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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by KS on April 6, 2001, at 8:27:58
I have so-called "treatment-resistant" depression (with some anxiety thrown in). I've been tried on all sorts of antidepressants and they have not benefitted me much. The only one that made a moderate improvement was Effexor XR 150mg bd (i.e., 300mg daily). Although it helps somewhat, it tends to level off or blunt ALL my feelings - good and bad. Anyone else found this? I've been told that I should try an MAOI like Parnate. I'd like to hear from anyone who has had success with this drug and how they tolerated the restricted diet, etc. Thanx. KS
Posted by Bradley on April 6, 2001, at 10:07:46
In reply to ANYONE HAD SUCCESS WITH PARNATE?, posted by KS on April 6, 2001, at 8:27:58
Parnate elimintates my treatment resistant depression quickly, but only works for 3 months. Then I try other things the rest of the year. So far I have'nt found anything that is as efficatious as Parnate. The diet has not been a problem for me. I'm thinking of trying Selegeline later in the year. There must be something available that will work like Parnate for me and last long term. Good luck.> I have so-called "treatment-resistant" depression (with some anxiety thrown in). I've been tried on all sorts of antidepressants and they have not benefitted me much. The only one that made a moderate improvement was Effexor XR 150mg bd (i.e., 300mg daily). Although it helps somewhat, it tends to level off or blunt ALL my feelings - good and bad. Anyone else found this? I've been told that I should try an MAOI like Parnate. I'd like to hear from anyone who has had success with this drug and how they tolerated the restricted diet, etc. Thanx. KS
Posted by SalArmy4me on April 6, 2001, at 14:55:36
In reply to ANYONE HAD SUCCESS WITH PARNATE?, posted by KS on April 6, 2001, at 8:27:58
Have you looked into the MAOI-type drug Moclobemide, which does not require the diet and has less side-effects than Parnate?
> I have so-called "treatment-resistant" depression (with some anxiety thrown in). I've been tried on all sorts of antidepressants and they have not benefitted me much. The only one that made a moderate improvement was Effexor XR 150mg bd (i.e., 300mg daily). Although it helps somewhat, it tends to level off or blunt ALL my feelings - good and bad. Anyone else found this? I've been told that I should try an MAOI like Parnate. I'd like to hear from anyone who has had success with this drug and how they tolerated the restricted diet, etc. Thanx. KS
Posted by BK on April 6, 2001, at 17:51:59
In reply to ANYONE HAD SUCCESS WITH PARNATE?, posted by KS on April 6, 2001, at 8:27:58
> I have so-called "treatment-resistant" depression (with some anxiety thrown in). I've been tried on all sorts of antidepressants and they have not benefitted me much. The only one that made a moderate improvement was Effexor XR 150mg bd (i.e., 300mg daily). Although it helps somewhat, it tends to level off or blunt ALL my feelings - good and bad. Anyone else found this? I've been told that I should try an MAOI like Parnate. I'd like to hear from anyone who has had success with this drug and how they tolerated the restricted diet, etc. Thanx. KS
KS,
I tried Nardil, another MAOI, and had tremendous sucess initially. Unfortunately, it lasted only three months and then I actually started to feel worst on it. I tried Nardil again several years later, but it never seemed to kick in as it once had. From reading herein, i noticed that this is not an uncommon effect with Nardil.
I've tried just about every other AD since and nothing has seemed to help my "treatment-resistant" depression. I'm currently taking Adrafinil, but haven't had much sucess with that either.
I strongly suggest that you give a MAOI a try. The dietary restrictions are significant, but not totally life changing. If this drug works for you, it will be well worth the dietary sacrifices. Good luck and let me know (and everyone else) how it works for you. Anyone out there who has found an effective replacement for Nardil, please let me know.
BK
Posted by sweetmarie on April 7, 2001, at 11:38:48
In reply to Re: ANYONE HAD SUCCESS WITH PARNATE?, posted by BK on April 6, 2001, at 17:51:59
> > I tried Nardil, another MAOI, and had tremendous sucess initially. Unfortunately, it lasted only three months and then I actually started to feel worst on it. I tried Nardil again several years later, but it never seemed to kick in as it once had. From reading herein, i noticed that this is not an uncommon effect with Nardil.
>
> I've tried just about every other AD since and nothing has seemed to help my "treatment-resistant" depression. I'm currently taking Adrafinil, but haven't had much sucess with that either.
