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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by halcyondaze on January 20, 2007, at 19:43:56
I am seriously considering switching to Nardil, as Parnate's side effects have become unbearable. I've never been on Nardil so I have some questions:
1) How long do I have to wash-out from Parnate before starting Nardil?
2) What are the main side effects you've noticed on Nardil?
3) I am very concerned about weight gain. Is there any way to prevent this on Nardil?
Thanks, everyone.
Posted by Phillipa on January 20, 2007, at 20:02:08
In reply to Parnate to Nardil switch, questions, posted by halcyondaze on January 20, 2007, at 19:43:56
Can I follow as two others think I should be on Nardil. Thanks in advance. Love Phillipa
Posted by laima on January 21, 2007, at 9:13:31
In reply to Re: Parnate to Nardil switch, questions » halcyondaze, posted by Phillipa on January 20, 2007, at 20:02:08
Is acne a typical side effect of parnate?
Posted by halcyondaze on January 21, 2007, at 10:45:01
In reply to Re: Parnate side effects, posted by laima on January 21, 2007, at 9:13:31
Cystic acne is listed as a side effect of Parnate. It happened to me the last time I went on it as well.
Posted by laima on January 21, 2007, at 10:55:24
In reply to Re: Parnate side effects, posted by halcyondaze on January 21, 2007, at 10:45:01
> Cystic acne is listed as a side effect of Parnate. It happened to me the last time I went on it as well.
That's terrible! If that happened to me it would null the anti-depressent effect. What an unfortunate side effect, I'm very sorry to hear about it. I hope that nardil or another MAOI works out better for you. Thanks for the information, too.
Posted by halcyondaze on January 21, 2007, at 15:20:32
In reply to Parnate to Nardil switch, questions, posted by halcyondaze on January 20, 2007, at 19:43:56
Can anyone help?
> I am seriously considering switching to Nardil, as Parnate's side effects have become unbearable. I've never been on Nardil so I have some questions:
>
> 1) How long do I have to wash-out from Parnate before starting Nardil?
>
> 2) What are the main side effects you've noticed on Nardil?
>
> 3) I am very concerned about weight gain. Is there any way to prevent this on Nardil?
>
> Thanks, everyone.
Posted by Quintal on January 21, 2007, at 18:40:24
In reply to Parnate to Nardil switch, questions, posted by halcyondaze on January 20, 2007, at 19:43:56
>1) How long do I have to wash-out from Parnate before starting Nardil?
Two weeks is the usual advice from pdocs.
I've never taken Nardil so I can't comment on the other questions. I wonder if the acne has somthing to do with dopamine? I've read other posts wehere people have suffered acne from Nardil too.
Q
Posted by tessellated on January 22, 2007, at 14:56:55
In reply to Parnate to Nardil switch, questions, posted by halcyondaze on January 20, 2007, at 19:43:56
i think switch rates, like the MAOI side effects, vary by person dramatically.
are you off the parnate, and what dosage were you on?
7-10 days i hear at times, though in very severe cases, and under controlled circumstances, i think you can do a cross taper. but i think things like this are done when vitals can be monitored. BP, and serotonin syndrome can come on in certain people quickly. where for me i could always sense the danger signs ahead of time.
on the flip side, i've done the parnate challenge twice for about 9 months, and the withdrawl is what intimidates me now. i found it could last almost two months, before i restablished some equilibrium. they say MAOI clears the body in 24hrs, but the effects linger 7-14 days, but i think the receptors or cytkines or ? take muchlonger to re/de sensitize.
l8
Posted by Tomatheus on January 23, 2007, at 11:52:10
In reply to Parnate to Nardil switch, questions, posted by halcyondaze on January 20, 2007, at 19:43:56
Halcyondaze,
See below for my responses...
> 1) How long do I have to wash-out from Parnate before starting Nardil?
