Psycho-Babble Medication Thread 1108690

Shown: posts 1 to 25 of 32. This is the beginning of the thread.

 

Nardil to Marplan

Posted by Jadde on February 26, 2020, at 16:40:57

Saw my pdoc today. After discontinuing Nardil due to surgery I have not been able to recapture its charm. Maybe 25/30%. So disappointing as Nardil gave me 3 years of feeling satisfied with life. Anyway, as a result of all the side effects With Nardil (mainly weight gain) I decided to cross taper from Nardil to Marplan. My doc said outright that it is a weaker A/D, but I decided a full response to Marplan might be better than a partial response to Nardil. Well see.

As for sleep, he agreed to trying Seroquel but wants me to stay on Olanzapine until the taper is complete.

Jade

 

Re: Nardil to Marplan

Posted by SLS on February 27, 2020, at 0:19:27

In reply to Nardil to Marplan, posted by Jadde on February 26, 2020, at 16:40:57

> Saw my pdoc today. After discontinuing Nardil due to surgery I have not been able to recapture its charm. Maybe 25/30%. So disappointing as Nardil gave me 3 years of feeling satisfied with life. Anyway, as a result of all the side effects With Nardil (mainly weight gain) I decided to cross taper from Nardil to Marplan. My doc said outright that it is a weaker A/D, but I decided a full response to Marplan might be better than a partial response to Nardil. Well see.
>
> As for sleep, he agreed to trying Seroquel but wants me to stay on Olanzapine until the taper is complete.
>
> Jade


Hi, Jade.

I can't speak on behalf of your doctor or your tortured brain, and while I can't guarantee that you would react badly to introducing Marplan while you are still taking Nardil, I would still urge caution and patience - just in case. I once became incoherent for two days and was hospitalized when I waited only 3 days between my last dose of Nardil and my first dose of Parnate. I think this reaction was a form of serotonin syndrome. No other explanations were offered.

My guess is that going from Nardil to Parnate is more dangerous than going from Parnate to Nardil. Parnate has a 3 hour half life. Nardil has a 12 hour half life after a single dose, but it actually inhibits its own metabolism when given chronically. It probably takes longer for MAO activity to recover with Nardil, but I haven't seen anything written about this.

If your doctor or his colleagues have already performed cross-titration successfully with these drugs, then perhaps there is nothing to worry about. Have you searched the Internet regarding this issue? My pharmacy should have Marplan waiting for me tomorrow. I took my last dose of Effexor about a week ago.

Wishing us both good luck!!!


- Scott

 

Re: Nardil to Marplan SLS

Posted by Jadde on February 27, 2020, at 7:26:55

In reply to Re: Nardil to Marplan, posted by SLS on February 27, 2020, at 0:19:27


>
> Hi, Jade.
>
> I can't speak on behalf of your doctor or your tortured brain, and while I can't guarantee that you would react badly to introducing Marplan while you are still taking Nardil, I would still urge caution and patience - just in case. I once became incoherent for two days and was hospitalized when I waited only 3 days between my last dose of Nardil and my first dose of Parnate. I think this reaction was a form of serotonin syndrome. No other explanations were offered.
>
> My guess is that going from Nardil to Parnate is more dangerous than going from Parnate to Nardil. Parnate has a 3 hour half life. Nardil has a 12 hour half life after a single dose, but it actually inhibits its own metabolism when given chronically. It probably takes longer for MAO activity to recover with Nardil, but I haven't seen anything written about this.
>
> If your doctor or his colleagues have already performed cross-titration successfully with these drugs, then perhaps there is nothing to worry about. Have you searched the Internet regarding this issue? My pharmacy should have Marplan waiting for me tomorrow. I took my last dose of Effexor about a week ago.
>
> Wishing us both good luck!!!
>
>
> - Scott

Hey Scott,

Based on your advice, and these charts, I think I will go with caution and patience.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919171/table/t3/?report=objectonly

https://www.nps.org.au/assets/Products/Guidelines-switching-antidepressants_A3.pdf

So taper off Nardil, 14 day wait, then start Marplan. Im just not in a place where I can take chances.

Funny thing happened when I dcd Nardil, I had a day or two of euphoria. Strange drugs.

