Psycho-Babble Medication Thread 1107944

Shown: posts 1 to 24 of 24. This is the beginning of the thread.

 

New US made Marplan now available...

Posted by PeterMartin on January 14, 2020, at 17:35:06

In 2016 Marplan (by Validus) went into "shortage" when the company making it for them was unable to effectively make it anymore (pills were crumbling). In 2018 an import version (Medlink/Danish) was allowed by the FDA to be sold by Validus.

It was just announced that Validus has started distributing their final/new version of Marplan which they are making in the US. (Below or See: https://validuspharma.com/blog/category/news/

I'm expecting to start a trial of it ASAP. Doctor has called it in and after a little bit of work w/ the pharmacy/manufacturer I should have some by the weekend. I'm very hopeful that it works as well as the Marplan I used from 2010-2016. The cost makes me want to cry though ($560 until my deductible kicks in at 3k :(

News from link:
----
Reintroduction of branded Marplan (isocarboxazid) 10 mg Tablets
In 2018 Validus Pharmaceuticals LLC coordinated with the U.S. Food and Drug Administration (FDA) to temporarily import Marplan® (isocarboxacid) from another manufacturer in Denmark (MediLink) in order to alleviate a critical drug shortage of Marplan® (isocarboxazid) 10 mg Tablets for our patients in the United States (US).

Validus Pharmaceuticals LLC is pleased to announce that we recently obtained FDA approval of Validus Marplan®. Validus successfully transferred the manufacture of Marplan® to a new site in the US and is prepared to reintroduce our branded Marplan® on Friday, January 10, 2020.

Product Name and DescriptionBottle CountNDC Number
Marplan® (isocarboxazid) 10 mg Tablets100 tablets30698-032-01
=

If you decide to try it make sure your doctor specifies NDC 30698-032-01 or you could possibly get the import version.

 

Re: New US made Marplan now available...

Posted by Lamdage22 on January 15, 2020, at 2:19:51

In reply to New US made Marplan now available..., posted by PeterMartin on January 14, 2020, at 17:35:06

Good luck. Is Marplan also GABAergic?

 

Re: New US made Marplan now available...

Posted by PeterMartin on January 15, 2020, at 2:24:04

In reply to Re: New US made Marplan now available..., posted by Lamdage22 on January 15, 2020, at 2:19:51

> Good luck. Is Marplan also GABAergic?

No it's not. Crushing social anxiety is the thing I'll miss most about Nardil.

 

Re: New US made Marplan now available...

Posted by undopaminergic on January 15, 2020, at 3:03:36

In reply to New US made Marplan now available..., posted by PeterMartin on January 14, 2020, at 17:35:06

>
> If you decide to try it make sure your doctor specifies NDC 30698-032-01 or you could possibly get the import version.
>

I'd love to try it, but it's not available in my country. Personally, if I had to choose I'd take the Danish version.

-undopaminergic

 

Re: New US made Marplan now available...

Posted by rose45 on January 15, 2020, at 9:11:05

In reply to New US made Marplan now available..., posted by PeterMartin on January 14, 2020, at 17:35:06

Was the Danish version available during the years that Validus stopped production ? Was it the same price as the Validus version? So could you have stayed on Marplan during those 3 years?

 

Re: New US made Marplan now available...

Posted by Lamdage22 on January 15, 2020, at 10:35:47

In reply to Re: New US made Marplan now available..., posted by rose45 on January 15, 2020, at 9:11:05

But you won't miss the weight gain

 

Re: New US made Marplan now available...

Posted by undopaminergic on January 15, 2020, at 11:27:43

In reply to Re: New US made Marplan now available..., posted by Lamdage22 on January 15, 2020, at 10:35:47

> But you won't miss the weight gain

I knew phenelzine (Nardil) often causes weight gain, but does isocarboxazid (Marplan) too?

-undopaminergic

 

Re: New US made Marplan now available...

