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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by LizinManhattan on February 6, 2006, at 21:00:44
Hi Everyone,
I have been lurking here for years and think this is the best board of its kind out there.
Anyway, I will soon be going off Parnate and my docotor mentioned some research indicating that the combination of Cymbalta and a Parkinson's drug might be a good alternative for me. Has anybody heard anything about this?
As an aside, the reason I am going off Parnate is that I have begun having spontaneous blood pressure issues (meaning I have not eaten any tyramine-rich food but my BP still spikes). While Parnate has been my life saver for the past 7 and a half years I can't handle the stress of uncontrolled BP spikes.
Thanks everyone,
Liz
Posted by forgetful mary on February 6, 2006, at 22:21:47
In reply to MAOI Alternative: Cymbalta Parkinson's drug?, posted by LizinManhattan on February 6, 2006, at 21:00:44
I started Parnate 2 months ago and having same problems as you...BP spikes without a catalyst. Also periodic depressive episodes....Had hope for it but the BP spikes are troubling even though it is of the mild variety. Good luck to you!
> Hi Everyone,
>
> I have been lurking here for years and think this is the best board of its kind out there.
>
> Anyway, I will soon be going off Parnate and my docotor mentioned some research indicating that the combination of Cymbalta and a Parkinson's drug might be a good alternative for me. Has anybody heard anything about this?
>
> As an aside, the reason I am going off Parnate is that I have begun having spontaneous blood pressure issues (meaning I have not eaten any tyramine-rich food but my BP still spikes). While Parnate has been my life saver for the past 7 and a half years I can't handle the stress of uncontrolled BP spikes.
>
> Thanks everyone,
> Liz
Posted by willyee on February 6, 2006, at 22:46:53
In reply to MAOI Alternative: Cymbalta Parkinson's drug?, posted by LizinManhattan on February 6, 2006, at 21:00:44
> Hi Everyone,
>
> I have been lurking here for years and think this is the best board of its kind out there.
>
> Anyway, I will soon be going off Parnate and my docotor mentioned some research indicating that the combination of Cymbalta and a Parkinson's drug might be a good alternative for me. Has anybody heard anything about this?
>
> As an aside, the reason I am going off Parnate is that I have begun having spontaneous blood pressure issues (meaning I have not eaten any tyramine-rich food but my BP still spikes). While Parnate has been my life saver for the past 7 and a half years I can't handle the stress of uncontrolled BP spikes.
>
> Thanks everyone,
> liz
One word for,one GIANT WORD,EMSAM.If you had luck with parnate,you are **probuably** a MAOI responder,emsam simply deprenyl is to supposedly be released this month,i believe the 26th.Deprenyl as you know is a Maoi,in fact it is quite similiar if not to some BETTER than parnate.
With emsam on the 26th being a patch,supposedly diet restrictions,and most other hazdardous the Moais contain will either be non-exsistent or at quite high doses extremly minimal.
Google it.
Posted by LizinManhattan on February 7, 2006, at 11:13:17
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug?, posted by forgetful mary on February 6, 2006, at 22:21:47
Hi,
I'm sorry you've been having problems on Parnate. Have you tried Nardil? It's supposed to have fewer BP issues. I was on that before Parnate and while it definitely helped my depression I gained about 20 pounds and it disturbed my sleep. There are a few posts about it on this board. Also, look at at the post below yours; seems promising!
Good luck!
Liz> I started Parnate 2 months ago and having same problems as you...BP spikes without a catalyst. Also periodic depressive episodes....Had hope for it but the BP spikes are troubling even though it is of the mild variety. Good luck to you!
>
>
> > Hi Everyone,
> >
> > I have been lurking here for years and think this is the best board of its kind out there.
> >
> > Anyway, I will soon be going off Parnate and my docotor mentioned some research indicating that the combination of Cymbalta and a Parkinson's drug might be a good alternative for me. Has anybody heard anything about this?
> >
> > As an aside, the reason I am going off Parnate is that I have begun having spontaneous blood pressure issues (meaning I have not eaten any tyramine-rich food but my BP still spikes). While Parnate has been my life saver for the past 7 and a half years I can't handle the stress of uncontrolled BP spikes.
