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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by rose45 on April 2, 2019, at 14:08:53
Things are really desperate. Only the maois have worked for me. Was doing fairly ok on parnate and reduced the dose slightly, and realised it was a mistake and upped it but too late. It doesnt work, and i am a shaking and trembling wreck. Do others have this effect when drugs stop working? Also severe insomnia.
Does anyone have any ideas what to try which might have similar properties? Just dont know what to do. Im i UK and things are pretty dire here.....
Posted by Christ_empowered on April 2, 2019, at 14:53:53
In reply to nardil and parnate have both pooped out on me, posted by rose45 on April 2, 2019, at 14:08:53
so sorry :-(
until the 70s/early 80s, there were these combo pills on the market...part upper, part neuroleptic. eventually, they were removed from the market, just like the old upper+downer combo pills. anyway...
i mention these because some psychopharmacologists have written about the "goof balls" and...turns out..
those sorts of combinations do help some people, sometimes, with some forms of depression and such (really reassuring, I know).
other than that...there was that big study that compared remeron+effexor to parnate and found the 'california rocketfuel' combination was just as effective and had a different adverse effect profile...
but i dont know the details behind all that.
:-( sorry about this. can you get some sort of psychological treatment?
Posted by rose45 on April 2, 2019, at 17:06:58
In reply to Re: nardil and parnate have both pooped out on me, posted by Christ_empowered on April 2, 2019, at 14:53:53
my fear is that my brain has been damaged in some way by all these drugs as when I am drug free i cannot function at all and am full of some chemical type fear. Its so frightening. Have you heard other people say this? I think it is called the baseline - Can you manage without medication?
Posted by rose45 on April 2, 2019, at 17:27:52
In reply to Re: nardil and parnate have both pooped out on me, posted by rose45 on April 2, 2019, at 17:06:58
Do you think stopping and starting again might work? Could this be an effective tactic when a drug poops out?
Posted by PeterMartin on April 2, 2019, at 21:36:01
In reply to Re: nardil and parnate have both pooped out on me, posted by rose45 on April 2, 2019, at 17:27:52
> Do you think stopping and starting again might work? Could this be an effective tactic when a drug poops out?
Stopping and starting can definitely work to jump start a response. Also make sure you stay consistent w/ dosing for at least 2 weeks before determining that something is or isn't working. You can't make a dose change and then judge whether or not it was beneficial by how you feel the next day. It generally takes 10 to 14 days w/ MAOis to feel a change in dose.
Another thing you can try at least w/ Nardil is switching between generic manufacturers. If you were taking Greenstone(I think that's what it's called) then switch to the Gavis kinda or vice versa. To do that you can either ask your pharmacy to order the other manufacturer (say that you think you may not be responding well to this kind perhaps because of the fillers in the pills). Or you can just bring your script/transfer your refills to another pharmacy that you called ahead to first that has the other brand (be it Gavis or Greenstone). For Nardil Gavis is generally thought of as a bit stronger than Greenstone but switching either might get the AD effect to kick in.....
Keep at it!!
Posted by PeterMartin on April 2, 2019, at 21:42:15
In reply to Re: nardil and parnate have both pooped out on me, posted by PeterMartin on April 2, 2019, at 21:36:01
Also be careful if you are supplementing w/ any vitamins/etc. For example taking too much B6.
Posted by rose45 on April 3, 2019, at 4:35:04
In reply to Re: nardil and parnate have both pooped out on me, posted by PeterMartin on April 2, 2019, at 21:42:15
Thank you so much PeterMartin for responding. Im in the UK and parnate is very expensive here and Im getting it on the NHS so dont have any choice re. which brand I get. Nardil pooped out on me 5 years ago, after working for 20 years. Thats when I went onto parnate.
Interestingly I have skyped Dr. Gillman quite often and did so again just now, asking him exactly re. your suggestion re.stopping and starting again and he said no. He suggested supplementing with either lithium, nortiptyline or methylphenidate, and hugely increasing the dose of parnate. In the UK, Im sure they wont agree to huge doses of parnate, and if 30 mg worked last time, I would prefer not to increae it too much anyway.
I prefer to stick with parnate, because although it is not as 'high making' as nardil, it works quicker and I had a horrendous time with nardil during the 8 weeks it took to work and for me it was not that stable, ie it made me 'high' and if I decreased by just one tablet, I would have to go through the whole 8 weeks again.
But instinctively I like the suggestion of stopping and starting again, as it only took 3 weeks to work originally, and I cant bear the thought of being a guinea pig to the psychiatrists again, and I am at home, with very little support, because my brother's wife has just been diagnosed with a horrible disease:Creutzfeld Jakob disease, and they are just concentrating on helping her.
Have you ever done this yourself? ie stop an maoi and then start again? If so, how long did you stop for? Please let me know whether you or anyone else you have spoken to has done this.
