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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by satsumas on July 20, 2008, at 18:02:59
Hi,
I'm talking to my doctor on Tuesday about trying Nardil or Parnate as I've gone through many rounds of med trials with nothing lifting my chronic atypical depression significantly except for Effexor, which put me at the edge of hypomania at 300mg and caused lots of compulsions and cravings, as well as generating a feeling of apathy. Tried Emsam, and while it gave me some pep, it caused terrible anxiety and didnt' give me the sense of calmness or positivity that effexor gave.I'm hoping that anyone with experience with Nardil and Parnate can help answer a few questions. Understand each person will respond differently, but from my research it seems as though Nardil is a bit more sedating, but pro-social, and Parnate is a bit more speedy, but harder-edged.
What med is more likely to help with giving me back DESIRE (romantic, achievement, etc.) and making me feel like I care about things again?
Effexor had a definite blunting of emotional affect effect. Do Naridl and Parnate share that effect with the SSRIs?
Nardil seems to be more sedating...so does that mean there is a risk of me feeling blissed out, but in bed all day, happy to stay that way?
Which med, if either, would help treat (or exacerbate) constant, exhausting obsessive thoughts?
Parnate seems to be more stimulating but less social. Is there a risk of being "content" with the stimulating aspect of the drug, but still isolated?
How, precisely, is Nardil pro-social? I'm assuming via it's effect on anxiety, so the physical sensations, but people seem to say it does more than that....any insight would be helpful. And does Parnate share any of Nardil's prosociability effects?
What drug is less/more likely to cause cognitive dysfunction, if at all?
I'm always "in my head", often because I'm bored and/or lonely (because i'm not motivated to do things with friends, or the things I do do are so unpleasurable...classic depressive cycle). What med is more likely to get me "out of my head" and into the world and people around me?
If anyone has experience with Emsam and Nardil or Parnate, would love to hear subjective comparisions. For me, Emsam didn't help mood and didn't help take away obsessive thoughts as much as it gave me a bit of energy, motivation, and made me actually feel "smarter".
Thanks, know there is a lot of questions...but i am desperate for some relief...i've wasted so many years of the prime of my life.Satsuma
Posted by Zeba on July 20, 2008, at 19:49:28
In reply to Nardil or Parnate decision - have questions!, posted by satsumas on July 20, 2008, at 18:02:59
I have never taken Nardil so I can't speak to how it would affect me versus Parnate. I took Parnate in the past and am on Parnate now, and it works well for me. I guess I have never needed something pro-social. I like it as I have more energy; it has amphetamine like qualities if I remember right from my psychopharmacology course. ECT has messed up some of my memories though. Anyway, I think some have said that Nardil caused them to gain weight which I don't want. Parnate has not blunted my affect or interfered in any way with romantic inclinations and capability. I don't know for males.
I did try Emsam, and it never really worked for me.
Zeba
Posted by blueboy on July 21, 2008, at 9:31:52
In reply to Nardil or Parnate decision - have questions!, posted by satsumas on July 20, 2008, at 18:02:59
> I'm hoping that anyone with experience with Nardil and Parnate can help answer a few questions. Understand each person will respond differently, but from my research it seems as though Nardil is a bit more sedating, but pro-social, and Parnate is a bit more speedy, but harder-edged.
>I'm surprised at your post. My pdoc told me that Nardil is the most "activating" of the MAOI's.
I took Nardil for about 22 months and although it provides tons of energy, my insomnia problems were horrendous.
> What med is more likely to help with giving me back DESIRE (romantic, achievement, etc.) and making me feel like I care about things again?
>As I understand it, any MAOI is likely to seriously hamper sexual activity. I am male, and it gave me serious problems with both erectile and orgasmic function.
As far as achievement goes, however, it was great. It's the only drug that really got me to work every day.
> Effexor had a definite blunting of emotional affect effect. Do Naridl and Parnate share that effect with the SSRIs?
>Not in my case, at all.
> Nardil seems to be more sedating...so does that mean there is a risk of me feeling blissed out, but in bed all day, happy to stay that way?
>Again, I don't know where you are getting your information. My pdoc told me, and I experienced, a noticeable surge in general energy.
> Which med, if either, would help treat (or exacerbate) constant, exhausting obsessive thoughts?
>OCD is notoriously difficult to treat with drugs. I only have a mild to moderate OCD problem, but I just can't remember how it went with Nardil. It might have helped.
> Parnate seems to be more stimulating but less social. Is there a risk of being "content" with the stimulating aspect of the drug, but still isolated?
