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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by 4WD on January 19, 2008, at 20:24:06
How do you go about choosing which one to ask your pdoc to try?
I have bad anxiety issues. Is Parnate bad for that?
What's the difference between the three?
Marsha
Posted by Phoenix1 on January 19, 2008, at 20:39:44
In reply to Nardil or Parnate or Marplan - what's the diff?, posted by 4WD on January 19, 2008, at 20:24:06
> How do you go about choosing which one to ask your pdoc to try?
>
> I have bad anxiety issues. Is Parnate bad for that?
>
> What's the difference between the three?
>
> MarshaIf you have anxiety issues, Nardil MAY be the better option. Both can help with anxiety in the long run. Just generalizations, but Nardil tends to be more sedating while Parnate tends to be more stimulating. There's been lots of dicussion on this, and most patients and doctors have their own preference. I've only been on Nardil. I know you're worried about weight gsin and it's a possibility. I find that Nardil makes me hungry at night. I combine it with a sleep med that also makes me hungry. I have to watch out for night times. But during the day, my appetite is pretty normal. Although I did gain some weight initially, it seems to have levelled off. With some willpower and careful watching of my diet, I hope to go back down to my baseline weight. I think Parnate is less likely tan Nardil to cause weight gain.
Phoenix1
Posted by Phillipa on January 19, 2008, at 21:18:43
In reply to Nardil or Parnate or Marplan - what's the diff?, posted by 4WD on January 19, 2008, at 20:24:06
Marsha Ed always thought I should be on nardil. Love Phillipa
Posted by Phoenix1 on January 20, 2008, at 10:57:51
In reply to Re: Nardil or Parnate or Marplan - what's the diff? » 4WD, posted by Phillipa on January 19, 2008, at 21:18:43
> Marsha Ed always thought I should be on nardil. Love Phillipa
Phillipa, did you ever try it?
Posted by Phillipa on January 20, 2008, at 18:31:52
In reply to Re: Nardil or Parnate or Marplan - what's the diff » Phillipa, posted by Phoenix1 on January 20, 2008, at 10:57:51
No and no plans to. I would rather be the way I am. Already have osteoporosis don't neeed to think of falling from low blood pressure which I already have. Plus having surgery next month. And supposed to see new pdoc in March. No one here that I'm allowed to see wil prescribe it for me anyways. Phillipa ps reason I know is that a fellow babbler found a doc in the area that would but I'd been to that large practice and it doesn't matter the circumstances the only one that will not allowed to see. My therapist explained it this way that there is competition amonst the docs for patients. Not right but how it is.
Posted by 4WD on January 20, 2008, at 20:28:51
In reply to Re: Nardil or Parnate or Marplan - what's the diff » Phoenix1, posted by Phillipa on January 20, 2008, at 18:31:52
> No and no plans to. I would rather be the way I am. Already have osteoporosis don't neeed to think of falling from low blood pressure which I already have. Plus having surgery next month. And supposed to see new pdoc in March. No one here that I'm allowed to see wil prescribe it for me anyways. Phillipa ps reason I know is that a fellow babbler found a doc in the area that would but I'd been to that large practice and it doesn't matter the circumstances the only one that will not allowed to see. My therapist explained it this way that there is competition amonst the docs for patients. Not right but how it is.
Sorry you can't get the option to try it. Maybe the new pdoc will prescribe it for you. Why do they say they won't prescribe it for you? For somebody with treatment resistant depression, it's a fairly common practice to try the patient on an MAOI.Anyway, just know that I am thinking about you. You know, I added your name to my prayer list.
Marsha
Posted by stargazer2 on January 20, 2008, at 22:34:38
In reply to Re: Nardil or Parnate or Marplan - what's the diff, posted by 4WD on January 20, 2008, at 20:28:51
Nardil worked twice (first in 1989 and 2007)
Marplan worked once (first in 1993, not in 2006)and Parnate never worked for me.Between Nardil and Marplan, I don't remember any major differences except the second time I tried Marplan I was on another med (Lamictal) and I think if you try any MAO, make sure you try it as a monotherapy first and give it a good chance to work on its own before adding any other med to it. It wasn't until I dropped 2 other meds that I was taking with Nardil that the dizziness subsided and I improved on Nardil alone.
I went back and looked at my notes and even now with Nardil, I was initially on it with Wellbutrin and then Nortriptylline, which I stopped on my own. When my pdoc asked why, I couldn't really remember but now I'm sure the other meds caused dizziness that I thought was exclusively related to Nardil.
At least for me, Nardil and Marplan worked the best as a monotherapy. For some reason my pdoc loves to add other meds and mentioned adding Abilify to Nardil at our last appt. I think I will have to reject this suggestion for fear of upsetting the cart which is steady right now.
Now is not a time to risk anything since Nardil seems to be working pretty well since I went from 45 to 60 a few weeks ago. I don't think he will suggest Abilify if I am stable when I see him.
