Psycho-Babble Medication Thread 797677

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

Parnate vs Nardil???

Posted by bleauberry on November 29, 2007, at 18:35:50

It seems like most people here prefer Nardil as the king of antidepressants. At askapatient.com parnate and nardil are both rated much higher than other antidepressants. The people who stopped it did so due to side effects but not lack of effectiveness. Someone said if nardil and parnate had been invented after SSRIs they would probably be viewed as improvements, rather than dinosaurs. A doctor's website said MAOIs would be first line treatment instead of last choice for a close family member.

Anyway, some questions:

Why not much mention of Parnate?

I know Nardil affects serotonin, NE, DA, and GABA. What about Parnate? Same or different? How do they differ?

How do side effects generally vary between the two?

My doc is talking antidepressants, and I figure if I am going to head into the world of side effects again, then I am at least going to get the most bang for the buck. No more fooling around with wanna-be-antidepressants.

 

Re: Parnate vs Nardil???

Posted by clubfitter on November 29, 2007, at 19:04:58

In reply to Parnate vs Nardil???, posted by bleauberry on November 29, 2007, at 18:35:50

thanks for posting...very interested in the responses here....

 

Re: Parnate vs Nardil??? bleauberry

Posted by Phillipa on November 29, 2007, at 19:09:33

In reply to Parnate vs Nardil???, posted by bleauberry on November 29, 2007, at 18:35:50

Bleuaberry going to babble you. Phillipa

 

Re: Parnate vs Nardil???

Posted by FredPotter on November 29, 2007, at 21:50:31

In reply to Parnate vs Nardil???, posted by bleauberry on November 29, 2007, at 18:35:50

After many months on Nardil the weight gain and sexual side-effects seem to be abating

 

Re: Parnate vs Nardil???

Posted by stargazer2 on November 29, 2007, at 22:55:35

In reply to Re: Parnate vs Nardil???, posted by FredPotter on November 29, 2007, at 21:50:31

Marplan and Nardil were the only MAO's that worked for me. I had absolutely no effect from Parnate but I may not have given it enough time. I used to want much quicker results, now I know it may take several months to work, not always weeks.

The first time I took Nardil (1989) and Marplan (1992) they worked in a few days. I still know the original formulas of both these drugs was superior to what is available today.

Nardil has taken me months to start to feel better after one relapse and an increase from 45 to 60. The original nardil I took 15 in the am and 15 in the pm. And no side effects to speak of. It was the best med I ever took.

Once you stop thinking of depression and relapsing, you are on the right medication, as long as the effects are long lasting.

Stargazer

Stargazer

 

Re: Parnate vs Nardil??? bleauberry

Posted by Jedi on November 30, 2007, at 2:21:27

In reply to Parnate vs Nardil???, posted by bleauberry on November 29, 2007, at 18:35:50

Hi,
I've taken both Nardil and Parnate. Nardil works better for me because of the affect on GABA which helps reduce social and generalized anxiety. Parnate does not affect GABA.

I have been on Nardil for most of eleven years. I have stopped it four times and each time led to a return of major depression. I always have a low level of depression (dysthymia) even while on Nardil. They call this double depression. I have tried over forty combinations of different antidepressants and augmentors. Nardil is the only one that has worked long term.

I recently had a 2nd trial of Parnate and I really wanted it to work. Parnate does not have the weight gain and delayed orgasm side effects of Nardil. You do have to be more careful with Parnate when it comes to tyramine and reactions to other meds. The medication was working fairly well for me when I had a very rare spontaneous hypertensive reaction. Maybe my dosage was to high, I don't know. I now take 90mg of Nardil, 2mg of clonazepam and 25mg of Seroquel for the med induced insomnia.

IMHO MAOIs should be the 2nd tier solution for atypical depression. If the SSRIs do not work, go right to the gold standard. So many people are in misery for so long while their doctor tries every med in the book before going to MAOIs. Some will even try ECT first and some will not use MAOIs at all. I had one psychiatrist who put me through 9 months of HELL, before I finally ditched him for a MD who would prescribe Nardil for me.
Take care,
Jedi


> It seems like most people here prefer Nardil as the king of antidepressants. At askapatient.com parnate and nardil are both rated much higher than other antidepressants. The people who stopped it did so due to side effects but not lack of effectiveness. Someone said if nardil and parnate had been invented after SSRIs they would probably be viewed as improvements, rather than dinosaurs. A doctor's website said MAOIs would be first line treatment instead of last choice for a close family member.
>
> Anyway, some questions:
>
> Why not much mention of Parnate?
>
> I know Nardil affects serotonin, NE, DA, and GABA. What about Parnate? Same or different? How do they differ?
>
> How do side effects generally vary between the two?
>
> My doc is talking antidepressants, and I figure if I am going to head into the world of side effects again, then I am at least going to get the most bang for the buck. No more fooling around with wanna-be-antidepressants.
>
>