> >
> > Thanks everyone,
> > Liz
>
>
Posted by LizinManhattan on February 7, 2006, at 11:18:34
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug?, posted by willyee on February 6, 2006, at 22:46:53
Wow!!! They are finally coming out with the patch! I had given up on it; I remember there was talk about it about 10 years ago all ready... Thank you SO MUCH for bringing this to my attention. It seems there's some squabbling about whether or not the patch should have to carry warning labels about diet. The FDA seems satisfied that the 20 mg is fine without the warnings but not the higher doses.
http://biz.yahoo.com/prnews/051121/clm059.html?.v=33Thanks again!
Liz> > Hi Everyone,
> >
> > I have been lurking here for years and think this is the best board of its kind out there.
> >
> > Anyway, I will soon be going off Parnate and my docotor mentioned some research indicating that the combination of Cymbalta and a Parkinson's drug might be a good alternative for me. Has anybody heard anything about this?
> >
> > As an aside, the reason I am going off Parnate is that I have begun having spontaneous blood pressure issues (meaning I have not eaten any tyramine-rich food but my BP still spikes). While Parnate has been my life saver for the past 7 and a half years I can't handle the stress of uncontrolled BP spikes.
> >
> > Thanks everyone,
> > liz
>
>
> One word for,one GIANT WORD,EMSAM.If you had luck with parnate,you are **probuably** a MAOI responder,emsam simply deprenyl is to supposedly be released this month,i believe the 26th.
>
> Deprenyl as you know is a Maoi,in fact it is quite similiar if not to some BETTER than parnate.
>
> With emsam on the 26th being a patch,supposedly diet restrictions,and most other hazdardous the Moais contain will either be non-exsistent or at quite high doses extremly minimal.
>
>
> Google it.
>
>
Posted by mogger on February 7, 2006, at 12:27:40
In reply to MAOI Alternative: Cymbalta Parkinson's drug?, posted by LizinManhattan on February 6, 2006, at 21:00:44
LizinManhattan,
my sister had the same problem with Parnate, she had a hypertensive crisis. Her doctor tried her on Selegiline (Parkinsons Med) and it has helped tremendously without the hyperstensive crisis'. Keep in mind you still have to worry about Tyramine but I think it is less. Talk with your doctor about it, she has really been helped by it.
mogger
Posted by willyee on February 7, 2006, at 13:17:54
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug? » LizinManhattan, posted by mogger on February 7, 2006, at 12:27:40
Thats what she means with t he patch,thats what the patch is,only there shuld be little to no restrictions period.
Posted by mogger on February 7, 2006, at 13:38:42
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug?, posted by willyee on February 7, 2006, at 13:17:54
Awesome,
looking forward to that coming out. I wonder if side effects might be less with the patch? My sister finds it very activating some times too much so I wonder if it might calm it down.
mogger
Posted by LizinManhattan on February 7, 2006, at 16:02:38
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug? » LizinManhattan, posted by mogger on February 7, 2006, at 12:27:40
So I just came back from my psychiatrist and I will be starting Remeron in a few weeks. It was between that and Lexapro. He seemed to think that Selegiline doesn't help many people and so is hesitant about having me go on the Selegiline patch. I think I will have to do some research about that though. Hmmm... I'm glad that your sister has found something that works for her and she must be very excited about the patch!
Liz
> LizinManhattan,
> my sister had the same problem with Parnate, she had a hypertensive crisis. Her doctor tried her on Selegiline (Parkinsons Med) and it has helped tremendously without the hyperstensive crisis'. Keep in mind you still have to worry about Tyramine but I think it is less. Talk with your doctor about it, she has really been helped by it.
> mogger
Posted by forgetful mary on February 7, 2006, at 18:49:50
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug? » forgetful mary, posted by LizinManhattan on February 7, 2006, at 11:13:17
Hi, well I took the Old Nardil successfully for 20 years and unfortunately the new one gave me insomnia , memory lapses, rashes and stomach problems to name a few, I may try emsam but I think I tried that drug years ago??, orally not as a patch of course,?? ....getting discouraged....