Stargazer
Posted by 4WD on January 20, 2008, at 22:47:09
In reply to Took all three, Nardil, Marplan and Parnate, posted by stargazer2 on January 20, 2008, at 22:34:38
Any difference in side effect profile between Nardil and Marplan? Did you notice a difference in the weight gain/carb cravings issue between the two? And what about insomnia? Was it less with Marplan than Nardil?
Thank you so much for answering my questions. I am going to have to do something drastically different and I see my pdoc on Thursday.
Thanks again,
Marsha
> Nardil worked twice (first in 1989 and 2007)
> Marplan worked once (first in 1993, not in 2006)and Parnate never worked for me.
>
> Between Nardil and Marplan, I don't remember any major differences except the second time I tried Marplan I was on another med (Lamictal) and I think if you try any MAO, make sure you try it as a monotherapy first and give it a good chance to work on its own before adding any other med to it. It wasn't until I dropped 2 other meds that I was taking with Nardil that the dizziness subsided and I improved on Nardil alone.
>
> I went back and looked at my notes and even now with Nardil, I was initially on it with Wellbutrin and then Nortriptylline, which I stopped on my own. When my pdoc asked why, I couldn't really remember but now I'm sure the other meds caused dizziness that I thought was exclusively related to Nardil.
>
> At least for me, Nardil and Marplan worked the best as a monotherapy. For some reason my pdoc loves to add other meds and mentioned adding Abilify to Nardil at our last appt. I think I will have to reject this suggestion for fear of upsetting the cart which is steady right now.
>
> Now is not a time to risk anything since Nardil seems to be working pretty well since I went from 45 to 60 a few weeks ago. I don't think he will suggest Abilify if I am stable when I see him.
>
>
> Stargazer
Posted by Phillipa on January 20, 2008, at 23:20:37
In reply to Re: Nardil or Parnate or Marplan - what's the diff, posted by 4WD on January 20, 2008, at 20:28:51
Marsha sweetie we have known one another for a long time now thank-you so much for adding me it means a lot to me. Love Phillipa
Posted by Phillipa on January 20, 2008, at 23:22:29
In reply to Took all three, Nardil, Marplan and Parnate, posted by stargazer2 on January 20, 2008, at 22:34:38
Stargazer no if it ain't broken no need to fix it right? Phillipa
Posted by tecknohed on January 21, 2008, at 0:01:13
In reply to Nardil or Parnate or Marplan - what's the diff?, posted by 4WD on January 19, 2008, at 20:24:06
> How do you go about choosing which one to ask your pdoc to try?
>
> I have bad anxiety issues. Is Parnate bad for that?
>
> What's the difference between the three?
>
> MarshaExactly what anxiety issues do you have? Nardil is usually 1st choice for social anxiety, yet some actually find Parnate effective for that too.
I take Marplan. 1st time I tried it I found it too activating (was on nothing else) so went strait back to nardil after couple of weeks. This time round I'm on 3mg Klonopin with Marplan & its very similar to Nardil & very helpfull. I dont know if Marplan raises GABA like Nardil does but if anyone knows then PLEASE PROVIDE SOME CONCRETE EVIDENCE! :)If you're NOT already on a benzo & have any type of anxiety then Nardil should be you're first choice I think. Marplan does have less side effects though & they're easier to manage. Marplan feels to me like simple MAOI - nothing else. Nardil & Parnate do other things besides MAO inhibition.
teck
Posted by stargazer2 on January 21, 2008, at 8:21:37
In reply to Re: Took all three, Nardil, Marplan and Parnate » stargazer2, posted by 4WD on January 20, 2008, at 22:47:09
I really had no side effects with either Nardil or Marplan when I first tried them (late 80's early 90's) They were both original formulas then and worked like a charm. Remember this was many years ago and both of the formulas changed so that I wouldn't be able to comment on how they might work today, except I am currently on Nardil and it is working well enough with some side effects that I can tolerate.
Personally, since my first successful MAO was Nardil, I would start with that. I have side effects that eventually mellow out after being on a set dose for awhile. The dose that I am currently on is 60 mg. It may take a few months to get the dose right and get used to the side effects.
I take nothing for insomnia but occasionally have early morning wakenings, but nothing that really bothers me too much.
If Nardil doesn't work, I would try Marplan next. The second time I took Marplan (2006), it did not work, but it may have been because I was also on Lamictal and between the dizziness and memory issues, I had to come off of them. I wish I was just on Marplan alone to see if this may have worked since the first time I took Marplan, it worked alone.
I realize now, after further evaluation, it may have been the combination of a MAO and something else that might have resulted in a failed trial and therefore the next time I have to try another med, I will try Marplan alone just to prove my theory.
My advice is just to try them and don't get too caught up with the side effects, since the primary goal is reduction of the mood disorder and then other meds could be added to fine tune any side effects that persist.
