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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Roslynn on June 18, 2010, at 16:24:38
Hi everyone,
My pdoc has finally come to the point where he feels we have exhausted other options for meds and he wants me to try an MAOI. (I was on EMSAM which worked a little but I had terrible rashes).
It seems to be between Nardil, Parnate and Selegiline. What are the major differences between them? And why did my pdoc not mention Marplan as a choice, when it seems a few people here are taking it?
Thank you for any help!
Roslynn
Posted by zonked on June 18, 2010, at 20:08:54
In reply to trying to choose an MAOI???, posted by Roslynn on June 18, 2010, at 16:24:38
This sounds cliche--but since I have taken all four, I think I can comment. :-)
Parnate was more "activating" to me, and did NOT cause me to gain weight. It was not activating in an anxiety-causing way for me, although it has had this effect on some people. It also helped somewhat with my ADD (it has properties similar to Dexedrine/Adderall/Amphetamine.)
Nardil was definately less "activating"; but relieved depression just as well. It is considered the "gold standard" if you have social/generalized anxiety, and I can see why. I could talk to anyone about anything on either of these when they were working; but with Nardil it was more of a calm/at ease/fuzzy feeling whereas with Parnate it was a bit stimulant-like. If that makes sense.
Nardil made me gain a lot of weight--40lbs in about a year and a half; Parnate did not. Nardil made me crave sugary/salty/savory foods, Parnate did not.
Both are the best drugs I've ever taken for depression--if you don't mind me asking, what is your DX/what are your symptoms? Other folks here, I'm sure, will weigh in also.
Selegiline made me way too anxious (don't remember the dose, but it was in pill form).
I am on 60mg Marplan now and it's too early to give a final verdict, but it *seems* somewhere in between Nardil and Parnate in terms of activation and has reduced my appetite. It's working for my depression, but it's too early to objectively tell how well or how evenly.
Best of luck to you, I'm sure you'll find the right MAOI for you, and glad you have a doc who'll prescribe them.
-z
> Hi everyone,
>
> My pdoc has finally come to the point where he feels we have exhausted other options for meds and he wants me to try an MAOI. (I was on EMSAM which worked a little but I had terrible rashes).
>
> It seems to be between Nardil, Parnate and Selegiline. What are the major differences between them? And why did my pdoc not mention Marplan as a choice, when it seems a few people here are taking it?
>
> Thank you for any help!
>
> Roslynn
Posted by stargazer2 on June 19, 2010, at 4:41:27
In reply to Re: trying to choose an MAOI??? » Roslynn, posted by zonked on June 18, 2010, at 20:08:54
Hi, I also have been on all 4 meds. First taking Nardil in 1986 with immediate relief. A few years later took Marplan with equally effacacious results, not sure of how long for the effects to begin though. MArplan was discontinued in 1993, so I was forced to come off of it.
Fast forward 20 years, trying Ensam with minimal results at all 3 doses.
Oh back up somewhere in there, tried Parnate with zero results...so out of the 4, have only had good results with NArdil and Marplan. The second "go" with Marplan (3-4 yrs ago) was ineffective, so back to Nardil again, and with a positive outcome.
So, those are my results. I did have sides with Nardil the second time around, not the first time. The sides were weight gain and GI distress (gas and constipation) which went away. Even the weight gain (20 lbs) has been corrected, so if you are in a desparate place, like I have always been, the weight gain has to be overlooked, at least for me it was.
Good luck on your jouney...at least you have many other travelers here.
Stargazer
Posted by SLS on June 19, 2010, at 6:03:26
In reply to Re: trying to choose an MAOI???, posted by stargazer2 on June 19, 2010, at 4:41:27
Hi.
> so back to Nardil again, and with a positive outcome.
How long have you been well on Nardil?
- Scott
Posted by stewie on June 19, 2010, at 23:49:03
In reply to Re: trying to choose an MAOI??? » stargazer2, posted by SLS on June 19, 2010, at 6:03:26
I think it is really important to take the maoi "plunge". But these drugs are sadly not for everyone.
So while, in my experience, Nardil was the most effective for depression and anxiety, it was also the most difficult for me to handle, and the cure became worse than the disease. One thing that no one ever warned me about was how difficult it would be to try to lower the dosage. The rebound depression was horrifying for me.
