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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 metamorphosis on January 26, 2009, at 4:17:09
So,I'm trying to make a decision between these two.After being treated with various ssri's,snri's,and wellbutrin my doctor is open to either Parnate or Nardil.I have SAD and SA with mild to moderate depression.I have lost intersts in a lot of my passions and become displacent.
My dilema is choosing between these two.From what I've read Nardil seems to work better on the anxiety issue due to its affect on GABA-great but tends to be sedating and can cause weight gain.Not good since I just got my weight under control and I don't want something that would be sedating.I thought of addind Provigil but it's to expensive.I don't know of another med that can be used safely that has stimulating properties like Provigil.
Now Parnate seems to be more stimulating,is pretty neutural with weight and is less prone to sexual dysfunction-great but does not seem to have such a strong anti-anxiety effect overall if I am correct.Which is bad for me.I'm throwing this out for any advice,feedback or experiences.I am currently in a washing out period for Wellbutrin before I see the doctor in 2 weeks.I also take Klonopin.
Posted by desolationrower on January 26, 2009, at 11:26:28
In reply to Nardil or Parnate, posted by metamorphosis on January 26, 2009, at 4:17:09
I would just choose to attack the problem that seems more to be the root cause and ignore the secondary problems, when deciding what to treat if there isn't a life-threatening or crisis-type symptom.
also, adrafinil, alcar, creatine, nicotine, or a stimulant/tca could all help fatigue added to an MAOI. of course there are anxiolytics too i see you're have a benzo.
-d/r
Posted by mav27 on January 26, 2009, at 11:41:24
In reply to Nardil or Parnate, posted by metamorphosis on January 26, 2009, at 4:17:09
well nardil was better for my social phobia as would be expected, it also didn't cause me and fatigue and i actually lost weight on it so you won't automatically get those 2 side effects.
Sexual dysfunction was the worst of anything i've ever taken by a million miles, parnate caused it as well but no where near as bad.
Posted by Vincent_QC on January 27, 2009, at 14:25:32
In reply to Re: Nardil or Parnate, posted by desolationrower on January 26, 2009, at 11:26:28
> I would just choose to attack the problem that seems more to be the root cause and ignore the secondary problems, when deciding what to treat if there isn't a life-threatening or crisis-type symptom.
>
> also, adrafinil, alcar, creatine, nicotine, or a stimulant/tca could all help fatigue added to an MAOI. of course there are anxiolytics too i see you're have a benzo.
>
> -d/rYou're right d/r...as usual... ;-)
I will go with the Nardil for his more neutral side-effects profile...I Can't still remember everything when I was on it, I was at the university, I had several big works to do...but if I sit and try to think about it 2 minutes, I Can remember that I had no side effect for the blood pressure with the NArdil, it was in fact more low than usual, I had no daytime sedation (The rivotril 8mg was causing it I think), and I never gain any weight on it...but I also remember that for my social phobia it was so so...I don't really improve on it (75mg/day)...I up to 90mg but I was not able to tolerate the hypotension orthostatic I had at the time...so I just give up.
The weight gain start with the Remeron try I had...continue with the Prozac and the Zoloft try I do after, I do 2 months on strict proteine diet, just whey proteine (600 calories days with tons of Potassium and salt), I loose all the 50 pounds I got from the severals tries I do on the SSRI's and the Remeron...and with the Cipralex(LExapro) experience last fall, I gain 45 pounds again...
I try the Parnate 1 month and I continue to gain weight...i'm now at 225 pounds...I Was 175 last summer..
In my one month trail on the PArnate I had several hypertensives crisis without food interraction. Hihg blood pressure and I experienced more orthostatic hypotension...all of this appear at a 20mg dose/day...30mg and 40 mg/day was the worst experience of my life...so I just stop...
I think it's different for everyone...The parnate is suppose to give some energy, in my case higher was the dose, the more higher was the daytime sedation. Insomnia was not too bad because I had some seroquel to help to sleep...I already had insomnia before the Parnate...
From a sexual point of view, Nardil is harder than the Parnate...on the Nardil, it was impossible to finish the job (sorry, i'm crude here)...on the Parnate, I just didn't think about sex, but I had no problem to achieve what I had to do...if you understand what I mean...lol (I'm talking about solo sexual acts of course....with my social phobia and the fact that I hate my body, I can't imagine myself to have sex with someone else!!! )... I was a lot humilited in the past because of this (my body)...the fact that I lost more than 250 pounds...and things like that...
Anyway, if you are not sensible to the NE effect of drugs, go with the Parnate, it seem to be a very effective drug for depression and also for social phobia...I feel some relief of my social anxiety on it, more than on the Nardil, but i'm not sure if it was because I was focusing on the side-effects on my heart and the fact that I forget the people around me...If it's your first time on a MAOI, maybe try the Nardil first...the dosage range is more high...some people will need 45mg other 90mg...
Dont forget something, MAOI's take times to built in your system...their good effects appears only lately...sometimes on the Parnate you have some days with remission feeling...like WOW I feel great today...and the day after it's just dull and not fun at all...The Nardil was more stable on this side...
That's hard to tell you wich ones to try first...since I try them in a VERY different context...
So one thing important, Nardil is more stable and have a more low side-effects profile exception of the sexual side effect..and Parnate kick in more fast but is more hard on the heart...
That's it...hope it can help!!!
Take care of you!
Vincent ;-)PS: Sometimes I write some contradictions...that's just because I can't really remember everything correctly...I have a short term memory problem...thanks to the benzo drugs and the severals tries on AD's I had in the last year!!! I will be hard at 70 yo! hahahaha I will be lost...lol
Posted by metamorphosis on January 29, 2009, at 14:26:46
In reply to Re: Nardil or Parnate (metamorphosis), posted by Vincent_QC on January 27, 2009, at 14:25:32
Thanks for the responses.I've been doing as much research as possible before I see my doc. in 2 weeks.Which brings up some more questions.As far as sexual side effects on Nardil,which seem pretty signifigant,are there any approved drugs to try to counterbalance this?Also I seem to be running into more posts on Marplan.Has it been effective for SAD/Depression for those taking it?How's it's side effect profile?Are they considered(sp?)less or more than Parnate/Nardil.Also I have no knowledge of anxiolytics.Any info on that would be greatly appreciated.One last thing.Can you or cant you take whey protein powder on MAOI's?I'm pretty clear on the other dieatary restrictions but seem to read conflicting posts on this.Thanks again for info/feedback!
Posted by desolationrower on January 30, 2009, at 0:15:09
In reply to Re: Nardil or Parnate (metamorphosis), posted by metamorphosis on January 29, 2009, at 14:26:46
> Thanks for the responses.I've been doing as much research as possible before I see my doc. in 2 weeks.Which brings up some more questions.As far as sexual side effects on Nardil,which seem pretty signifigant,are there any approved drugs to try to counterbalance this?
theres nothing 'approved' but there are a few things that sometimes work, although sometimes not. anorgasmia seems harder to rectify than arousal problems, and libido does not seem often affected.
>Also I seem to be running into more posts on Marplan.Has it been effective for SAD/Depression for those taking it?How's it's side effect profile?Are they considered(sp?)less or more than Parnate/Nardil.Also I have no knowledge of anxiolytics.Any info on that would be greatly appreciated.
unless there is some reason not to, choose a benzo, either a short one to take on occasion or a longer-acting one to take regularly.
>One last thing.Can you or cant you take whey protein powder on MAOI's?I'm pretty clear on the other dieatary restrictions but seem to read conflicting posts on this.Thanks again for info/feedback!
whey protein is fine.
-d/r
This is the end of the thread.
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