Im seeing the psychiatrist tomorrow and that is all that is available on the nhs here. I dont think he knows much about maois. So would appreciate yr answer asap.
How are you doing on marplan ?
Thank you for caring.
Posted by rose45 on April 3, 2019, at 4:37:43
In reply to Re: nardil and parnate have both pooped out on me, posted by PeterMartin on April 2, 2019, at 21:36:01
> > Do you think stopping and starting again might work? Could this be an effective tactic when a drug poops out?
>
> Stopping and starting can definitely work to jump start a response. Also make sure you stay consistent w/ dosing for at least 2 weeks before determining that something is or isn't working. You can't make a dose change and then judge whether or not it was beneficial by how you feel the next day. It generally takes 10 to 14 days w/ MAOis to feel a change in dose.
>
> Another thing you can try at least w/ Nardil is switching between generic manufacturers. If you were taking Greenstone(I think that's what it's called) then switch to the Gavis kinda or vice versa. To do that you can either ask your pharmacy to order the other manufacturer (say that you think you may not be responding well to this kind perhaps because of the fillers in the pills). Or you can just bring your script/transfer your refills to another pharmacy that you called ahead to first that has the other brand (be it Gavis or Greenstone). For Nardil Gavis is generally thought of as a bit stronger than Greenstone but switching either might get the AD effect to kick in.....
>
> Keep at it!!When I was in the Maudsley hospital they told me not to take any vitamin B supplements with MAOs, so I dont.
>
>
Posted by rose45 on April 3, 2019, at 5:04:41
In reply to Re: nardil and parnate have both pooped out on me, posted by rose45 on April 3, 2019, at 4:37:43
Just to clarify, have been on 30 mg parnate for 5 years, but stupidly played around reducing the dose to 20 and some days to 10 as I was feeling good. When I realised it was no long working, I upped to my usual 30 mg for one month and now up to 40 mg for almost one month but it still isnt working. When this happened with nardil 5 years ago, I did try to keep increasing, but it made no difference - I had been on it for 20 years so I dont believe Dr. Gillman is right by suggesting I keep increasing.
How long do you think I would have to be off it , for it to work again?
Posted by PeterMartin on April 9, 2019, at 1:10:31
In reply to Re: nardil and parnate have both pooped out on me, posted by rose45 on April 3, 2019, at 5:04:41
AFAIK 30mg is a relatively low dose of Parnate. I'm sorry I am late in responding :(
So long as you don't have any blood pressure spikes or additional side effects it'd probably make sense to try going a little higher w/ the parnate dose.
Marplan works pretty well for me but it's impossible to get at the moment. I couldn't get it at all last year (manufacturer had problems and it was just not avaialble at all). Finally 2 months ago the US company that owns the rights got permission to import it from the Denmark which is the only other place in the work it's being manufacturered at the moment. I'm paying a lot to go back on it :(
It's mild though - I think I'm abnormal w/ my depression and it helps aspects that make it a good fit for me. They say it's good for depersonalization so maybe I have some of that - I have better sense of self on it but I wouldn't say I "feel good" on it which is why I tend not to recommend it.
I actually see my doc in 2 days and I'm thinking if there's anything I could add to help a bit. My moods have been a bit down. it could be a bit of w/d after a year of Nardil and then switching over the Marplan but.....
What did you and your doctor decide to do?
Posted by rose45 on April 9, 2019, at 5:00:56
In reply to Re: nardil and parnate have both pooped out on me, posted by PeterMartin on April 9, 2019, at 1:10:31
thank you so much for your response. Im on 40 mg now, but tried 50 mg and couldnt stand it. Even now, Im so anxious and losing lots of weight because I cant eat etc.... the nhs in uk is so slow and im still having to wait to see a proper psychiatrist. I feel like fainting all the time. Have you known or heard of anyone who came of parnate and then started again successfully? I really dont want to go back on to nardil, and I dont think anything else will work. We dont have marplan available here. It used to work well for you in the past disnt it?
Posted by pedr on April 14, 2019, at 19:53:12
In reply to nardil and parnate have both pooped out on me, posted by rose45 on April 2, 2019, at 14:08:53
> Things are really desperate. Only the maois have worked for me. Was doing fairly ok on parnate and reduced the dose slightly, and realised it was a mistake and upped it but too late. It doesnt work, and i am a shaking and trembling wreck. Do others have this effect when drugs stop working? Also severe insomnia.
>
> Does anyone have any ideas what to try which might have similar properties? Just dont know what to do. Im i UK and things are pretty dire here.....Sorry things are bad Rose. I ended up in the psych ward whilst on Nardil and Parnate just made me severely depressed. The only thing that lifts my mood is adderall. However it only lasts a couple of hours -_- Provigil/Nuvigil can also help but are unreliable day to day for me. HTH.
