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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by kakalak on November 30, 2011, at 15:53:05
After 3 long months trying Parnate I've decided I just can't handle the side effects. I wanted it to work so badly. It seems to work just OK for my depression and anxiety but the insomnia (worst side effect) is making me feel awful. I have to take Ambien every night and most days it leaves me feeling strung out.
My pdoc wants me to try Nardil. He said I don't need to do a wash-out and has me tapering off the Parnate while increasing the Nardil dosage. For those of you that have been through this, did you find that Nardil worked better than the Parnate? What is the equivalent dosing? I'm currently taking 40mg. From what I've read on here there's typically a wash-out period and I'm not confident in my pdocs dosing recommendation.
Any help is much appreciated!
Posted by SLS on December 1, 2011, at 12:00:13
In reply to Parnate to Nardil Switch, posted by kakalak on November 30, 2011, at 15:53:05
> My pdoc wants me to try Nardil. He said I don't need to do a wash-out and has me tapering off the Parnate while increasing the Nardil dosage.
I wonder what your doctor uses as evidence to support this practice. It contravenes the prevailing opinions on this matter. Since stroke is a possible outcome according to some sources, I would just double check with him.
- Scott
Posted by Sailboat77 on December 11, 2011, at 14:19:13
In reply to Re: Parnate to Nardil Switch » kakalak, posted by SLS on December 1, 2011, at 12:00:13
I take Seroquel for sleep and it works better than any other sleep medication on the market. I take 60mg of Parnate and wouldn't be able to sleep without the Seroquel.
Posted by kakalak on December 12, 2011, at 11:20:42
In reply to Re: Parnate to Nardil Switch, posted by Sailboat77 on December 11, 2011, at 14:19:13
I was concerned when my pdoc said I didn't need a washout period when switching from one MAOI to another.
I contacted him about my concerns, he did more research and said he was only able to find a couple of case reports (20 years old and older) that described a hypertensive crisis when co-administering an MAOI. In his opinion, the likelihood of a problem with the switch is very small. But if a problem were to arise, it could be a serious problem. Given the seriousness of the complications that could arise in the unlikely event that an interaction does occur, he suggested it would be prudent to have a 10-day washout.
I had an appointment with him while I was tapering off Parnate and we discussed it further. He discussed my concerns with several pdocs who had more experience with MAOIs and based on their extensive experience a washout was not needed. Instead, I tapered off Parnate over the course of 10 days, day 10 took a final dose of 10mgs of Parnate, and day 11 took 15mg of Nardil. So far I haven't had any increase in my BP. I will be on 45mg of Nardil at the end of the this week.
I wanted to post this in case anyone was in a similar situation and confused. My current pdoc was not the doc that prescribed me an MAOI and he admittedly doesn't have as much experience with MAOIs as they aren't commonly prescribed that often. Fortunately he was able to provide research to back up his recommendations, discuss my concerns with his colleagues, and took the time to listen to and answer all my questions. Over the past decade I've learned that some doctors aren't as knowledgeable as you'd think. I used to be timid and did whatever the doctor suggested and now I question everything. I've had numerous pdocs brush me off because they had too many patients and didn't have the time. I've found it difficult and very time consuming to find good doctors.
I'm hoping Nardil will work better than Parnate did for me. It's hard not to think the past 3 months were wasted. I am more than ready to start feeling better again.
This is the end of the thread.
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