Thanks for the advice, may we both have a successful journey with Marplan! Looking forward to hearing about your experience with it :)

Jade


 

Re: Nardil to Marplan

Posted by PeterMartin on February 27, 2020, at 21:00:44

In reply to Re: Nardil to Marplan SLS, posted by Jadde on February 27, 2020, at 7:26:55

It's always good to be cautious. Just to offer the other side though, I've gone Marplan to Nardil and back to Marplan cross tapering (1 day washout). I didn't have any problems. There was a study/article from 2018 w a title saying it was ok but sadly the study txt is not free:

J Clin Psychopharmacol. 2018 Feb;38(1):92-94. doi: 10.1097/JCP.0000000000000809.
Monoamine Oxidase Inhibitor Switching Strategies: No Adverse Events Associated With Outpatient Cross-taper or Inpatient Rapid Switch

https://www.ncbi.nlm.nih.gov/pubmed/29189408

Obv it's best to be safe but if you find yourself having to do less than 14days you'll be ok. At least in my opinion.

Btw I'm feeling really good the past few days. It's my 5th or 6th week on Marplan. I had started it while being on Ritalin but I quit taking Ritalin a week ago. I think it was making me worse.

At my pdoc apt on Monday (3days ago) we decided to add a low dose of Desipramine (25mg). Definitely feeling much better w.o. the Ritalin and perhaps the Desipramine is helping my adhedonka a touch already also.

So far so good on this restart of Marplan w. My current cocktail:

Marplan 40
Lamictal 200 (Unichem verified batch by Valisure)
Desipramine 25 (Heritage / ordered verified but seems good)
Metformin 1500 (Mylan)
Seroquel (~15mg for sleep)


 

Re: Nardil to Marplan

Posted by undopaminergic on February 28, 2020, at 3:00:41

In reply to Re: Nardil to Marplan SLS, posted by Jadde on February 27, 2020, at 7:26:55

>
> Funny thing happened when I dcd Nardil, I had a day or two of euphoria. Strange drugs.
>

What is "dcd"?

> Thanks for the advice, may we both have a successful journey with Marplan!
>

Good luck to both of you, I wish I could join in, but they don't have Marplan (or other classic MAOIs) here.

-undopaminergic

 

Re: Nardil to Marplan

Posted by undopaminergic on February 28, 2020, at 3:06:00

In reply to Re: Nardil to Marplan, posted by PeterMartin on February 27, 2020, at 21:00:44

> Obv it's best to be safe but if you find yourself having to do less than 14days you'll be ok. At least in my opinion.
>

I agree. There is no obvious reason why there should be a problem. Both have the same effect, mainly. Nardil has a GABAergic metabolite, but that would seem, if anything, to make it safer.

-undopaminergic

 

Re: Nardil to Marplan

Posted by Jadde on February 28, 2020, at 18:12:24

In reply to Re: Nardil to Marplan, posted by PeterMartin on February 27, 2020, at 21:00:44

> It's always good to be cautious. Just to offer the other side though, I've gone Marplan to Nardil and back to Marplan cross tapering (1 day washout). I didn't have any problems. There was a study/article from 2018 w a title saying it was ok but sadly the study txt is not free:
>
> J Clin Psychopharmacol. 2018 Feb;38(1):92-94. doi: 10.1097/JCP.0000000000000809.
> Monoamine Oxidase Inhibitor Switching Strategies: No Adverse Events Associated With Outpatient Cross-taper or Inpatient Rapid Switch
>
> https://www.ncbi.nlm.nih.gov/pubmed/29189408
>
> Obv it's best to be safe but if you find yourself having to do less than 14days you'll be ok. At least in my opinion.
>

Im kinda stuck, I want to be cautious but my pdoc said with the cross taper I would benefit by Marplan working faster coming straight off Nardil. Very tempting. Havent decided yet which way to go. On the bright side, my insurance will cover Marplan. No way I could afford it on my own. I will pick it up tomorrow so I have to make up my mind.


> Btw I'm feeling really good the past few days. It's my 5th or 6th week on Marplan. I had started it while being on Ritalin but I quit taking Ritalin a week ago. I think it was making me worse.

Hey thats great!! My dr wont prescribe most augments other than APs. He mentioned Abilify and Geodon, both of which I have tried and will not try again. Abilify gave me crazy RLS, and Geodon felt like I was in a coma. So Ill stick with Zyprexa or try Seroquel depending on how much trouble sleeping I have on Marplan.