> Hi,
> I'm sorry you've been having problems on Parnate. Have you tried Nardil? It's supposed to have fewer BP issues. I was on that before Parnate and while it definitely helped my depression I gained about 20 pounds and it disturbed my sleep. There are a few posts about it on this board. Also, look at at the post below yours; seems promising!
> Good luck!
> Liz
>
> > I started Parnate 2 months ago and having same problems as you...BP spikes without a catalyst. Also periodic depressive episodes....Had hope for it but the BP spikes are troubling even though it is of the mild variety. Good luck to you!
> >
> >
> > > Hi Everyone,
> > >
> > > I have been lurking here for years and think this is the best board of its kind out there.
> > >
> > > Anyway, I will soon be going off Parnate and my docotor mentioned some research indicating that the combination of Cymbalta and a Parkinson's drug might be a good alternative for me. Has anybody heard anything about this?
> > >
> > > As an aside, the reason I am going off Parnate is that I have begun having spontaneous blood pressure issues (meaning I have not eaten any tyramine-rich food but my BP still spikes). While Parnate has been my life saver for the past 7 and a half years I can't handle the stress of uncontrolled BP spikes.
> > >
> > > Thanks everyone,
> > > Liz
> >
> >
>
>
Posted by mogger on February 7, 2006, at 23:35:41
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug? » mogger, posted by LizinManhattan on February 7, 2006, at 16:02:38
Good luck with the Remeron, I am on that as well! I am at 45mg at bedtime and it helps me sleep and with my depression. Let us know of your progress, mogger
Posted by willyee on February 8, 2006, at 8:44:36
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug? » mogger, posted by LizinManhattan on February 7, 2006, at 16:02:38
> So I just came back from my psychiatrist and I will be starting Remeron in a few weeks. It was between that and Lexapro. He seemed to think that Selegiline doesn't help many people and so is hesitant about having me go on the Selegiline patch. I think I will have to do some research about that though. Hmmm... I'm glad that your sister has found something that works for her and she must be very excited about the patch!
> Liz
>
> > LizinManhattan,
> > my sister had the same problem with Parnate, she had a hypertensive crisis. Her doctor tried her on Selegiline (Parkinsons Med) and it has helped tremendously without the hyperstensive crisis'. Keep in mind you still have to worry about Tyramine but I think it is less. Talk with your doctor about it, she has really been helped by it.
> > mogger
>
>I find it odd your doc would say deprenyl doesent help many when......A there are two forms of deprenyl,tabs and liquid.
The tabs are totaly not anti deprssants,and although im sure they can be prescribed OFF LABEL
this is something that from my view is extremly extremly rare,.....reason being a docter is reluctant to use Maois period,so i cant imagine why a docter who takes the less known road and chooses to use a Moai with his patients will not use the MAIN two,and instead go with a very rarly used maoi in the pysch world.....deprenyl?
I mean its rare enough a doc would choose to use maois,.......but to go a step further and use one that has almost no documented history in depression.The throwing the last brick on the heap tell you "most people dont have success on it" which would have to indicate either he or someone has seen this strange deprenyl treatment done often,i dont buy that very much,just something there doesent sound right,had he simply said most people dont do well on MOAIS would have made sense,but of course would have been inaccurate as maoi users do no worse than ssri users.As far as deprenyl liquid,well its not a drug here in the U.S so we wont even go there.......final thought,ur doc blew u off on the deprenyl discussion,i personaly believe and again this whole post is just my own belief is that when a doc doesent know enough as he/she wants to on a subject,they seem to like to discredit it and move on and away.
Big bucks,lots of work and time are invested in the deprenyl patch,its not even out yet,so i logicaly cant see how a docter can come to the conclusion of saying most people dont do well on deprenyl,lets get it on the market first maybe?
Oh i see manhattan,manhattenite are you? Man i miss shopping on 34th st.
Posted by mogger on February 8, 2006, at 11:02:47
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug?, posted by willyee on February 8, 2006, at 8:44:36
Take a look at this link, there are some positive reports of Selegiline/Deprenyl.
mogger
Posted by LizinManhattan on February 8, 2006, at 19:17:44
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug?, posted by mogger on February 7, 2006, at 23:35:41
I'm not too excited about the Remeron because of the weight gain that 25% of users supposedly get. I'm supposed to start on 15 mg, but that won't be until March 8th (after coming off of Parnate and letting it wash out). Then, a week after that I'm supposed to go to 30 mg. and then I guess we'll see.