Posted by PeterMartin on January 15, 2020, at 13:45:51

In reply to Re: New US made Marplan now available..., posted by rose45 on January 15, 2020, at 9:11:05

> Was the Danish version available during the years that Validus stopped production ? Was it the same price as the Validus version? So could you have stayed on Marplan during those 3 years?

It wasn't available until the start of 2019 (Feb/March). My insurance wouldn't cover it nor count it towards my deductible. It was slightly more expensive ($600 a month).

I did try it for a couple months and did "well", but I didn't find it worked as well as I remembered. That may just have been me knowing that it wasn't going to be the "final" version I'd be on. Also I was having bigtime issues w/ TEVA discontinuing their version of generic Lamotrigine....so switching around on different Lamictal generics may have also kept me from having a great response to the danish version.

I'll let you know how it goes w/ the US version. Hoping to have some w/in a few days.

 

Re: New US made Marplan now available...

Posted by PeterMartin on January 15, 2020, at 13:52:03

In reply to Re: New US made Marplan now available..., posted by undopaminergic on January 15, 2020, at 11:27:43

> > But you won't miss the weight gain
>
> I knew phenelzine (Nardil) often causes weight gain, but does isocarboxazid (Marplan) too?
>
> -undopaminergic
>

Not anywhere near as much in my experience. The trend is to gain, but over 7 or 8 years I gained maybe 15 to 20lbs that could have been just aging/not being active enough/diet/etc. With Nardil I'm constantly freaking out about the scale that moves up.

I added Metformin when I started Nardil and that pretty much seems to have nullified most of the weight gain issues. It's still seemingly impossible to lose weight for me. I'm hoping w/ Marplan I'll be able to drop a bit.

 

Re: New US made Marplan now available...

Posted by PeterMartin on January 18, 2020, at 11:10:13

In reply to Re: New US made Marplan now available..., posted by PeterMartin on January 15, 2020, at 13:52:03

With help from the manufacturer (drop shipped to pharmacy since its so new), I picked up and began taking he "new" Maplan yesterday.

Bottle and pills look exactly the same as they did pre-shortage. Hopefully I'll respond. Definitely have some w/d from stopping Nardil 6days ago. In the last Marplan usually takes about 17 days to give me a noticable response.

At $500 for a bottle of 100 10mg pills I really need it to work. In the past it's helped a ton with focus/productivity. I'm sure I'll update. Current meds:

Marplan 40mg (New 2019+ Validus version)
Lamictal 150mmg (Taro generic)
Metformin XR 1500mg (Amneal generic)
Seroquel ~25mg (To sleep)
Ritalin 40mg (Started slow no reaction at all w/ MAOi - less effective 8mths after starting low. Feels same as off MAOi)


 

Re: New US made Marplan now available...

Posted by Lamdage22 on January 19, 2020, at 6:44:15

In reply to Re: New US made Marplan now available..., posted by PeterMartin on January 18, 2020, at 11:10:13

Are you diabetic?

 

Re: New US made Marplan now available...

Posted by PeterMartin on January 19, 2020, at 23:29:57

In reply to Re: New US made Marplan now available..., posted by Lamdage22 on January 19, 2020, at 6:44:15

Not diabetic.

It's been a terrible couple of days (5 & 6 off of Nardil and on to Marplan).

Empty feeling. Lost of self-loathing - intentionally listening to music that makes me feel insignificant.....but at least that's feeling. Looking up old places I lived and people I knew. Feeling distant, old.

Hope this subsides soon.

So far can't say I feel anything from Marplan - side effects or otherwise. I know it usually takes 14 to 17 days for me.

 

Re: New US made Marplan now available...

Posted by PeterMartin on January 21, 2020, at 2:55:15

In reply to Re: New US made Marplan now available..., posted by PeterMartin on January 19, 2020, at 23:29:57

Today was a definite improvement. The morning and early afternoon were good and I was able to focus on some stuff I'm usually interested in.