> At my pdoc apt on Monday (3days ago) we decided to add a low dose of Desipramine (25mg). Definitely feeling much better w.o. the Ritalin and perhaps the Desipramine is helping my adhedonka a touch already also.
>
> So far so good on this restart of Marplan w. My current cocktail:
>
> Marplan 40
> Lamictal 200 (Unichem verified batch by Valisure)
> Desipramine 25 (Heritage / ordered verified but seems good)
> Metformin 1500 (Mylan)
> Seroquel (~15mg for sleep)
>
Looks like we may have similar med cocktails. I have Metformin but have been chicken to try it. Does it help with weight gain for you?

Thank you for your post,

Jade


 

Re: Nardil to Marplan undopaminergic

Posted by Jadde on February 28, 2020, at 18:18:46

In reply to Re: Nardil to Marplan, posted by undopaminergic on February 28, 2020, at 3:00:41

> >
> > Funny thing happened when I dcd Nardil, I had a day or two of euphoria. Strange drugs.
> >
>
> What is "dcd"?

Sorry, discontinued.

>
> > Thanks for the advice, may we both have a successful journey with Marplan!
> >
>
> Good luck to both of you, I wish I could join in, but they don't have Marplan (or other classic MAOIs) here.


Sorry to hear that. I became psychotic on Parnate, and prior to that it wasnt as effective as Nardil (for me not even close). So whatever similarities their are with Nardil and Marplan I have hopes that Marplan will also work for me.

> -undopaminergic
>

Jade

 

Re: Nardil to Marplan

Posted by Jadde on February 28, 2020, at 18:22:36

In reply to Re: Nardil to Marplan, posted by undopaminergic on February 28, 2020, at 3:06:00

> > Obv it's best to be safe but if you find yourself having to do less than 14days you'll be ok. At least in my opinion.
> >
>
> I agree. There is no obvious reason why there should be a problem. Both have the same effect, mainly. Nardil has a GABAergic metabolite, but that would seem, if anything, to make it safer.
>
> -undopaminergic

Im on the fence. Picking up Marplan tomorrow so I will decide soon. Thank you for your advice,

Jade


 

Re: Nardil to Marplan

Posted by Jadde on February 29, 2020, at 7:35:38

In reply to Re: Nardil to Marplan, posted by Jadde on February 28, 2020, at 18:22:36

https://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/WATAG/WAPDC/Antidepressant-switching-strategies-March-2013.pdf

 

Re: Nardil to Marplan

Posted by Jadde on February 29, 2020, at 7:36:58

In reply to Re: Nardil to Marplan, posted by Jadde on February 29, 2020, at 7:35:38

https://gpnotebook.com/simplepage.cfm?ID=x20190918181526587321&linkID=80188&cook=yes

 

Re: Nardil to Marplan

Posted by Lamdage22 on February 29, 2020, at 10:30:39

In reply to Re: Nardil to Marplan, posted by Jadde on February 29, 2020, at 7:36:58

It's not just meds that can help. Just keep that in mind in case it doesn't work out.

 

Re: Nardil to Marplan Lamdage22

Posted by Jadde on February 29, 2020, at 13:37:33

In reply to Re: Nardil to Marplan, posted by Lamdage22 on February 29, 2020, at 10:30:39

> It's not just meds that can help. Just keep that in mind in case it doesn't work out.

I will. I know there are many ways I could improve my mental health that dont involve meds. However, when you find a med that brings you out of deep despair (Nardil) its hard to remember that some things are under your control. For example, I know that exercise, proper diet, and therapy all have their place. For me, those things alone do not treat my depression in a way that a good med does.

Jade

 

Re: Nardil to Marplan

Posted by Lamdage22 on February 29, 2020, at 23:14:11

In reply to Re: Nardil to Marplan undopaminergic, posted by Jadde on February 28, 2020, at 18:18:46

Well, I improved as much or more from regular blueberries as I did with Venlafaxine or Trazodone. To be fair, I'm on a low dose of both. I don't like the sexual side effects of Venlafaxine and I don't like the evil metabolite of Trazodone. My feeling is that higher dosages wouldn't even be more effective. The blueberries don't have any side effects. But yeah, I wish I had a full response to an Antidepressant, too. But I have given up on that for now. Too many trials. Too many disappointments and nasty side effects. And not much left to try anyway.