>Again, my impression is that Nardil is very stimulating, moreso than Parnate.
> How, precisely, is Nardil pro-social? I'm assuming via it's effect on anxiety, so the physical sensations, but people seem to say it does more than that....any insight would be helpful. And does Parnate share any of Nardil's prosociability effects?
>I didn't notice much "prosocial" effect from Nardil although, again, I might not have noticed. I have serious problems with social anxiety but, as far as I remember, Nardil didn't have any huge effect on this.
> What drug is less/more likely to cause cognitive dysfunction, if at all?
>Again, don't know. Nardil did not affect my cognition, except to the degree it made me hypomanic, thus affecting my judgment.
> I'm always "in my head", often because I'm bored and/or lonely (because i'm not motivated to do things with friends, or the things I do do are so unpleasurable...classic depressive cycle). What med is more likely to get me "out of my head" and into the world and people around me?
>Don't know, sorry. The only thing that helps me overcome my social anxiety is a small dose of a benzo, clonazepam. It's a miracle drug for me in this context, as a small enough dose to keep drowsiness out of the picture is sufficient to relieve a lot of anxiety.
> If anyone has experience with Emsam and Nardil or Parnate, would love to hear subjective comparisions. For me, Emsam didn't help mood and didn't help take away obsessive thoughts as much as it gave me a bit of energy, motivation, and made me actually feel "smarter".
>I did take a sub-therapeutic dose of selegiline (10mg/day) for a while, with no effect at all.
>
> Thanks, know there is a lot of questions...but i am desperate for some relief...i've wasted so many years of the prime of my life.
>I can relate. I'm very sorry for your problem. I understand and share exactly the pain you feel from this.
About Ensam and oral selegiline:
I have asked two very good pdocs the question, "Why is Ensam (which is very expensive) any better than selegiline (the pill form of Ensam)? They both were at a loss of words and actually, a bit embarrassed.IMO, Ensam is mostly a way for the drug company to repatent a generic drug and raise the price through the roof. The steady delivery of drug is a non-starter, due to the very long period of raising/lowering blood levels of any MAOI.
Ensam might be quite helpful for people who have trouble remembering to take pills, but IMHO it's pretty much a rip-off otherwise. (I have to pay for my own drugs, btw, so I take a very close look at drug prices).
I have a major question for you. Are you sure that your depression is unipolar rather than bipolar? I suggest the following: Spend the money to sit down with a good psychiatrist for a full hour or more, with the single instruction that you want a diagnosis. I went to a university clinic (cost me $400) and was told, after 30 years of treatment for depression, that I was "definitely bipolar".
The drug regimen is quite different. I had difficult and sometimes bizarre reactions, especially to Effexor and Wellbutrin. Even higher dosage Prozac.
Now I have been started on a mood stabilizer (Lamactil) which has few side effects, but has yet to do me much good.
The reason I ask is because you mentioned hypomania.
Nardil is the only drug that did me any good but you have to realize, it is a very "dirty" drug with a lot of side effects. It also made me hypomanic and I wasted a huge amount of money during the hypomanic stage.
Posted by satsumas on July 21, 2008, at 9:47:14
In reply to Re: Nardil or Parnate decision - have questions!, posted by blueboy on July 21, 2008, at 9:31:52
Thanks for the followup. My original diagnosis was depression 5 years ago, then after a hypomania, incuded by 300mg of Effexor I was on, changed to bipolar 2. I've only had one other period of hypomania, also caused by high dose of Effexor.
Was on lamictal+effexor for a long time, before i started to get the sense that my thinking was cloudy and the medicine was killing my motivation and desire. Then tried lamictal only (plus focalin) last year, and it did nothing for the depression, and was a huge waste of time.
Thanks for the response. DId Nardil affect your DESIRE for romance, or a relationship (if you were single at the time)? I'm less concerned about the mechanics, as I've never had a physical problem with libido in all my many trials of meds. I'm more concerned about it taking away the more broadly-defined libido instinct...for love, relationships, success, etc. To me this is as core of a symptom of my depression as anhedonia and low-energy. I would consider it a failed med if all something did was resolve the anhedonia and improve my mood but bliss me out to a point where I just didn't care about things I used to, or know in my rational brain to care about.
Tryied Mirapex last month on top of my most recent Efx trial to treat this issue...unclear as to whether it worked or not, but still on 1.5mg mirapex a day. Needed to resolve the Efx issue first.
