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Re: Nardil or Marplan?

Posted by tom2228 on June 6, 2014, at 9:35:47

In reply to Re: Nardil or Marplan? tom2228, posted by rose45 on June 3, 2014, at 18:55:35

> > I have been on all 3 and Marplan is my favorite.
> >
> > Marplan makes me feel like myself (it is supposedly good for depersonalization/ dissociative symptoms) and allows me to be more in touch with memories of how I've felt throughout the years.
> >
> > I consider Marplan to be the cleanest. In general I find it to be relatively low on side effects. Some do say that the other two have more "umph" for depression, but that's a matter of subjectivity.
> >
> > - Mechanism wise it is the closest to a pure MAOI
> > --Nardil has effects on GABA transaminase and phenylethylamine as a metabolite;
> > --Parnate is stronger on MAOI-B and has an effect on GABA-B;
> > --Marplan has has less-pronounced effects on dopamine beta-hydroxylase and tryptophan metabolism, although it "feels" the closest to a pure MAOI)
> >
> > -whereas the other two can have sedation problems, Marplan seems to be neutral to some and activating to others (I find it pretty stimulating at 40mg and over)
> >
> > -Marplan lacks, or is more forgiving in terms of the afternoon sleepiness you speak about
> >
> > -Marplan tends to be weight-neutral (whereas Nardil is is known of weight gain)
> >
> > -Sexual side-effects are not as bad a Nardil in my experience
> >
> > -The insomnia is nowhere near the insomnia on Parnate, I've found.
> >
> Thank you Tom for the information. Im wondering how long were you on Parnate and Nardil, and why did you stop them ?
>
> Are you currently on Marplan ? Do you need to take sleeping meds with it?
>
> I was on Nardil for 23 years, until it stopped working. I managed to sleep most of the time without sleeping pills. I am now on parnate, which has helped get rid of the anxiety and depression, but I am also very tired on it, and have total insomnia and the sleeping pills are a problem, because here in the uk,gps are instructed not to give out sleeping pills for longer than a certain period.I went to see a new psychiatrist yesterday, who is supposedly an expert in maois, and he was surprised that i found parnate to be energising in that it causes insomnia, but at the same time, makes me so tired during the day. Here, on psychobabble, I have read several people who have similar experiences with parnate.
>
> Also I have not put on weight with parnate, but I put on a lot of weight with nardil. I have read that marplan is more similar to nardil. Would you agree? Did it create weight issues for you?
>
> I would really appreciate getting answers to the above, because I have to take the decision on whether to stop the parnate, and try marplan, and changing drugs involves so much pain and is so problematic, it would be nice to have an idea re. whether it would be worth it.
>

I am currently taking Marplan 40mg. While I don't need to take sleeping meds for it, I am currently taking desipramine as well, which is mildly mildly sedating and helps with my sleep. I have been on Marplan without other sleep-aiding medications without much problems, as long as I take the second set of pills before 4-5pm (I take them in the morning and at 2pm). I would say that while everyone is different, for me the insomnia is nowhere near that of Parnate and isn't as bad as, but similar to, Nardil.

I stopped taking Nardil due to sedation mainly, also weight gain, sexual dysfunction, and only having a partial response up to 75mg. At that dose I had trouble staying awake during the day or keeping my eyes open at times. Although it was nice for my anxiety, social and generalized, and had a nice effect on my depression albeit not up to my standard of Marplan.

Parnate was more effective than Nardil for my depression (up to 60mg), but the two reasons I stopped were side-effects and to go back to Marplan. The side-effects I experienced were sedation (different from the Nardil but still troublesome), tension, and insomnia (I needed sleep aids for a while), and some anxiety. You are definitely not alone in finding Parnate energizing yet sedating. In my experience and what I've read, that is fairly common and characteristic of Parnate actually!

Earlier of last year I had been off MAOIs for a couple months and needed to get back on them. After trialing Nardil and next retrying Parnate, I started to realize what I really needed to do was go back to my Marplan. I had taken Marplan for 3 years to good effect on my depression and anxiety. I had established a sense of self on Marplan and wanted dearly to get back to it and continue where I left off so to speak. On Marplan I am closest to my true emotions and feel more present in my life -- it helps with dissociation/ depersonalization/ derealization that I sometimes experience especially when on meds that are not Marplan -- who I consider myself to really be. Thus my anxiety is best on Marplan. My depression is only responding partially this time, so I am taking a tricyclic (desipramine) with it along with other meds.

Marplan is qualitatively different from Nardil. But it is more similar to Nardil than Parnate, in my opinion. Unlike Nardil it is weight-neutral (at least for me). I find it has the fewest side effects in general, very few.

Whether it is worth it to switch is entirely up to you and your doctor (which is partly based on what you tell him, of course). What about trying Nardil again but adding nortriptyline or desipramine (desipramine leads to less weight gain)? They are indeed safe with MAOIs, although your doctor may not agree. I have tried both with Marplan and they have greatly helped me respond to treatment again and retain the "feeling" of being on the MAOI that I like the best.

Hope this helps, and best of luck to you,
Tom



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poster:tom2228 thread:1065513
URL: http://www.dr-bob.org/babble/20140512/msgs/1066517.html