I did not stay on parnate long enough for it to do anything for depression. Once I started feeling the desperate need to sleep at 2 pm, I knew I wasn't going down the maoi road anymore.It seems logical to me that starting with selegeline would be good, but I don't know much about oral dosing and effects. It is so sad that the adhesive causes so many people to get rashes.
I think everyone wants tons of support and info about maois - and this is important to get, but in the end, it just winds up being a journey, a gamble and a crap shoot.
Best of luck with it.
Posted by Roslynn on June 20, 2010, at 17:44:14
In reply to trying to choose an MAOI???, posted by Roslynn on June 18, 2010, at 16:24:38
Thank you everybody for the information! It's all kind of scary to me. I think my pdoc is leaning toward Parnate. Also, selegiline could be an option since I had a partial response to EMSAM.
A follow-up question: do the docs usually prescribe the emergency drug that lowers your blood pressure so that you have it with you at all times? Or are you just supposed to head to the ER if you're having a hypertensive crisis?
Thank you,
Roslynn
Posted by Roslynn on June 20, 2010, at 17:58:18
In reply to Re: trying to choose an MAOI??? » Roslynn, posted by zonked on June 18, 2010, at 20:08:54
Zonked,
Thank you for the helpful information!
Just to answer your question, my diagnosis is atypical depression, sometimes bipolar II depending on the doctor. My symptoms include crying spells, suicidal ideation, hopelessness, feelings of anxiety/dread, guilt, fatigue and irritability...
>
> Both are the best drugs I've ever taken for depression--if you don't mind me asking, what is your DX/what are your symptoms? Other folks here, I'm sure, will weigh in also.
>
Posted by stewie on June 20, 2010, at 21:00:29
In reply to Re: trying to choose an MAOI???, posted by Roslynn on June 20, 2010, at 17:44:14
> Thank you everybody for the information! It's all kind of scary to me. I think my pdoc is leaning toward Parnate. Also, selegiline could be an option since I had a partial response to EMSAM.
>
> A follow-up question: do the docs usually prescribe the emergency drug that lowers your blood pressure so that you have it with you at all times? Or are you just supposed to head to the ER if you're having a hypertensive crisis?
>
> Thank you,Roslynn,
I had to ask my doctor for something. I knew to do this from having read this site a lot. He prescribed Cartia, I believe, but don't quote me. It was something that drops your blood pressure really fast. I never needed to use it. Ask for everything and anything you feel the need to. If I had remained on nardil I would have gotten a bracelet that said I was on it.
This just might be a wonder drug for you, so you owe it to yourself to try.
> Roslynn
Posted by Roslynn on June 21, 2010, at 13:53:57
In reply to Re: trying to choose an MAOI???, posted by stewie on June 20, 2010, at 21:00:29
Dear Stewie,
Thank you so much for the information, you are so kind. I'm going to ask my doc about the emergency pill and also, if Parnate or another MAOI works out, I will get a medical bracelet. Thank you for your words of encouragement.
Roslynn
> Roslynn,
> I had to ask my doctor for something. I knew to do this from having read this site a lot. He prescribed Cartia, I believe, but don't quote me. It was something that drops your blood pressure really fast. I never needed to use it. Ask for everything and anything you feel the need to. If I had remained on nardil I would have gotten a bracelet that said I was on it.
> This just might be a wonder drug for you, so you owe it to yourself to try.
> > Roslynn
>
>
Posted by stewie on June 21, 2010, at 15:40:25
In reply to Re: trying to choose an MAOI??? » stewie, posted by Roslynn on June 21, 2010, at 13:53:57
> Dear Stewie,
>
> Thank you so much for the information, you are so kind. I'm going to ask my doc about the emergency pill and also, if Parnate or another MAOI works out, I will get a medical bracelet. Thank you for your words of encouragement.
>
> Roslynn
My pleasure Roslynn...
I forgot to say that I DID put a little note in my wallet that I was on Nardil immediately.
I will be thinking of you as you get closer to the big day :-)
Diane
>
>
> > Roslynn,
> > I had to ask my doctor for something. I knew to do this from having read this site a lot. He prescribed Cartia, I believe, but don't quote me. It was something that drops your blood pressure really fast. I never needed to use it. Ask for everything and anything you feel the need to. If I had remained on nardil I would have gotten a bracelet that said I was on it.
> > This just might be a wonder drug for you, so you owe it to yourself to try.
> > > Roslynn
> >
> >
>
>
This is the end of the thread.
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