>
> I strongly suggest that you give a MAOI a try. The dietary restrictions are significant, but not totally life changing. If this drug works for you, it will be well worth the dietary sacrifices. Good luck and let me know (and everyone else) how it works for you. Anyone out there who has found an effective replacement for Nardil, please let me know.
>
> BKHi
I had a similar MAOI (Nardil) experience, but for me it only worked for 3 weeks.
It seems to me that with cases of `treatment resistant` depression (which I also suffer from, in a very severe form), combination therapy is probably the only answer (taking more than one medication at a time).
I`ve been trying loads of different meds over the past 10 years, and still absolutely no luck (depression not alleviated at all). However, there does come a point when your consultant will (or should) consider a combination of meds as opposed to just one. Resistance to medication, does not need to mean resistance to all medication, it just means that a suitable one (or more than one) has not been found as yet.
I am due to be treated for my resistant depression at a unit which specifically deals in this type of condition (resistant or `refractory` depression). The bloke who will be treating me is a specialist in this area, and it`s his opinion that `treatment resistant depression` is a misnomer. In other words, it implies that the patient/sufferer has been resistant to treatment, where in fact the right treatment has not yet been found. Basically, the patient/sufferer has been failed by the treatment. I don`t know whether this makes sense, the way I`ve put it. Basically what he`s saying is that the patient has been failed by the medication, and by implication by those administering it. I hope that this makes some sense.
It`s easy to feel that you`ve exhausted all avenues - I do, most of the time. It`s also scary to contemplate the possibility that NO medication will ever be found. This is unlikely to be the case - as we speak (write), new treatments are coming onto the market, being researched etc.
I write this to convince myself as much as anything. I`ve been very ill for a very long time, and find it hard to keep going and remain optimistic. However, I do recognise this to be `depression-speak`, which is very hard to get beyond.
This thing cannot last forever.
Anna.
Posted by KS on April 7, 2001, at 12:11:37
In reply to I use Parnate 3 months a year., posted by Bradley on April 6, 2001, at 10:07:46
> I've also been thinking about selegiline. Look it up on biospychiatry.com, they've got some really encouraging things to say about selegiline and its effects on depression. Has anyone ever given you a good enough reason why the effects of Parnate only last 3 months for you? It seems that this might be more common : check other replies to my initial posting. Cheers, KS.
> Parnate elimintates my treatment resistant depression quickly, but only works for 3 months. Then I try other things the rest of the year. So far I have'nt found anything that is as efficatious as Parnate. The diet has not been a problem for me. I'm thinking of trying Selegeline later in the year. There must be something available that will work like Parnate for me and last long term. Good luck.
>
>
>
>
>
> > I have so-called "treatment-resistant" depression (with some anxiety thrown in). I've been tried on all sorts of antidepressants and they have not benefitted me much. The only one that made a moderate improvement was Effexor XR 150mg bd (i.e., 300mg daily). Although it helps somewhat, it tends to level off or blunt ALL my feelings - good and bad. Anyone else found this? I've been told that I should try an MAOI like Parnate. I'd like to hear from anyone who has had success with this drug and how they tolerated the restricted diet, etc. Thanx. KS
Posted by blackjack on April 7, 2001, at 19:24:20
In reply to ANYONE HAD SUCCESS WITH PARNATE?, posted by KS on April 6, 2001, at 8:27:58
I'll cast another vote for Parnate. It is the only single antidepressant that ever got me back to 100%. But, like a lot of folks, it pooped-out, in my case after about 9 months. It is certainly worth a try, tho. Hey, nine months of feeling human again is better than nothing.
Also, if you find it works well, but you can't put up with the diet or other restrictions, consider combining something like Effexor or Wellbutrin with a stimulant like Dexedrine or Ritalin.
Posted by SLS on April 9, 2001, at 10:33:05
In reply to I use Parnate 3 months a year., posted by Bradley on April 6, 2001, at 10:07:46
>
> Parnate elimintates my treatment resistant depression quickly, but only works for 3 months. Then I try other things the rest of the year. So far I have'nt found anything that is as efficatious as Parnate. The diet has not been a problem for me. I'm thinking of trying Selegeline later in the year. There must be something available that will work like Parnate for me and last long term. Good luck.
>
>
>
This sounds very much like a case one of my doctors came across. What he did was to cycle between Parnate and Nardil. When one began to exhibit diminishing returns, he would switch to the other. Of course, the two week washout was used between drugs, but this seemed to be the best strategy they had found to date.Of course, if you have never tried Nardil, you might be pleasantly surprised.