According to a recently published article on the role of MAOIs in psychiatric practice (Fiedorowicz & Swartz, 2004), a washout period of 14 days following the discontinuation of an MAOI is recommended before starting another antidepressant. As stated in the article: "While it is generally safe to begin a different antidepressant after a 14-day washout, patients should be monitored closely after the washout period since there have been case reports of interactions, including serotonin syndrome, following 14-day washout periods. Similar caution should be exercised when switching from one MAOI to another, although more rapid switches (1-8 days) have been safely performed."
> 2) What are the main side effects you've noticed on Nardil?
I took a few different versions of Nardil, and the three side effects that I noticed on a consistent basis no matter what version of the drug I took were weight gain, insomnia, and increased sweating. The latter two side effects varied in their intensity depending on the version of Nardil that I was taking (both side effects were mild when I took my partially homemade enteric version of the Australian Nardil, but ranged from moderate to severe in their intensity when I was taking film-coated versions of the drug).
I also experienced urinary retention (which ranged from moderate to severe in its intensity) and anorgasmia on a consistent basis when I took the regular film-coated versions of Nardil. Preparing my Nardil tablets (either Pfizer's U.S. version of Nardil or Link Pharmaceuticals' Australian version of the drug) in emptied-out enteric capsules prevented the anorgasmia from occurring and usually did the same with the urinary retention. Other side effects that I noticed at certain points while taking various versions of Nardil included extreme sleepiness (as a start-up side effect), lightheadedness and dizziness (also as a start-up side effect), akathisia, difficulty concentrating, muscle aches, and back pain (only when I took 75 mg/day of Pfizer's U.S. version of Nardil).
> 3) I am very concerned about weight gain. Is there any way to prevent this on Nardil?
Unfortunately, I think that some weight gain on Nardil is almost inevitable for most individuals, especially in the therapeutic dose range (60-90 mg/day). I rarely gain weight from taking medications, but I would estimate that I probably gained somewhere between 10 and 20 pounds during the time that I spent on Nardil (4-5 months, if I'm remembering correctly). Depending on what you normally eat, it might be a good idea to follow a reduced-calorie diet and/or to cut back on fatty and sugary foods, but I don't think that it would be a good idea to deprive your body of the nutrients that it needs just to avoid gaining weight on Nardil. It would also obviously be a good idea to exercise regularly if you're not already doing so, although the excessive sweating that you could potentially get from Nardil might make it somewhat difficult to exercise.
Interestingly, the findings of one study (Camarena et al., 2004) suggest that a low-activity variant of the MAO-A gene may be preferentially transmitted in obese individuals with a body mass of at least 35 kg/m2. So, reducing MAO-A activity to a significant extent by inhibiting the enzyme with Nardil might lead to an increase in body mass that is more or less inevitable. Given this possibility and the fact that weight gain is commonly associated with Nardil use, I think that it is particularly important to take reasonable measures to minimize any potential Nardil-induced weight gain as much as possible. However, the complete avoidance of weight gain on Nardil may not be realistic.
Tomatheus
==
REFERENCE
Camarena, B., Santiago, H., Aguilar, A., Ruvinskis, E., Gonzalez-Barranco, J., & Nicolini, H. (2004). Family-based association study between the monoamine oxidase A gene and obesity: Implications for psychopharmacogenetic studies. Neuropsychobiology, 49, 126-129. Abstract: http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=76720&ProduktNr=224082&Ausgabe=229950&filename=76720.pdf
Fiedorowicz, J. G., & Swartz, K. L. (2004). The role of monoamine oxidase inhibitors in current psychiatric practice. Journal of Psychiatric Practice, 10, 239-248. Abstract: http://www.practicalpsychiatry.com/pt/re/jpsychpract/abstract.00131746-200407000-00005.htm;jsessionid=F2KP4gtxBsgZps5tGT1CQ784jtBt5whXFgTwmp1vLd7nnbw7NQDM!990059801!-949856144!8091!-1
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