Liz> Good luck with the Remeron, I am on that as well! I am at 45mg at bedtime and it helps me sleep and with my depression. Let us know of your progress, mogger
Posted by LizinManhattan on February 8, 2006, at 19:18:56
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug?, posted by mogger on February 8, 2006, at 11:02:47
Thanks! I will definitely check it out!
Liz> Take a look at this link, there are some positive reports of Selegiline/Deprenyl.
> mogger
>
>
> http://www.selegiline.com/future.html
Posted by gibber on February 8, 2006, at 22:46:23
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug? » forgetful mary, posted by LizinManhattan on February 7, 2006, at 11:13:17
Liz,
I'm interested in your nardil and parnate experience. I'm on Nardil and have noticed some improvement in depression but it comes and goes and now its mostly going. Nardil has me awake at night for hours sometimes and that's not good, also the sexual sides are bad. Did you feel the Parnate was better for you despite the BP spikes? What sort of depresssion symptoms did you have, atypical? I have atypical depression...sleeping alot, mood reactivity, cognitive trouble. I'll be trying parnate if the nardil doesn't start working soon.Thanks
Posted by LizinManhattan on February 9, 2006, at 14:31:43
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug?, posted by gibber on February 8, 2006, at 22:46:23
Nardil wiped out my depression completely. However, I gained about 15-20 lbs and I too was awake for hours each night. It didn't matter when I took it or how I spaced the doses. I don't remember much about the sexual side effects. I definitely have atypical depression and I found that Nardil and Parnate helped me more than any other medicine I had tried in the previous 10 years.
As far as Parnate, I don't have any insomnia as I know some people do. However, my dreams are extremely vivid and detailed. Also, I start dreaming very early in my sleep cycle. If I have just taken a 10 minute nap I will have had a dream; I don't think that is normal. In addition, I am sleepy a lot.
Parnate saved my life and enabled me to live a pretty normal, albeit very sleepy, life. However, after ending up in the ER and almost dying from a hypertensive crisis and then having a subsequent severe BP spike I feel I can't stay on it. For the first 2 years I followed the diet perfectly. Then, my doctor said that I could start trying some mozzarella cheese. I had no reaction eating cheese, inculding cheddar and swiss, for 5 years and then a couple of weeks ago I had a couple of slices of swiss and I ended up in the ER. The subsequent spike was unprovoked. Supposedly that can happen on Parnate.
I'm sorry Nardil isn't doing it for you. I wish you the best of luck with Parnate if you do end up on it. It certainly helped me. Who knows? I might end up going back on it if I can't find anything else that helps.
Liz> Liz,
> I'm interested in your nardil and parnate experience. I'm on Nardil and have noticed some improvement in depression but it comes and goes and now its mostly going. Nardil has me awake at night for hours sometimes and that's not good, also the sexual sides are bad. Did you feel the Parnate was better for you despite the BP spikes? What sort of depresssion symptoms did you have, atypical? I have atypical depression...sleeping alot, mood reactivity, cognitive trouble. I'll be trying parnate if the nardil doesn't start working soon.
>
> Thanks
Posted by gibber on February 9, 2006, at 19:47:46
In reply to Re: MAOI Alternative: Cymbalta Parkinson's drug? » gibber, posted by LizinManhattan on February 9, 2006, at 14:31:43
Liz,
The fact that you tried cheddar and swiss on Parnate is concerning. I'm sure the tyramine issue does NOT go away after taking the med for any length of time. You were probably just lucky that the first few servings of cheese didn't react. Was your trip to the ER really unprovoked? Am I reading your post right?ps- I posted the EMSAM info in the other thread.