Hit a period of a few hrs in the early evening where I felt detached (not like myself) and irritable. I took half of my nighttime meds slightly earlier than usual 9pm instead of bedtime (12:15) and that seemed to have helped.

I know it's going to take time to stabilize during this switch from Nardil to Marplan. The good news is today marked 1wk and I had moments where I felt like Marplan was doing things I felt it was when I first started it in 2010. I was never really able to explain it then aside from saying it made me feel more like myself. Confident and focused.

On that 2010 trial I remember after 2wks I started to really praise its effects. I didn't have that experience when I trialed the Dutch Medlink version for 4months Las year. I really hope I do this time around......I really hope this "new" Marplan gets me back from a long period of anhedonia....

I'll follow up.

 

Re: New US made Marplan now available...

Posted by Lamdage22 on January 21, 2020, at 6:09:06

In reply to Re: New US made Marplan now available..., posted by PeterMartin on January 19, 2020, at 23:29:57

Good Luck with Marplan.

we are in the same boat with Metformin. I'm not diabetic either, I just think it helps me against the calorie cravings from my meds. Some say it's even an antidepressant.

 

Re: New US made Marplan now available... » PeterMartin

Posted by SLS on January 22, 2020, at 20:01:05

In reply to New US made Marplan now available..., posted by PeterMartin on January 14, 2020, at 17:35:06

Hi, PeterMartin.

How would you compare your experiences with Marplan and Nardil?

How would you compare your experiences with Marplan and Parnate?

Dosages?

I may have to make a decision next week as to which MAOI to take. I've given both Parnate and Nardil several extended trials each. Both drugs produce a mild improvement, but certainly not enough to make life easy and rewarding.

Thanks for any response.


- Scott

 

Re: New US made Marplan now available...

Posted by PeterMartin on January 22, 2020, at 22:21:07

In reply to Re: New US made Marplan now available... » PeterMartin, posted by SLS on January 22, 2020, at 20:01:05

> How would you compare your experiences with Marplan and Nardil?
>
> How would you compare your experiences with Marplan and Parnate?
>
> Dosages?
>
> I may have to make a decision next week as to which MAOI to take. I've given both Parnate and Nardil several extended trials each. Both drugs produce a mild improvement, but certainly not enough to make life easy and rewarding.
>

Hey Scott - always nice to see your name on the forum!

It's too early to tell how Marplan is going to work for me. I stopped Nardil (75mg for ~6months) on 10days ago and began Marplan the day after. So far last week was pretty good w/ a big reduction in the Nardil side effects (I could pee / achieve orgasm again), but I've definitely experienced some w/d this week.

I got really depressed/anxious two days ago and made a rash decision to take 2.5mg of Zyprexa + 300mg of Lithium (neither of which I have taken in many yrs / the Zyprexa only during my last hospitalization for mania in 2015). Of course that combo knocked me out and I slept most of yesterday. Pretty sure I'm still dealing w/ the "hangover" of those today.

That said there have been a few moments where I've found myself optimistic that even though I feel terrible nows something is different. Hopefully it'll be like my 2010 Marplan experience where after ~2wks I felt a big change. I'm still sleeping late and that's uncommon for me when I'm "on" Marplan where I tended to get up at 6/6:30 read to go (not 8am).

I think the key to remember is that this is "brand new" Marplan. Validus (who owns the rights) relocated their manufacturing to the US after a company that had been making it for them started delivering unusuable product (crumbling pills). You may have seen me post a lot about how I feel different generic brands of medications affect me differently. And surly you know how manufacturing changes w/ Nardil in '03/'04 made a huge difference in how well it worked for some people.

So in some ways I'm hoping to be amazed at how well it works. I had a life changing experience thanks to Marplan in 2010. It made me feel together and while not "feeling good" per say I was just my best-self in some ways.

