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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by comftnumb on December 20, 2002, at 5:56:00
I have treatment resistant social phobia with comorbid depression and obsessive traits. I've been on Zoloft, Topamax, Effexor, and Wellbutrin. Currently I take 2mg of Klonopin which works well enough that I don't worry and obsess all the time, but I'm still afraid of taking social risks. I can't approach people I don't know or ask girls out on a dates.
I'll keep using Klonopin though it's somewhat unmotivating. I want to try Nardil or Parnate to treat my SP and hopefully counter some of Klonopin's sedative/passiveness effects. My question is which one should I pick, Nardil or Parnate? I know Nardil has been studied more for SP, but Parnate has no weight gain or sexual side effects and tends to be more activating!!!! Also Nardil has been extremely unavailable. I've tried local and online pharmacies and all are on backorder.
My question to you: What has your personal experiences been with Parnate or Nardil for social phobia? Particularly info on Parnate would be appreciated. Also if you've been on SSRIs prior to using an MAOI, and how they compare.
Posted by djmmm on December 20, 2002, at 8:30:44
In reply to Parnate or Nardil: which one for social phobia?, posted by comftnumb on December 20, 2002, at 5:56:00
Parnate is definitely more stimulating, but other than that, I haven't really noticed any difference....one thing, I have been dreaming (or remembering my dreams) since I started Parnate... on Nardil, I didn't dream at all.
If I were you, I would try Nardil first and see if you can tolerate it. I say this because Nardil was the med that cured me. After a week or so on Nardil, I noticed a PROFOUND difference in my anxiety level, depression and motivation..
FWIW, I never gained weight on Nardil, never had a hypertensive reaction, and only minimal sexualy probs. (MUCH less than the SSRIs)
Posted by cosis on December 20, 2002, at 16:14:39
In reply to Parnate or Nardil: which one for social phobia?, posted by comftnumb on December 20, 2002, at 5:56:00
My doctor recommended me Nardil but he said both were about the same, Parnette was just known more as the drug for depression
Posted by Mr.Scott on December 21, 2002, at 0:54:25
In reply to Parnate or Nardil: which one for social phobia?, posted by comftnumb on December 20, 2002, at 5:56:00
All the research points to Nardil, but everyone is different. I had read a study on pub med that indicated Nardil has a huge effect on GABA which Parnate does not. I never tried Parnate though so i can't speak from actual experience.
Posted by Lawrence S. on December 21, 2002, at 23:43:03
In reply to Re: Parnate or Nardil: which one for social phobia?, posted by Mr.Scott on December 21, 2002, at 0:54:25
I vote Nardil. I have tried them both for SP. and Nardil was the winner!
Posted by jonh kimble on December 22, 2002, at 1:05:30
In reply to Re: Parnate or Nardil: which one for social phobia?, posted by djmmm on December 20, 2002, at 8:30:44
Nardil is considered best bet
Posted by chad_3 on December 22, 2002, at 21:32:49
In reply to Parnate or Nardil: which one for social phobia?, posted by comftnumb on December 20, 2002, at 5:56:00
Nardil -
See my site - I have Pubmed links also including a reference to treatment of SP + OCD - Nardil succeeds here where SSRI's usually fail.
Try Nardil but see my site. Click link on Nardil and other links also. If you type "nardil" on google I think I am in the top 10.
Chad
http://www.socialfear.com/> I have treatment resistant social phobia with comorbid depression and obsessive traits. I've been on Zoloft, Topamax, Effexor, and Wellbutrin. Currently I take 2mg of Klonopin which works well enough that I don't worry and obsess all the time, but I'm still afraid of taking social risks. I can't approach people I don't know or ask girls out on a dates.
>
> I'll keep using Klonopin though it's somewhat unmotivating. I want to try Nardil or Parnate to treat my SP and hopefully counter some of Klonopin's sedative/passiveness effects. My question is which one should I pick, Nardil or Parnate? I know Nardil has been studied more for SP, but Parnate has no weight gain or sexual side effects and tends to be more activating!!!! Also Nardil has been extremely unavailable. I've tried local and online pharmacies and all are on backorder.
>
> My question to you: What has your personal experiences been with Parnate or Nardil for social phobia? Particularly info on Parnate would be appreciated. Also if you've been on SSRIs prior to using an MAOI, and how they compare.
>
>
>
Posted by Iolite on December 23, 2002, at 20:38:27
In reply to Parnate or Nardil: which one for social phobia?, posted by comftnumb on December 20, 2002, at 5:56:00
> I have treatment resistant social phobia with comorbid depression and obsessive traits. I've been on Zoloft, Topamax, Effexor, and Wellbutrin. Currently I take 2mg of Klonopin which works well enough that I don't worry and obsess all the time, but I'm still afraid of taking social risks. I can't approach people I don't know or ask girls out on a dates.
Hello. I am unable to help you with regard to your phobia, but would just like to interject regarding the Klonopin. I took it for 2 years when I was being treated for Cancer and it really helped my anxiety attacks quite a lot! I finally slept and to some degree did not suddenly freak out of nowhere re: cancer.