How long did it take Nardil to kick-in? You have any major s/e besides insomnia (and what do you use for it?)
THanks much.
satsuma
Posted by satsumas on July 22, 2008, at 7:15:28
In reply to Nardil or Parnate decision - have questions!, posted by satsumas on July 20, 2008, at 18:02:59
Popping thread up -- anyone else have any insight here? Really appreciate it if so...
Posted by blueboy on July 22, 2008, at 10:43:49
In reply to Re: Nardil or Parnate decision - have questions! » blueboy, posted by satsumas on July 21, 2008, at 9:47:14
> Thanks for the response. DId Nardil affect your DESIRE for romance, or a relationship (if you were single at the time)? I'm less concerned about the mechanics, as I've never had a physical problem with libido in all my many trials of meds. I'm more concerned about it taking away the more broadly-defined libido instinct...for love, relationships, success, etc.
Nah, IMO Nardil should actually help with that. But be careful what you say about sexual side effects -- Nardil is one nasty drug.
>
> How long did it take Nardil to kick-in? You have any major s/e besides insomnia (and what do you use for it?)I don't remember some things. I'd guess a few weeks on Nardil, until I had been at 60mg for a week or two.
My side effects included insomnia, hypomania, stomach acid, rash, both erectile and orgasmic dysfunction, postural hypotension, weight gain, some others. They would mostly come at random times. These were all fairly severe, like when I say "stomach acid" I mean a burst of fire. Except the hypomania, which was more or less constant and not extreme.
Posted by Justherself54 on July 22, 2008, at 17:39:21
In reply to Nardil or Parnate decision - have questions!, posted by satsumas on July 20, 2008, at 18:02:59
I've been on Nardil and am now on Parnate
> What med is more likely to help with giving me back DESIRE (romantic, achievement, etc.) and making me feel like I care about things again?Both are good for motivation, Nardil more than Parnate.
>
> Effexor had a definite blunting of emotional affect effect. Do Naridl and Parnate share that effect with the SSRIs?No..I probably feel more "normal" emotions on MAOI's
>
> Nardil seems to be more sedating...so does that mean there is a risk of me feeling blissed out, but in bed all day, happy to stay that way?I did not find Nardil sedating, nor do I find Parnate sedating
>
> Which med, if either, would help treat (or exacerbate) constant, exhausting obsessive thoughts?Nardil was better for controlling racing thoughts
>
> Parnate seems to be more stimulating but less social. Is there a risk of being "content" with the stimulating aspect of the drug, but still isolated?I wanted to socialize far more on Nardil than Parnate, self-isolation has always been a problem for me, however, I am socializing...albiet reluctantly at times and usually end up having a good time
>
> How, precisely, is Nardil pro-social? I'm assuming via it's effect on anxiety, so the physical sensations, but people seem to say it does more than that....any insight would be helpful. And does Parnate share any of Nardil's prosociability effects?I don't know why they act differently with socialibility. I found Nardil caused a bit of hypomania...nothing dreadful happened...other than I was able to make some needed changes in my life...
>
> What drug is less/more likely to cause cognitive dysfunction, if at all?I found Nardil caused me to transpose letters when typing..and also I would type words that had to place in the sentence structure...very strange and annoying
>
> I'm always "in my head", often because I'm bored and/or lonely (because i'm not motivated to do things with friends, or the things I do do are so unpleasurable...classic depressive cycle). What med is more likely to get me "out of my head" and into the world and people around me?
>Nardil was better for social motivation..Parnate is better for staying on task with projects and things like reading..
> If anyone has experience with Emsam and Nardil or Parnate, would love to hear subjective comparisions. For me, Emsam didn't help mood and didn't help take away obsessive thoughts as much as it gave me a bit of energy, motivation, and made me actually feel "smarter".I feel "smarter" on Parnate. Nardil's side effects were too harsh for me. They were urinary problems, horrible gas, loss of balance, extreme insomnia, an insatiable urge for eating sweets which led to close to a 25 plus extra pounds (added to the 60 pounds SSRI's put on uggg), and the final one which caused my pdoc to pull me off was throwing up in my sleep...I didn't have hypotension issues with Nardil nor Parnate but it turns out my normal blood pressure is now high, so Parnate has lowered it to the normal range...
As for male libedo problems, I can't comment cause I'm female...and not in a relationship at the moment
Hope this helps...if you have any more questions, I'll be glad to respond..sorry I didn't sooner, but just had my daughter and 3 grandkids for a week and my brain is just now recouping from sensory overload!
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