Posted by LizinManhattan on February 9, 2006, at 22:04:10
In reply to parnate and cheese, posted by gibber on February 9, 2006, at 19:47:46
Hi,
I only tried cheese after my doctor told me it was OK, for two years prior I had nothing with tyramine. If I saw that a food contained soy sauce I wouldn't have it; I wouldn't touch a banana if it looked the least bit overripe etc. After my doctor told me pizza (=mozzarella specifically) would be OK I tried some. I monitored my blood pressure the first 20 or so times and then my doctor came to the conclusion that I probably was not very sensitive to it. He had apparently come across some new info. that stated that the tyramine issue had been grossly overstated and that really only 3% or so of MAOI users were sensitive to tyramine while on an MAOI.
So after a while of having mozzarella pizza we decided I should try more aged cheeses. Everything was fine for years. Then a couple of weeks ago, I had two slices of swiss cheese and I ended up in the emergency room. So no, my visit to the ER was not unprovoked. However, a week later when I had had nothing with tyramine (I had been scared senseless from my ER experience and had returned to my completely tyramine free diet) I had a very close call.
I remember when I first went on MAOIs I had a great book my Jack Gorman about psychiatric medicines and I remember reading that Parnate could cause hypertensive crises without any tyramine ingestion.
Who knows? Maybe my body chemistry changed? Maybe MAOIs start to act differently in the body after a while. I don't know much about the biochemistry involved but I know MAOIs can poop out on people after a while, maybe they can also start wreaking blood pressure havoc for people as well?
In any case, if I ever do go on Parnate again I will once again be leading a tyrsmine free existence. It really has been a good medicine to me. I hope it will be for you too if you go on it.
Liz> Liz,
> The fact that you tried cheddar and swiss on Parnate is concerning. I'm sure the tyramine issue does NOT go away after taking the med for any length of time. You were probably just lucky that the first few servings of cheese didn't react. Was your trip to the ER really unprovoked? Am I reading your post right?
>
> ps- I posted the EMSAM info in the other thread.
>
>
Posted by gardenergirl on February 9, 2006, at 23:11:26
In reply to Re: parnate and cheese » gibber, posted by LizinManhattan on February 9, 2006, at 22:04:10
Mozzarella is not an aged cheese. It's fresh, and thus contains very little tyramine. That's why your doc said it was okay to try mozzarella. Aged cheese like Swiss and cheddar are still no-no's. It's true that sensitivity to tyramine varies. It's also true that tyramine content varies. Perhaps the swiss cheese you ate before the BP spike was more aged than usual?
gg
Posted by gibber on February 10, 2006, at 8:05:51
In reply to Re: parnate and cheese » LizinManhattan, posted by gardenergirl on February 9, 2006, at 23:11:26
I eat mozzarella all the time on Nardil. But like gardener said its still not aged like swiss. Where did your doctor get that study? Its true sensitivity to tyramine varies as does the content in different batches of the same food. If you're really jonesin' for some cheese you can have any processed cheese like kraft singles or velveeda. You can google dr. bob here for detailed do's and don'ts. Someone named elizabeth put out a good one. I usually confirm things my doctor says by a search on google, it takes a little time but it is your life you're messing with.
Posted by willyee on February 10, 2006, at 8:42:24
In reply to Re: parnate and cheese » LizinManhattan, posted by gardenergirl on February 9, 2006, at 23:11:26
> Mozzarella is not an aged cheese. It's fresh, and thus contains very little tyramine. That's why your doc said it was okay to try mozzarella. Aged cheese like Swiss and cheddar are still no-no's. It's true that sensitivity to tyramine varies. It's also true that tyramine content varies. Perhaps the swiss cheese you ate before the BP spike was more aged than usual?
>
> ggGood point cause i have eatan pizza normaly,which is a fair amount for the 5 years ive been on it,and when i eat pizza im not shy with how much i eat.
The only thing that gave me a direct interaction was the third day on it,soy sauce,i dident know i was eating soy sauce.but now if i have chinease its wings and white rice not a single thing else.
Posted by ed_uk on February 10, 2006, at 16:09:55
In reply to Re: parnate and cheese » gibber, posted by LizinManhattan on February 9, 2006, at 22:04:10
The tyramine content of cheeses is very variable. Different batches of the same cheese can contain very different quantities of tyramine, hence the risk of eating cheese - even if you haven't had a bad reaction previously.
Ed
This is the end of the thread.
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