My best bet for the remaining 50% of depression and anxiety right now is therapy. I think I can't drug away the issues that my upbringing has caused. The dentist had to give me a pep talk because no one else does. These things are so important. I hope to find a good therapist. I am scheduled for Thursday. Sounded nice on the telephone.

Good luck to you. MAOI turned me into a maniac. I have gotten rid of a lot of friends that way. But when I felt good on MAOI, it was awesome. So I get it. I just don't like to see when people think their life is over when they don't respond to meds.

 

Re: Question

Posted by Jadde on March 2, 2020, at 10:46:53

In reply to Re: Nardil to Marplan, posted by Lamdage22 on February 29, 2020, at 23:14:11

If I were to quickly cross taper Nardil to Marplan, will I still experience all the withdrawals coming off of Nardil? Or will the Marplan, being an MAOI, cancel those out?

My thinking is that if Im gonna go thru the w/ds either way, I may as well do the slow taper off Nardil then start Marplan a couple of weeks later. If Marplan will cancel those out the fast cross taper makes more sense.

Picking up Marplan today.

Thanks, Jade

 

Re: Question

Posted by Lamdage22 on March 2, 2020, at 11:03:44

In reply to Re: Question, posted by Jadde on March 2, 2020, at 10:46:53

I felt more anxious after an abrupt switch from Nardil to Parnate, not more depressed, however.

 

Re: Question

Posted by Lamdage22 on March 2, 2020, at 11:06:36

In reply to Re: Question, posted by Lamdage22 on March 2, 2020, at 11:03:44

Which makes sense as Nardil is a GABA-T inhibitor and i believe Parnate has a stimulating metabolite?

 

Re: Question

Posted by undopaminergic on March 2, 2020, at 13:00:08

In reply to Re: Question, posted by Jadde on March 2, 2020, at 10:46:53

> If I were to quickly cross taper Nardil to Marplan, will I still experience all the withdrawals coming off of Nardil? Or will the Marplan, being an MAOI, cancel those out?
>

Cross-titration will keep the MAO inhibition in effect; as the MAOI effects from phenelzine (Nardil) diminish, the MAOI effects from isocarboxazid (Marplan) will increase, keeping up the effect, and so, there will be no withdrawal with respect to MAO inhibition.

However, Nardil has a GABAergic metabolite that Marplan lacks, and you may experience some withrawal from that as you phase out Nardil. If you go slow, you should be all right.

-undopaminergic

 

Re: Question

Posted by PeterMartin on March 2, 2020, at 13:59:10

In reply to Re: Question, posted by undopaminergic on March 2, 2020, at 13:00:08

I just did this switch (Nardil-->Marplan w/o a washout) in January and did once a couple years ago.

I actually felt pretty good for the first 2 weeks or so after switching. I don't remember having any w/d the last time around but I did have some issues this time. Really the big problem I had was restless leg (zaps). I can't be 100% sure that they came about due to stopping Nardil and not some other reason but there ws a period of 10 days or so I had terrible sleep. It would make sense that the decrease in Gaba could have caused me to have that issue.

The great news is I'm doing fantastic the past week or so. It's very much like the first time I too Maprlan where I just feel like "my best self". I'm on point/positive and my brain backs up that feeling (vs. trying to undercut/doubt everything).

I hope you dont' experience much w/d and get to a good place w/ Marplan. It seems to be a med that works really well for the people who it does work for......sounds odd but......it's definitely the best medicine I've found for me to this point (1999 to 2020).

I should note my other meds though:

Marplan 40mg (since Jan 9)
Desipramine 25mg (Only 8days so far)
Lamictal 200mg (Unichem verified batch)
Metformin 1500 (Mylan IR verified batch)
Seroquel ~25mg (for sleep)

I have been drinking crystal light the past few weeks also which has aspartame (breaks down to phenylalanine). I do think that may help a touch as well and I know there's a lot of "bad news" research about Aspartame. At some point I'll go back to water only but I'm not looking to tinker w/ too much while I'm doing really well for the first time in a months.

Good luck!!