Is this new US Marplan any different than the 2010 version I took? Will I respond again? etc? Too early to tell. I didn't feel as though the Dutch Medlink version Validus imported in 2019 which I tried for 6 months was extremely effective for me. It just be that my illness is different now - not sure. I've always been wanting to get the -final- -new- version of Marplan. Now I'm on it....but it's only day 9 (first 4 days were left over Medlink-Danish until I got the new US kind). It's been super clean as far as sides, but I'm not at that 2wk+ period where I should be feeling something moodwise.

If you try it I'd suggest trying to think of it as a new drug as I am. The fact that Validus had to stop using the manufacturer due to "quality concerns" could mean that there were issues before they even reached that point. My best responsse to Marplan was 2010-2014. This is their corporate page which has the note about manufacturing being in the US now: https://validuspharma.com/blog/category/news/

Nardil for me was very inconsistent. There's one study on pubmed suggesting it's not great for bipolar depression. Maybe that's why - not sure. It was fantastic for social anxiety, but I never felt particularly motivated to do anything. I also had a lot of the typical side effects worst for me being urinary retention (minutes to start peeing), sexual side effects, and weight gain. I remained pretty much weight neutral thanks to Metformin, but the fear of gaining and the belly bloat even w/o wt gain was bothersome.

I've done two trials w/ Parnate and both times had spontaneous hypertensive issues after taking any dose over 30mg. In 2010 I had gotten up to 60mg before I realized my BP was spiking so high after dosages. That's when I switched to Marplan which was amazing until 2015.

I tried Parnate again in 2016 when Marplan became unavailable and again had the same bp spike issue. This time I had a bp cuff. After a month my doc raised me to 40mg as I was terribly depressed. My bp at that point was super low and I was dizzy upon standing or doing any physical activity. My first day on 40mg my bp reached 230/125 an hour after taking my final pill. That was the end of my 2nd Parnate trial.

I feel like I've been rambling so I hope the above makes sense. I'm still a little out of it from making yesterday a sleep day. I'm feeling a bit better tonight and I'm trying to remain optimistic about Marplan.

I'm not sure if what I've written helps you at all in terms of your decision next week. I'll update w/ my progress over the next few days and hopefully I'll have a good response to mention. In general MAOi changes don't really "hit me" until 14 to 17days.

I would say that if you try the new Marplan try to remember that it could be better than it was for you last time. Who knows.

-P

 

Re: New US made Marplan now available... » PeterMartin

Posted by SLS on January 22, 2020, at 23:13:05

In reply to Re: New US made Marplan now available..., posted by PeterMartin on January 22, 2020, at 22:21:07

Hi.

Thanks for taking the time to respond.

> I would say that if you try the new Marplan try to remember that it could be better than it was for you last time. Who knows.

I forgot about the peeing thing. I am all-too familiar with that. I had a couple of amazing responses to Nardil, but it never really lasted for very long. I felt 100% normal a couple of times on it, but psychotic mania emerged a few times. The other thing is that I always find myself switching back to Parnate, although I can't remember why right now.

I will give consideration to Marplan. I appreciate your input.

:-)


- Scott

 

Re: New US made Marplan now available...

Posted by PeterMartin on January 25, 2020, at 22:30:58

In reply to Re: New US made Marplan now available... » PeterMartin, posted by SLS on January 22, 2020, at 23:13:05

I woke up today w/ mild akathesia or kinda like full body RLS. It's definitely a w/d effect of Nardil or making a slight reduction in my Lamictal (from 200 to 15).

Buuut, once that passed in the early morning I had a really great day. I do feel like "something" is working already w/ Marplan. I felt bad in the past saying it was successful for me because it's not like it makes me *feel* good....It just somehow makes me act/think better and then in turn I feel better.

Obviously it's still very early in this trial but if my slowly improving outlook s due to the Marplan than I'm going to be very happy.

I'll followup.

