
Thank you for asking, but I wasn't even aware of this combo. After reading about it in the "tips" section, it sounds interesting. Right now I'm in the middle of evaluating a parnate/lithium trial. I just increased the lithium to 600mg and felt nauseas throughout the day. Anyway,thanks for the suggestion Shellie and good luck with the serzone. I'm sure you will be rewarded for all your diligence.
Sincerely,
Anthony
Posted by Ant-Rock on October 23, 2000, at 18:52:01
In reply to Re: Parnate Ant-Rock, posted by Anna P. on October 23, 2000, at 14:05:56
> Hi Anthony,
>
> Most of all, thank you for your advice and assurance - it means a lot to me too.
> Somehow it calmed me down. I talked with my doctor and he advised me to do a washout with Moclobemide, or start Parnate at 1/4 tablet at my own risk.
> He is one of the best psychopharmacologists, and he said he had cases with Parnate-Reboxetine interactions. Well, for me restarting Moclobemide didn't make any sense as the last time I was on it, it barely worked.
> I started Parnate at 1/2 tablet last Friday. On Saturday evening my BP went up to 130/90, and I was scared. I took some Lorazepam and I was fine. I want to increase Parnate further now.
>
> Now another topic. Anthony, you've wrote that you expect some relief from the higher dose of Lithium.
> Can you explain what does it mean to you?
> Does Lithium increase your energy?
>
> I will tell you about my Li experience. I took Li for 10 days with Reboxetine that doesn't work for me anymore. I hoped that Li will bring back some of my response to Reboxetine. Well, it did nothing at 300 mg, and I kept slowing down. No good or bad side effects. After 10 days I started to cry for 2 days, and be extremely nervous. I stopped Li immediately. I need a medicine that helps, not getting me worse.
> Like my old combo Moclobemide + Revia: controled anxiety and gave me 100 % self control. So I don't know how Lithium works. Maybe it works better with Parnate?
>
> Anthony, is Adrafinil helpful?
>
> Best wishes,
>
> Anna P.Hello Anna,
I really don't know how Lithium works as an augmentor, but my Psyc-doc wants me to give it a try at 600mgs. I think I remember reading on this board that it somehow increases seretonin. Today was my third day on 600mgs and I felt pretty crappy, with on and off nausea all day.
On a better note, Friday I took a 10mg adderal for the first time and had a wonderful energy boost. If the Li doesn't show any promise, I will ask my doc to augment adderal.
On the adrafanil question, I actually weened off of it, feeling It would be to many meds and I wouldn't be able to tell what's doing what. I suppose it helped a little, but vey hard to tell at this point.
So Anna, I wish you good luck with the Parnate. It is a good med with both mental and physical stimulating properties. For the first couple of months insomnia can be a problem, but this effect eventually goes away. Also drinking lots of water helps with dry-mouth.
Sincerely,Anthony
This is the end of the thread.
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