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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by blueberry1 on February 20, 2007, at 16:26:07
Ok, people here have been hinting to me for some time now to try an maoi. Since ssris and all kinds of things actually seem to make my depression worse right away. The only thing I've responded to well was ECT but that only lasted 2 days before turning me into a mean bitch followed by a severe depressive crash. Been treading water ever since in major depression everyday.
Recently wellbutrin had me curled up on the couch in a deeper depression after just 2 days. Zoloft or lexapro just feel like crap.
I did try moclobemide years ago and I swear it had me really really depressed the very first day. So even the maoi thing kind of worries me.
Not many options. Tramadol is one. Also nardil or parnate.
So, nardil or parnate? Here are my questions.
I wonder if either one could spark a dysphoric mania or turn me into a mean bitch like ECT did. I do not want to take a mood stabilizer. I just need a mood elevator.
Nardil is worse for sexual dysfunction, right? I wonder why that is? Does parnate have sexual dysfunction too? Anorgasmia, impotence, lack of desire, any of those?
I do have a fair amount of anxiety, nervousness, and social withdrawal/anxiety. From what I have heard nardil is probably better for that. But if the sexual dysfunction is there, then the deal is off.
Parnate is stimulating, right? I like that. I guess if it was too stimulating I could mellow it out with a benzo. Worried about a stimulating drug when I have anxiety to begin with.
Seems like most, or almost all, of people that try parnate do improve. I can't even remember anyone saying they didn't, except for those who did ok with it then stopped it then went back to it and it didn't work again.
Anyway, your expert opinion, which should I go for...nardil or parnate? If you have any questions to ask me that may help you decide which would be best for me, please ask.
Thanks!
blueberry
Posted by Quintal on February 20, 2007, at 17:34:12
In reply to Nardil or Parnate?, posted by blueberry1 on February 20, 2007, at 16:26:07
I wouldn't worry about your bad reaction to moclobemide, I've never seen a case where anybody has done well on it, and I felt no effect from it myself at all. I think you're right to go straight for the big guns Parnate and Nardil without trying EMSAM and Marplan. Nardil is the only MAOI I haven't taken and the anorgasmia puts me right off it, as opposed to Parnate + benzo for my anxiety. If depression is your main problem I'd go straight for Parnate and take the dose as high as you can tolerate. Also consider augmenting it with Lamictal and a benzo. I had my best response ever from that combo and Parnate was the major player there I'm sure.
>I wonder if either one could spark a dysphoric mania or turn me into a mean bitch like ECT did. I do not want to take a mood stabilizer. I just need a mood elevator.
That could happen at low doses in the first week. I became much more depressed and even suicidal during the first three days, but that was quickly replaced with euphoria and wellbeing after I raised the dose to 80-120mg. I'd encourage you to push through that until you're taking at least 80-120mg a day for a week.
>Does parnate have sexual dysfunction too? Anorgasmia, impotence, lack of desire, any of those?
I've seen one other poster complain of that but I didn't experience any sexual problems myself and I'm very sensitive to that. In fact, Parnate increased my sex drive and ability. I think it's possible to reverse Parnate sexual dysfunction with cyproheptadine (which will also aid sleep), but I don't think it will be a problem.
>Parnate is stimulating, right? I like that. I guess if it was too stimulating I could mellow it out with a benzo. Worried about a stimulating drug when I have anxiety to begin with.
Parnate felt a lot like coke to me at the doses I described. Maybe that would be especially good with you being an ex-coke user? Perhaps that's exactly what you need to reverse your depression? I took Parnate with 4mg Klonopin and I'm reluctant to take it without a benzo. From my own experiences and from what I've read here Parnate works best with a 'downer' to smooth the jitters and help sleep.
>I can't even remember anyone saying they didn't, except for those who did ok with it then stopped it then went back to it and it didn't work again.
I improved a great deal with Parnate. I agree with Chairman_MAO that Parnate is one of the few true mood elevators among antidepressants as opposed to mood flatteners and anaesthetics like SSRIs.
I'm still thinking of going back to it again and have loads of bottles in my cupboard ready for use when I do. I thoroughly recommend you try it.
Good luck.
Q
Posted by stargazer on February 20, 2007, at 17:51:48
In reply to Nardil or Parnate?, posted by blueberry1 on February 20, 2007, at 16:26:07
Nardil worked for me, Parnate did absolutely nothing. So it's up to you but I would go with Nardil again given the chance.