Pete
Posted by rose45 on April 15, 2019, at 16:36:15
In reply to Re: nardil and parnate have both pooped out on me » rose45, posted by pedr on April 14, 2019, at 19:53:12
so are you able to still go to work and live a life ? When the drugs dont work for me, Im barely able to function at all.
Posted by pedr on April 15, 2019, at 17:01:25
In reply to Re: nardil and parnate have both pooped out on me, posted by rose45 on April 15, 2019, at 16:36:15
> so are you able to still go to work and live a life ? When the drugs dont work for me, Im barely able to function at all.
Well I work from home all the time due to my MI and chronic pain and I make sure Im asleep by 8pm every night since I have no more Adderall and my depression is unbearable without it. So Id call that sort of working but no life.
Posted by rose45 on April 17, 2019, at 8:00:58
In reply to Re: nardil and parnate have both pooped out on me » rose45, posted by pedr on April 15, 2019, at 17:01:25
sorry to hear pdr, but at least you can work. I cannot and have no income coming in.
Just discovered that Im now dependent on benzos, which ive been taking more of, very stupidly because I wasnt functioning without them. What a catastrophe and a mess. Will have to reduce them slowly, and still dont know whether parnate is working or not...... Im only on meds as I cannot survive without them, unlike so many on here who seem to go on them and come off fairly easily. Am reallyl suffering with extreme anxiety and worry because of all this.
Apologies for the negative post.
Posted by pedr on April 17, 2019, at 9:13:18
In reply to Re: nardil and parnate have both pooped out on me, posted by rose45 on April 17, 2019, at 8:00:58
> sorry to hear pdr, but at least you can work. I cannot and have no income coming in.
>
> Just discovered that Im now dependent on benzos, which ive been taking more of, very stupidly because I wasnt functioning without them. What a catastrophe and a mess. Will have to reduce them slowly, and still dont know whether parnate is working or not...... Im only on meds as I cannot survive without them, unlike so many on here who seem to go on them and come off fairly easily. Am reallyl suffering with extreme anxiety and worry because of all this.
>
> Apologies for the negative post.Hi Rose,
firstly theres no need at all to apologise for a negative post - this is a mental health forum! For the majority of every single day I have a very similar, negative outlook and can empathise somewhat. Ive been though periods of being unable to work and its just horrible (I was inpatient last year for a while for example).
Its really easy to become dependent on benzos. Theyre almost universally efffective and have an immediate effect, its unsurprising so many of us struggle with them. Im currently weaning myself off of Valium actually. BTW have you tried Buspar as an alternative? Its no panacea for me but I think it helps.
I hope the Parnate does work out, it sounds like you need and deserve a break.
All the best,
Pete
Posted by frank_23423 on April 30, 2019, at 16:55:44
In reply to Re: nardil and parnate have both pooped out on me » rose45, posted by pedr on April 17, 2019, at 9:13:18
Hi Rose,
How are you hanging in there?
You can see my post(s) from this month detailing a similar story to yours. Long story short, I did go back on Nardil and it is kicking in once again, as it has several times before in the past (almost) 20 years.
https://www.dr-bob.org/babble/20190206/msgs/1104230.html
One thing I did notice is that it did not work until I pushed it up to a max dosage. Apparently, we use higher dosages of MAOIs in the US, and most studies seem to suggest that you need .7 mg / KG of weight for Parnate and 1 mg / KG of weight for Nardil before they're fully effective.
For example, I weigh about 90 KG (thanks, Nardil :) and need 90 mg of Nardil initially and at least 60 mg of Parnate before they really kick in. Later on - after 3 months or so, I'm able to reduce down to 60 mg of Nardil or 40 mg of Parnate without sliding backwards. Anything lower, and I regress. Every week or two, I hit the max dose for a day or two, and this seems to do the trick.
MAOIs aren't like SSRIs where you take the same dose every day forever - you kind of need to max out the MAOI inhibition, then back off for a few weeks, and then hit it hard again, temporarily, etc.
Also, I was on Klonopin @ about 1mg /day for almost two months but, like you, started to rely on them too much. I was able to taper off without too many problems over about 2 weeks. There is a lot of good support over at benzobuddies.org.
Hope things get better for you!
'Frank' from the US
Posted by TH on May 17, 2019, at 19:07:59
In reply to Re: nardil and parnate have both pooped out on me, posted by frank_23423 on April 30, 2019, at 16:55:44
> One thing I did notice is that it did not work until I pushed it up to a max dosage. Apparently, we use higher dosages of MAOIs in the US, and most studies seem to suggest that you need .7 mg / KG of weight for Parnate and 1 mg / KG of weight for Nardil before they're fully effective.
Hi Frank, I'd be very interested in having one of those studies on hand for doctors appointments if you can find a link?
This is the end of the thread.
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