- Scott
Posted by MarkG on April 9, 2001, at 11:53:51
In reply to ANYONE HAD SUCCESS WITH PARNATE?, posted by KS on April 6, 2001, at 8:27:58
I have been taking Parnate now for about 6 weeks. During the first two weeks, I found Parnate to be extremely effective at a very low dose (10-20mg), however, this effect subsided. Increased concentration, focus, and mood... my doc said that this was likely due to Parnate's amphetamine-like properties. Unfortunately, I have not regained that effect. Since then, I have raised the dose as high as 20mg bid, but felt cognitively slow, uncoordinated, and extremely fatigued. I had to cut back to 20mg in the morning to keep from being so tired that I couldn't function. Overall, I have seen some improvement, though- I don't have the spiraling, hopeless feelings I have had in the past.
As far as the diet goes, I haven't had any reactions... although I'm really good now about not eating cheese, sausage, or alcohol. It can be somewhat of a pain- I had to go to the emergency room a couple of weeks back for back pain and it was difficult to find drugs that would not interact w/MAOIs.
Overall, I hear that many people have had lots of luck with Parnate and some have used it successfully for years, so it sounds (like everything else) it's trial and error. I think the diet would be definitely worth it if it is effective! Good luck on a Parnate trial if you should try to go that route!
Posted by jb on April 11, 2001, at 10:07:41
In reply to ANYONE HAD SUCCESS WITH PARNATE?, posted by KS on April 6, 2001, at 8:27:58
Hi, KS. Yes, I've had success with Parnate, an MAOI. I took it primarily for social phobia (giving presentations to large groups, primarily). It's very activating and energizing. I had some difficulty getting to sleep, initially, but that wore off over about two weeks. You might want to discuss this with your physician, so he could titrate the dose slowly, if that's appropriate for you (double emphasis on the "you"). It caused fairly severe dry mouth. I always had a diet drink or water or non-sugar mouth drop wherever I went. Also, my speech pattern slowed significantly. My wife and co-workers noticed this. The side effects of dry mouth and slowed speech didn't diminish over time, for me. Also, my appetite curtailed, and I lost about 8 lbs.
Regarding dietary restrictions, I found them excessive,in some ways, and, again, for me. For example, I eat pizza like crazy and drink light beer. I also drink white wine. I stay away from regular beer and red wine. I don't eat the very aged food products, such as the aged cheeses (blue cheese, etc), dates, pickled foods, aged meats, etc. I eat pizza cheese, mozarella, and cheddar and colby cheese with no problem. I also eat parmesan cheese with a salad, but that's in moderation. I stay away from antihistamines and all cold medications except Robutussin DM. And, I tell my personal physician and any other physician that I'm taking and MAOI.
Your physician can prescribe a medication which you can carry which is an antidote for a hypertensive crisis if you somehow eat a tyramine-rich food and have a bad reaction.
Separately, Phenelzine is another MAOI worth consideration and discussion with your physician. I believe the other non-selective, non-reversible MAOI available is Isocarboxazid.
Hope this helps.
JB
Posted by Lawrence S. on April 15, 2001, at 0:02:21
In reply to Re: ANYONE HAD SUCCESS WITH PARNATE?, posted by blackjack on April 7, 2001, at 19:24:20
> I'll cast another vote for Parnate. It is the only single antidepressant that ever got me back to 100%. But, like a lot of folks, it pooped-out, in my case after about 9 months. It is certainly worth a try, tho. Hey, nine months of feeling human again is better than nothing.
>
> Also, if you find it works well, but you can't put up with the diet or other restrictions, consider combining something like Effexor or Wellbutrin with a stimulant like Dexedrine or Ritalin.It worked for me, however I found the dry mouth intolerable. It seemed like I would drink a gallon of water and still be thirsty. Also it seemed to be less tolerable to hypertensive reactions. I found Nardil to be more robust for s. phobia.
Posted by JT on November 4, 2001, at 16:18:46
In reply to Re: ANYONE HAD SUCCESS WITH PARNATE?, posted by MarkG on April 9, 2001, at 11:53:51
Anyone had any success cocktailing Parnate with others for tx resistant dperession and anxiety? I am on low starter docs of Parnate, .5 mg Klonopin and .01 mg Catapress. JT
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