Marplan worked the first time but not the second time.
Nardil would be the one to try, it is on my 'next try' lists if Emsam stops working.
Stargazer
Posted by Phillipa on February 20, 2007, at 21:25:24
In reply to Re: Nardil or Parnate?, posted by stargazer on February 20, 2007, at 17:51:48
Blueberry why not start with the EMSAM first? You can cut the patches as you're sensitive to meds. Love Phillipa
Posted by willyee on February 21, 2007, at 0:12:21
In reply to Re: Nardil or Parnate?, posted by Phillipa on February 20, 2007, at 21:25:24
> Blueberry why not start with the EMSAM first? You can cut the patches as you're sensitive to meds. Love Phillipa
Why would she want to do that?If my reading here is correct unfortunatly she is not a rookie,and has had already ECT sessions?Textbook data actualy suggests the best treatment for hardcore depression is actualy ECT followed by maintainace parnate.
I know im partial to this drug so i can definatly widen my spectrum and see Nardil as just a valuable option.
Emsam HOWEVER,seems to have an extremly low success rate,and at the least would not be an option for someone such as blueberry who has been through your more hardcore treatments,either would the reversable maois,these emsam and the latter might,MIGHT be options for mild depression if that but in blueberrys case id definatly recomend you go as you plan to one of the two more solid options of either parnate or Nardil,as far as augmenting with a benzo youll learn that as you start and wouldent worry to much about it.Phillpa,you are using monotherapy benzo if im not mistaken,personaly unless its like xanax as needed for panic situations,i would never see a benzo used to treat a emotional disorder as monotherapy,they simply in my view arent built that way,and usualy lead to tolerance,worsend depression to horrid states,and possably quicker and more robust addiction and dependance.
Again this excludes there use on a as needed basis for panic like the most common xanax i.e plane rides,highway driving etc.
Posted by platinumbride on February 23, 2007, at 23:35:21
In reply to Nardil or Parnate?, posted by blueberry1 on February 20, 2007, at 16:26:07
Bluberry,
Given what you have written here and in other posts, maybe parnate is the best place to start. You like energy, hate sexual dysfunctiion, etc.
You hinted at thoughts of being bipolar before, so maybe lithium wouldn't be such a bad idea with parnate.
Finally, you would always have nardil and augmentors (unless you see the same ultra cautious with maoi augmentation, but gung-ho to recommmend ect pdoc that I do).
I messed around with tramadol. it wasn't really worth it for me, as I developed tolerance to it quickly. Same was true with vicodin.
I have a feeling you will choose parnate. FWIW, I am on a low dose of it now (cautious pdoc again), and I don't think I am going to feel much until we get way above where we are now.
Good luck to you,
Diane
> Ok, people here have been hinting to me for some time now to try an maoi. Since ssris and all kinds of things actually seem to make my depression worse right away. The only thing I've responded to well was ECT but that only lasted 2 days before turning me into a mean bitch followed by a severe depressive crash. Been treading water ever since in major depression everyday.
>
> Recently wellbutrin had me curled up on the couch in a deeper depression after just 2 days. Zoloft or lexapro just feel like crap.
>
> I did try moclobemide years ago and I swear it had me really really depressed the very first day. So even the maoi thing kind of worries me.
>
> Not many options. Tramadol is one. Also nardil or parnate.
>
> So, nardil or parnate? Here are my questions.
>
> I wonder if either one could spark a dysphoric mania or turn me into a mean bitch like ECT did. I do not want to take a mood stabilizer. I just need a mood elevator.
>
> Nardil is worse for sexual dysfunction, right? I wonder why that is? Does parnate have sexual dysfunction too? Anorgasmia, impotence, lack of desire, any of those?
>
> I do have a fair amount of anxiety, nervousness, and social withdrawal/anxiety. From what I have heard nardil is probably better for that. But if the sexual dysfunction is there, then the deal is off.
>
> Parnate is stimulating, right? I like that. I guess if it was too stimulating I could mellow it out with a benzo. Worried about a stimulating drug when I have anxiety to begin with.
>
> Seems like most, or almost all, of people that try parnate do improve. I can't even remember anyone saying they didn't, except for those who did ok with it then stopped it then went back to it and it didn't work again.
>
> Anyway, your expert opinion, which should I go for...nardil or parnate? If you have any questions to ask me that may help you decide which would be best for me, please ask.
>
> Thanks!
> blueberry
This is the end of the thread.
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