Currently:
Marplan 40mg (New US 2020 Validus kind)
Lamictal 150mg (Taro)
Metformin ER 1500mg (Amneal)
Ritalin 40mg (Was Brand now Malli<sp>)
Seroquel 25mg (For sleep)

 

Re: New US made Marplan now available... » SLS

Posted by sigismund on January 27, 2020, at 15:29:37

In reply to Re: New US made Marplan now available... » PeterMartin, posted by SLS on January 22, 2020, at 23:13:05

>The other thing is that I always find myself switching back to Parnate, although I can't remember why right now.


In spite of the mood brightening of Nardil you felt less stable on it?

 

Re: New US made Marplan now available...

Posted by PeterMartin on January 28, 2020, at 3:05:05

In reply to Re: New US made Marplan now available... » PeterMartin, posted by SLS on January 22, 2020, at 23:13:05


> I forgot about the peeing thing. I am all-too familiar with that. I had a couple of amazing responses to Nardil, but it never really lasted for very long. I felt 100% normal a couple of times on it, but psychotic mania emerged a few times.
>

If you go back on Nardil I'd highly recommend trying again to push for Metformin. I know you asked about it and you pdoc wasn't comfortable. Thing is there are some recent studies that suggest it could be helpful for preventing mania (along w minimizing the potential wt gain side effects).

Latest study (albeit in women w PCOS): https://www.ncbi.nlm.nih.gov/pubmed/31969278

There was another good one that I can't find at the moment. The study wasn't reviewing metformin for preventing mood issues, but somehow found that those in the study taking metformin had significantly less mood related hospitalizations over the duration. Need to find that.

Notwithstanding, if you search pubmed or scholar.google.com for metformin the recent studies hint that in time it may be repurposed mood issues.

Still early on in my Marplan trial but on a run of good days at the moment. Had nightmares last night which was difficult but today was 2wks off Nardil and on Marplan. Almost certain I'm having some rebound REM. Should subside.

 

Re: New US made Marplan now available... » sigismund

Posted by SLS on February 2, 2020, at 22:05:37

In reply to Re: New US made Marplan now available... » SLS, posted by sigismund on January 27, 2020, at 15:29:37

> >The other thing is that I always find myself switching back to Parnate, although I can't remember why right now.
>
>
> In spite of the mood brightening of Nardil you felt less stable on it?

I can't remember exactly why I always become unhappy with Nardil and end up going back on Parnate. I am not particularly greedy. I wouldn't be 100% happy without a 100% improvement, but I'll take 50%. I don't think I'm unrealistic as to what to expect. I have my memories of improvements and remissions to help me gauge the magnitude of my response to treatment. I am sure that I'm not chasing a Nardil hypomania. I've been playing with Trintellix and Effexor for two years, - using Parnate as an intermission. Trintellix and Effexor both tickled my brain in a way that produced a brief awakening. Not only did I have the energy to do things, but I had a strong desire to do things. It felt good to do things. Doing things was rewarding. My mind became active and sharp. The assertiveness and self-confidence that appeared was pretty cool, too. Food tasted better, colors were more vivid, and music was magical. The problem is that these responses occurred only when I increased or decreased the dosage. Staying at the same dosage doesn't work. This is also what I experience with MAOIs, but not with TCAs. Each of these brief responses lasted for 2-4 days. Tickling the brain? Moving back and forth through a zone? I don't know. After 6 months of cycling between hopeful improvements and crushing relapses, I decided that it was time to move on.

When it works, Nardil has mood-brightening and motivational properties that Parnate lacks (for me). My thoughts are clearer and I am more sociable. Despite this, I always end up asking my doctor to switch me to Parnate. If Nardil had given me a stable 50% improvement, I doubt that I would have wanted to stop taking it so many times. My doctor agreed that it was worth trying Marplan again, since I was so impatient and impulsive the last time. He also came up with two interesting ideas. I will add Buspar now and then see what happens with Marplan. If we get stuck, he wants to switch me from nortriptyline (Pamelor) to trimipramine (Surmontil). He had one patient who was not responding adequately to taking a combination of Parnate and nortriptyline. She did very well once he switched her to trimimpramine.