 

Re: Parnate vs Nardil???/Jedi

Posted by stargazer2 on November 30, 2007, at 7:41:50

In reply to Re: Parnate vs Nardil??? bleauberry, posted by Jedi on November 30, 2007, at 2:21:27

Jedi, isn't it amazing that the pdocs that are supposed to help you prefer to use meds off-label, like atypical AP's, rather than try the MAO's? They are being fed a bunch of bull by the drug reps about the AP's working so well for depression. At least for me that is the case.

He knew I had a history of the MAO's working yet would rather use AP's and have me in a zombie, death like state rather than going back to the MAO's which were known to work for me. And he is a pdoc that prescribes MAO's.. Of course it was at my insistence, after a year and a half of trying every new off-label med for which I got samples galore, that I said enough is enough.

The AP's DO NOT work for me or they work so minimally, it's just prolonging the suffering OR using me as a guinea pig. I have chosen to not suffer needlessly just so I can be the one who miraculously recovers using them. It just has proven it is NOT going to happen.

The last few nights I only took 25 mg of Nortriptylline to help me from frquent wakenings.
Again, my own decision. I had stopped Nortrip and that was the only change I noticed going off it and it was a late effect.

Nardil works for me, not the expensive AP's which do absolutely nothing for me other than confuse me and never give me a clear-cut response. No more time to waste. 30 years on this roller coaster is long enough to not ever use me as your compliant, pleasant patient. I should have been paid for all the time that was wasted trying every useless medication. That's what the drug companies should do, not give you free samples only, but pay you for your time and lost life. I wonder if the pdocs get paid to precribe all the meds left by the drug reps? I hate to believe this but it has crossed my mind.

It hope and pray Nardil will continue to work as well as it is. I'm always waiting for the ceiling to fall again, that is the reality of depression treatment. Poop-out and depression go hand in hand. You have to do the rest by exercising (critical for me), Taling vitmains, eating and sleeping well, researching options, challenging your pdoc on what to use, etc.

If you are a passive patient you will simply be given meds and will spend a lifetime trying to reach the right treatment. My attitude has changed in the last year and I finally have been given my choice of treatments.

I would not be on Nardil if it was up to my pdoc. It's like he is clueless and only prescribes all the latest, most expensive meds. Getting free samples of the newest meds is not a good thing like I once thought it was. Especially as they only cause more time to be lost for me. Time cannot be replaced. Wake up before you're following me down the road for another 30 years. Irreplacable.

Stargazer

 

Re: Parnate vs Nardil???/Jedi

Posted by Molitor on November 30, 2007, at 10:31:42

In reply to Re: Parnate vs Nardil???/Jedi, posted by stargazer2 on November 30, 2007, at 7:41:50

My experiences with Parnate/Nardil are fairly consistent with the other posts here. I have one point of concern for people who are new to the drug, and that is dosage.

I took Nardil or Parnate (except for a few breaks) pretty much consistently since the mid 1980s, and I was always at 45mg Nardil or 30mg Parnate. The only time I'd increase the dose is when the drugs started to lose effectiveness, and the only thing increasing the dose did was to increase the side-effects and make it harder to quit the med. (The drugs never totally lost effectiveness, but the effectiveness to side-effect ratio eventually becomes unacceptable.)

I never had a problem with sexual side-effects, or postural hypotension, except when I first started the drugs, and it went away rapidly. My big side-effects have always been fatigue/sleepiness/muscle weekness, and on Nardil, overeating leading to weight gain.

Now, everyone's different, and I'm not saying that people won't require dosages higher than what I take, but I can't help but wonder if a lot of the problems with side-effects/rapid poop-out are exacerbated by ramping up the dosage too high, too quickly. Both drugs still take well over a month for me to BEGIN to get any sort of decent, stable response.

Unfortunately, with MAOIs like other ADs, time is absolutely crucial. People who are rapidly increasing their dose might blow right past their optiminal dose, and when the drug starts working, they may think it's because the require a high dose, not because of elapsed time. While they may get good therapeutic response, they almost certainly will endure unnecessarily severe side-effects, which is something to consider for a drug people may be on for years.