But after awhile I found that Klonopin was more sedating than I wanted. So I tried Ativan. Ativan was calming but not sleepy. (Xanax did NOTHING for me, zero.)
Anyway not to push drugs or and I don't mean to be completely off topic here, just wanted to suggest that I had switched from Klonopin to Ativan very successfully when I was having major panics, and it worked very well for me.
Best of luck to you
Iolite
Posted by Bobbiedobbs on January 1, 2003, at 19:52:34
In reply to Re: Parnate or Nardil: which one for social phobia?, posted by Iolite on December 23, 2002, at 20:38:27
Have had extensive experience with both. Nardil is by far superior, at the same time, by far has greater side effects. There's no question you should try Nardil first.
Posted by ace on January 2, 2003, at 0:48:23
In reply to Parnate or Nardil: which one for social phobia?, posted by comftnumb on December 20, 2002, at 5:56:00
> I have treatment resistant social phobia with comorbid depression and obsessive traits. I've been on Zoloft, Topamax, Effexor, and Wellbutrin. Currently I take 2mg of Klonopin which works well enough that I don't worry and obsess all the time, but I'm still afraid of taking social risks. I can't approach people I don't know or ask girls out on a dates.
>
> I'll keep using Klonopin though it's somewhat unmotivating. I want to try Nardil or Parnate to treat my SP and hopefully counter some of Klonopin's sedative/passiveness effects. My question is which one should I pick, Nardil or Parnate? I know Nardil has been studied more for SP, but Parnate has no weight gain or sexual side effects and tends to be more activating!!!! Also Nardil has been extremely unavailable. I've tried local and online pharmacies and all are on backorder.
>
> My question to you: What has your personal experiences been with Parnate or Nardil for social phobia? Particularly info on Parnate would be appreciated. Also if you've been on SSRIs prior to using an MAOI, and how they compare.
>
>
>
Hi!,Sorry to hear of your probs. I have been on Nardil for 4 weeks 4 days, it hasn't kicked in yet, but I feel positive about it that it will.
I'll have to agree with the others -- Nardil would be the one. Problems with asking for dates and stuff like that is a social phobia. And, from what I've read, there won't be any problems like that when the Nardil kicks in!Parnate seems best for depression. More stimulating.
With regards to the SSRIs. I went off Zoloft just before Nardil. It was preety poor -- it only helped my OCD minimally and hardly, if any, effect on my phobic anxiety. But when I went off (the 1st time, 6 or so months ago) it, even though it didn't help my derealization/phobic anxiety when on it, it made it worse!! So it doesn't help something in the first place, then we i go off the drug it makes it worse!!
As you can probably tell i am not a big fan off SSRIs! From what i know MAOIs eclipse them.Whatever the case, your going in the right direction now with the old MAOIs!
Take Care,
Ace
Posted by chad_3 on January 2, 2003, at 13:44:35
In reply to Re: Parnate or Nardil: which one for social phobia?, posted by ace on January 2, 2003, at 0:48:23
Hi -
I also have SP, also dysthymia. Anyway - here is a link on treatment of SP + OCD. It is off Pubmed - and has a link back to my website from there. It cites the effectiveness of Nardil for SP + OCD. Nardil compared to Parnate is has more 5ht than DA or NE, while Parnate is more equalized.
http://www.socialfear.com/Treatment_outcome_of_SP_+_OCD.html
Chad
> > I have treatment resistant social phobia with comorbid depression and obsessive traits. I've been on Zoloft, Topamax, Effexor, and Wellbutrin. Currently I take 2mg of Klonopin which works well enough that I don't worry and obsess all the time, but I'm still afraid of taking social risks. I can't approach people I don't know or ask girls out on a dates.
> >
> > I'll keep using Klonopin though it's somewhat unmotivating. I want to try Nardil or Parnate to treat my SP and hopefully counter some of Klonopin's sedative/passiveness effects. My question is which one should I pick, Nardil or Parnate? I know Nardil has been studied more for SP, but Parnate has no weight gain or sexual side effects and tends to be more activating!!!! Also Nardil has been extremely unavailable. I've tried local and online pharmacies and all are on backorder.
> >
> > My question to you: What has your personal experiences been with Parnate or Nardil for social phobia? Particularly info on Parnate would be appreciated. Also if you've been on SSRIs prior to using an MAOI, and how they compare.
> >
> >
> >
> Hi!,
>
> Sorry to hear of your probs. I have been on Nardil for 4 weeks 4 days, it hasn't kicked in yet, but I feel positive about it that it will.
> I'll have to agree with the others -- Nardil would be the one. Problems with asking for dates and stuff like that is a social phobia. And, from what I've read, there won't be any problems like that when the Nardil kicks in!
>
> Parnate seems best for depression. More stimulating.
> With regards to the SSRIs. I went off Zoloft just before Nardil. It was preety poor -- it only helped my OCD minimally and hardly, if any, effect on my phobic anxiety. But when I went off (the 1st time, 6 or so months ago) it, even though it didn't help my derealization/phobic anxiety when on it, it made it worse!! So it doesn't help something in the first place, then we i go off the drug it makes it worse!!