We'll see.

I'm always glad to see you, but I never think to ask how you are.

How are you?

:-)


- Scott

 

Re: New US made Marplan now available... » SLS

Posted by undopaminergic on February 3, 2020, at 3:11:37

In reply to Re: New US made Marplan now available... » sigismund, posted by SLS on February 2, 2020, at 22:05:37

> a brief awakening. Not only did I have the energy to do things, but I had a strong desire to do things. It felt good to do things. Doing things was rewarding. My mind became active and sharp. The assertiveness and self-confidence that appeared was pretty cool, too. Food tasted better, colors were more vivid, and music was magical.
>

Wow, you're describing my initial response to pramipexole (Sifrol, Mirapex). Especially the parts about things being rewarding, food more tasty, colours more vivid, and music sounding magical. It also helped me take initiatives, which I suppose overlaps with a desire to do things. It helped my motor function as well, especially coordination, perhaps the speed in particular -- I could cram more motor actions into a shorter moment, even within a second!

> I will add Buspar now and then see what happens with Marplan. If we get stuck, he wants to switch me from nortriptyline (Pamelor) to trimipramine (Surmontil).
>

I'm currently on trimipramine, 100 mg, and it *seems* to be helping with mood. I can't recall having a negative thought in days! I don't seem to have a "mood" disorder any more. I can't say how much that is due to the trimipramine.

-undopaminergic

 

Re: New US made Marplan now available... » undopaminergic

Posted by SLS on February 6, 2020, at 10:35:11

In reply to Re: New US made Marplan now available... » SLS, posted by undopaminergic on February 3, 2020, at 3:11:37

Hi, U.

> > a brief awakening. Not only did I have the energy to do things, but I had a strong desire to do things. It felt good to do things. Doing things was rewarding. My mind became active and sharp. The assertiveness and self-confidence that appeared was pretty cool, too. Food tasted better, colors were more vivid, and music was magical.
> >
>
> Wow, you're describing my initial response to pramipexole (Sifrol, Mirapex). Especially the parts about things being rewarding, food more tasty, colours more vivid, and music sounding magical. It also helped me take initiatives, which I suppose overlaps with a desire to do things. It helped my motor function as well, especially coordination, perhaps the speed in particular -- I could cram more motor actions into a shorter moment, even within a second!
>
> > I will add Buspar now and then see what happens with Marplan. If we get stuck, he wants to switch me from nortriptyline (Pamelor) to trimipramine (Surmontil).
> >
>
> I'm currently on trimipramine, 100 mg, and it *seems* to be helping with mood. I can't recall having a negative thought in days! I don't seem to have a "mood" disorder any more. I can't say how much that is due to the trimipramine.

Wow. I'm glad you are feeling better. Have you ever tried nortriptyline?

>
> -undopaminergic
>

 

Re: New US made Marplan now available... » SLS

Posted by undopaminergic on February 6, 2020, at 13:37:13

In reply to Re: New US made Marplan now available... » undopaminergic, posted by SLS on February 6, 2020, at 10:35:11

> >
> > I'm currently on trimipramine, 100 mg, and it *seems* to be helping with mood. I can't recall having a negative thought in days! I don't seem to have a "mood" disorder any more. I can't say how much that is due to the trimipramine.
>
> Wow. I'm glad you are feeling better. Have you ever tried nortriptyline?
>

Trimipramine is my first tricyclic.

In my understanding, nortriptyline is primarily a noradrenaline reuptake inhibitor. Trimipramine is not, but is more like antipsychotics, especially clozapine. I think its antidepressant action is at least partially due to its antagonism of the histamine H2-receptor.

-undopaminergic


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