 

Re: Question Lamdage22

Posted by Jadde on March 2, 2020, at 14:50:12

In reply to Re: Question, posted by Lamdage22 on March 2, 2020, at 11:03:44

> I felt more anxious after an abrupt switch from Nardil to Parnate, not more depressed, however.

What was abrupt in terms of time? One day Nardil, the next Parnate?

 

Re: Question undopaminergic

Posted by Jadde on March 2, 2020, at 14:57:20

In reply to Re: Question, posted by undopaminergic on March 2, 2020, at 13:00:08


>
> However, Nardil has a GABAergic metabolite that Marplan lacks, and you may experience some withrawal from that as you phase out Nardil. If you go slow, you should be all right.
>
> -undopaminergic
>

The GABA that Marplan lacks is making me nervous. Im wondering if the amount of GABA in Nardil was one of its big benefits. I did not find Nardil to be a relaxing med. I liked the energy it gave me. Cognitively Im crap right now, making this decision even more difficult. Ugh

 

Re: Question PeterMartin

Posted by Jadde on March 2, 2020, at 15:07:16

In reply to Re: Question, posted by PeterMartin on March 2, 2020, at 13:59:10

> I just did this switch (Nardil-->Marplan w/o a washout) in January and did once a couple years ago.

So one day Nardil, the next Marplan? My doc has me on this schedule (havent started yet):

4/0
3/1
2/2
1/3
And then 3 Marplan daily for a couple of weeks, till I see him again.
Too fast?

> I actually felt pretty good for the first 2 weeks or so after switching. I don't remember having any w/d the last time around but I did have some issues this time. Really the big problem I had was restless leg (zaps). I can't be 100% sure that they came about due to stopping Nardil and not some other reason but there ws a period of 10 days or so I had terrible sleep. It would make sense that the decrease in Gaba could have caused me to have that issue.
>
> The great news is I'm doing fantastic the past week or so. It's very much like the first time I too Maprlan where I just feel like "my best self". I'm on point/positive and my brain backs up that feeling (vs. trying to undercut/doubt everything).
>

Hey thats awesome!

> I hope you dont' experience much w/d and get to a good place w/ Marplan. It seems to be a med that works really well for the people who it does work for......sounds odd but......it's definitely the best medicine I've found for me to this point (1999 to 2020).
>
> I should note my other meds though:
>
> Marplan 40mg (since Jan 9)
> Desipramine 25mg (Only 8days so far)
> Lamictal 200mg (Unichem verified batch)
> Metformin 1500 (Mylan IR verified batch)
> Seroquel ~25mg (for sleep)

Do any of these meds replace GABA?

>
> I have been drinking crystal light the past few weeks also which has aspartame (breaks down to phenylalanine). I do think that may help a touch as well and I know there's a lot of "bad news" research about Aspartame. At some point I'll go back to water only but I'm not looking to tinker w/ too much while I'm doing really well for the first time in a months.
>
This is funny, I too drink several glasses of Crystal Light each day.

> Good luck!!

Thanks!

Jade

 

Re: Nardil to Marplan Jadde

Posted by SLS on March 3, 2020, at 9:42:37

In reply to Re: Nardil to Marplan SLS, posted by Jadde on February 27, 2020, at 7:26:55

Hi.

Sorry I haven't been around for a few days.

I started taking Marplan yesterday after a 10-day washout from Effexor.

I had a similar reaction to the discontinuation of Nardil in 1990. I ended up being hospitalized for psychotic mania.


- Scott

 

Re: Nardil to Marplan PeterMartin

Posted by SLS on March 3, 2020, at 9:46:42

In reply to Re: Nardil to Marplan, posted by PeterMartin on February 27, 2020, at 21:00:44

Hi.

I'm glad that you are feeling better. It gives me hope. How long have you been taking 40 mg/day for? Is your doctor willing to go up to 60 mg/day?

I began taking Marplan yesterday with a 10mg dose late in the day. Today I'll take 20 mg. How quickly did you increase the dosage?


- Scott

 

Re: Nardil to Marplan

Posted by Stargazer2 on March 3, 2020, at 9:51:09

In reply to Re: Nardil to Marplan Jadde, posted by SLS on March 3, 2020, at 9:42:37

Scott,
Good luck with Marplan. I am hoping you get a good response with it. It will be on my list to try if necessary. I think I told you it was the first AD that made a difference in my life. I hope it can do this for you.
SG2


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