> As you can probably tell i am not a big fan off SSRIs! From what i know MAOIs eclipse them.
>
> Whatever the case, your going in the right direction now with the old MAOIs!
>
> Take Care,
> Ace
>
Posted by Chairman_MAO on October 25, 2005, at 18:17:08
In reply to Re: Parnate or Nardil: which one for social phobia?, posted by djmmm on December 20, 2002, at 8:30:44
I have a feeling that this is due to the fact that phenelzine is an irreversible MAOI and tranylcypromine is not (despite the official rap that it is). It is no moclobemide, but the mechanism of MAO inhibition by tranylcypromine is fundamentally different than the hydrazines (suicide substrates, I believe).
Even on 200mg/day tranylcypromine, I remembered dreams. Of course, this could be due tot he sleep aid I was taking.
Posted by Chairman_MAO on October 25, 2005, at 18:27:10
In reply to Parnate or Nardil: which one for social phobia?, posted by comftnumb on December 20, 2002, at 5:56:00
I find Nardil to be more stimulanting, or, rather, "energizing" than parnate. I feel most people do not express what they truly mean here. Parnate feels somewhate like speed (it is, after all, just amphetamine with the isopropyl backbone cyclicized). It also has metabolites tah block ne, 5th, and da reuptake to varying degrees.
For whatever reason, I have found 1mg/kg phenelzine MORE energizing than 200mg/day tranylcypromine. 200mg/day tranylcypromine at times provided more of a direct euphoria, and was profoundly pro-sexual (that is the best feature of it, IMHO; low or high-dose (not mid-dose, though, heh) tranylcypromine is the most pro-sexual licit drug in existence). But when it came to something which propelled me out of bed, etc, Nardil seemed to win. Plus, if I didn't take Parnate every 3 hours, some of its metabolites would get too anxiogenic for me. I certainly am not your "average bear" in terms of med response, though (the right dose of d-amphetamine (usually somwhere around 30-60mg) drops my heart rate because of the decrease in anxiey)
Posted by jparsell82 on October 25, 2005, at 21:07:05
In reply to Parnate being more stimulating, posted by Chairman_MAO on October 25, 2005, at 18:27:10
Why did I have a poor response to both Parnate and Nardil? I have treatment resistant SAD and OCD plus depression and ADD symptoms. On Nardil I felt "spaced out", lazy, couldn't concentrate, couldn't listen or talk to people very well, it was hard to think on Nardil, foggy headed. Parnate was anxiogenic for me. Do you think I should have pushed my dose of Nardil higher or something? I was taking 60mg for about 6 weeks(Link Pharmaceuticals brand). I had really high hopes for Nardil because I struggle every day with my SAD.
Posted by Chairman_MAO on October 25, 2005, at 22:37:02
In reply to Re: Parnate being more stimulating, posted by jparsell82 on October 25, 2005, at 21:07:05
If you were not taking 1mg/kg Nardil, you weren't taking enough to be able to say you gave it a fair trial. If you want to be absolutely sure, have your doctor measure your platelet MAO level before you start the med, then follow it down to 80% of the pre-drug level. I have never spoken to anyone whose doctor has done this, however. I trust that a lot more than logarhythmic relationships, which do not seem to always make sense, esp. for overweight/underweight people.
60mg is generally considered the minimum therapeutic dose for SAD. If you want to try something to improve your cognition, I recommend the following:
--galantamine
--provigil
--Piracetam and its analogues (pramiracetam is the best, but can be too much for some people. I think oxiracteam + galantamine both in moderate doses would work well)
--for straight-out brain fog issues, the drug pyritinol may work wonders. If you need more help in this area, babblemail me.
Posted by jparsell82 on October 26, 2005, at 0:05:12
In reply to Re: Parnate being more stimulating » jparsell82, posted by Chairman_MAO on October 25, 2005, at 22:37:02
> If you were not taking 1mg/kg Nardil, you weren't taking enough to be able to say you gave it a fair trial. If you want to be absolutely sure, have your doctor measure your platelet MAO level before you start the med, then follow it down to 80% of the pre-drug level. I have never spoken to anyone whose doctor has done this, however. I trust that a lot more than logarhythmic relationships, which do not seem to always make sense, esp. for overweight/underweight people.
>
> 60mg is generally considered the minimum therapeutic dose for SAD. If you want to try something to improve your cognition, I recommend the following:
>
> --galantamine
> --provigil
> --Piracetam and its analogues (pramiracetam is the best, but can be too much for some people. I think oxiracteam + galantamine both in moderate doses would work well)
> --for straight-out brain fog issues, the drug pyritinol may work wonders. If you need more help in this area, babblemail me.
>Thanks for the suggestions. I've tried a lot of different smart drugs. I only get mild relief from them... some actually make my focus worse by making me more "spaced out". Adderall helps my focus and some aspects of my social anxiety but makes other aspects worse. And anything too serotonergic seems to give me cognitive problems. I don't know... maybe I'll give Nardil another try. I really need something that works for fear and boosts my confidence. Again, thanks for the input,
Josh
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