Back in 1987, the psychiatrist I saw for meds, prescibed Nardil as the second AD she tried. It was a success and worked after a few days, or so it seemed at the time. Back then there were so few meds for depression, but she wasn't afraid of MAO's at all, since they were prescribed without the fear that they are associated with today. This is overblown, since the SSRI's have less side effects supposedly, but I had more with them than MAO's.
My worse days with depression were in the 90's and in the last 6 yeras or so, when I tried every new med for depression and none of them really worked very well. Those have been my darkest days as many years passed and I functioned on the periphery with little joy or life.
I envy that everyone today can be helped so much with a forum like this. I had to believe in my doctor and keep trying over and over for years without any other form of support. It was just me and him and most of the time, I felt so alone and often times came very close to giving up. I'm amazed that I was able to work most of those years because I was so depressed and out of sorts. It proves you can force yourself to do just about anything you have to do, even if you are suffering greatly. People do it everyday just to survive.
Time will tell if I can actually function at work again or if will cause me to relapse as it has done in the past. It's been about 2 years now and I am finally stable enough (?) to start looking for a job...scarey though and my confidence is low, but the time has come to move forward and see if Nardil will hold me together in the real world, and not just in my secure and stressfree non-working world.
Stargazer
Posted by Phillipa on January 21, 2008, at 18:16:44
In reply to Try Nardil first, then Marplan if necessary, posted by stargazer2 on January 21, 2008, at 8:21:37
Great post Stargazer. Love Phillipa
Posted by stargazer2 on January 22, 2008, at 22:09:30
In reply to Re: Try Nardil first, then Marplan if necessary » stargazer2, posted by Phillipa on January 21, 2008, at 18:16:44
...except I didn't know it at the time. Actually I did feel pretty good the first time I tried Nardil. I was able to do public speaking and things I was too uncomfortable to do prior to taking it. And with Marplan the same except I think it took longer to work.
It was so long ago, about 20 years ago, when I cried out for medication since my so called therapist at the time wasn't able to make any progress with my depression after 3 years of trying. I told him "enough is enough" and demanded he send me to a psychiatrist. This pdoc was amazing. Nardil was the second med she prescribed and it worked at once. Unfortunately, she was moving out of state and I next saw an idiot pdoc who insisted that I didn't need Nardil long term and should be able to come off it. When I begged her to let me stay on it, she didn't think I should be on it as long as I had been. But I kept telling her, as I tried to come off it, all my symptoms returned. I don't think she even listened to me. She was not for me so I found a new pdoc but by then Nardil had pooped. Stupid pdoc, who said docs know what they're doing, a novice Yalie with no common sense. I fired her a$$ after a few of these disagreements.
Remember when they only treated depression for weeks or months, never longer?
Stargazer
Posted by Phillipa on January 22, 2008, at 23:48:29
In reply to Thanks Phillipa, those were the good old days, posted by stargazer2 on January 22, 2008, at 22:09:30
Stargazer actually no as my first ad was an SSRI they only gave me benzos for panic disorder fine til thyroid pooped out a week after marrying Greg. Did he do it? The pdoc said well you signed a piece of paper but lymes found at the same time. Phillipa
Posted by 4WD on January 23, 2008, at 19:01:33
In reply to Re: Thanks Phillipa, those were the good old days » stargazer2, posted by Phillipa on January 22, 2008, at 23:48:29
Thank you all for all the support and and advice and encouragement. Nardil scares me because of the diet issues no this or that or that and everthing has to be perfectly fresh and the possible insomnia and the possible return of the bulimia.
but it would all be worth it if I could get my life back. I think I am going to ask my pdoc tomorrow for a trial of Nardil.
My anxiety isn't social anxiety. It is fear plain and simple - fear of nothing and of evertthing. I take 4-6mg a day of Klonopin for it along with Geodon, Celexa, Gabitril and Trazadone.
I don't know what I would do without this board.
Thank you all so much.
Marsha
Posted by Phillipa on January 23, 2008, at 20:01:39
In reply to thanks for all the help and support/advice, posted by 4WD on January 23, 2008, at 19:01:33
Marsha good luck and please keep us posted okay? Love Phillipa
Posted by tecknohed on January 23, 2008, at 20:50:31
In reply to thanks for all the help and support/advice, posted by 4WD on January 23, 2008, at 19:01:33
Yes, what Phillipa said!
And dont worry about the diet - its ALOT simpler than its made out to be :) You'll just need to give a few things up, like cheese & some alcoholic drinks. And of course some of your meds will need to go too. Nardil's best started on its own, but of course you'll need to reduce your Klonopin slowly, if thats what you wish to to. But Nardil WILL help you to lower your Klonopin dose. And you can still stay on Klonopin - you just might like to reduce the dose maybe.All the best!
teck
Posted by Phillipa on January 23, 2008, at 21:03:14
In reply to Re: thanks for all the help and support/advice » 4WD, posted by tecknohed on January 23, 2008, at 20:50:31
Tech slept the day away or fishing? Love Phillipa. Marsha listen to tech he is great.
This is the end of the thread.
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