So that's my advice to newbies: Some things just take time. Baking a cake at 3000 degrees for 1 minute doesn't produce a better cake, faster.

 

Re: Parnate vs Nardil???

Posted by rskontos on November 30, 2007, at 21:32:29

In reply to Parnate vs Nardil???, posted by bleauberry on November 29, 2007, at 18:35:50

>>Someone said if nardil and parnate had been invented after SSRIs they would probably be viewed as improvements, rather than dinosaurs. A doctor's website said MAOIs would be first line treatment instead of last choice for a close family member.>>

I think this is very interesting indeed. Goes to show that not all new things are better than what you have. and the trophy goes to the heaviest hitting reps I would imagine not the best meds...sad but true......

so that brings me to another point if the p-docs don't like to prescribe which doc type are you most likely to get nardil from since on my thread I was told it will be hard to get anyone to prescribe Nardil.....which seems to work for anxiety too as well as depression......cause I am not likely the SSRI's...

rk


 

Re: Parnate vs Nardil???

Posted by Molitor on November 30, 2007, at 23:18:41

In reply to Re: Parnate vs Nardil???, posted by rskontos on November 30, 2007, at 21:32:29

> >>Someone said if nardil and parnate had been invented after SSRIs they would probably be viewed as improvements, rather than dinosaurs. A doctor's website said MAOIs would be first line treatment instead of last choice for a close family member.>>
>
> I think this is very interesting indeed. Goes to show that not all new things are better than what you have. and the trophy goes to the heaviest hitting reps I would imagine not the best meds...sad but true......
>

Funny, but true. In the 1980s, Eli Lilly proclaimed Prozac a revolution because unlike TCAs and MAOIs, it specifically targeted the one single neurotransmitter that caused depression and anxiety -- Thus being miraculously effective with virtually no side-effects. Two decades later, Lilly would have us believe that Cymbalta is some amazing advance over SSRIs because it targets MORE that one neurotransmitter.

To find a doctor who prescribes MAOIs, I would ask my existing pdoc to refer me to one. They're usually pretty understanding about this, especially if you're just spinning your wheels and not getting any better. If that doesn't work, you could try to contact a university or hospital-level doctor or department for a referral.

I don't think MAOIs should be first line treatment, but people who are likely to benefit shouldn't have to jump through expensive and emotionally exhausting hoops for years before getting them.

 

Re: Parnate vs Nardil??? Molitor

Posted by Phillipa on November 30, 2007, at 23:38:00

In reply to Re: Parnate vs Nardil???, posted by Molitor on November 30, 2007, at 23:18:41

Maybe at a big University Hospital or a large city. Not here though supposed to be one but he doesn't. Phillipa

 

Re: Parnate vs Nardil???/phillipa

Posted by stargazer2 on December 2, 2007, at 18:21:12

In reply to Re: Parnate vs Nardil??? Molitor, posted by Phillipa on November 30, 2007, at 23:38:00

you would think so, but when I went to the big kahuna at Yale, when I asked him ?'s about Nardil, you could tell he was clueless. He was used to the latest and greatest meds, not the old tried and true meds. MAO's were in fashion long before his time and it didn't seem as though he regarded them with any validity. So large city hospitals is not always the way to find a pdoc familiar with MAO's. You just have to ask if they use them.

SG

 

Re: Parnate vs Nardil???/phillipa stargazer2

Posted by Phillipa on December 2, 2007, at 20:02:23

In reply to Re: Parnate vs Nardil???/phillipa, posted by stargazer2 on December 2, 2007, at 18:21:12

Stargazer very true. Phillipa

 

Re: Parnate vs Nardil???/phillipa stargazer2

Posted by sonic_gb on December 3, 2007, at 8:49:54

In reply to Re: Parnate vs Nardil???/phillipa, posted by stargazer2 on December 2, 2007, at 18:21:12

Hi Stargazer2,

My experience has been that the younger docs who have no experience with MAOI's are petrified to prescribe them. They would rather tell you all about their dangers than listen to your objective, journal reference supported evidence, and acceptance of the dietary limitations issues. Asking, justifying, begging doesn't seem to be enough. Maybe I'll set up a lab in my basement and synthesize some phenelzine :)

Sonic

 

Re: Parnate vs Nardil???/Sonic

Posted by stargazer2 on December 3, 2007, at 9:23:33

In reply to Re: Parnate vs Nardil???/phillipa stargazer2, posted by sonic_gb on December 3, 2007, at 8:49:54

I'm sure if MAO's are discussed in their training the emphasis is on thie risks not the efficacy of them. My feeling is that the newer meds may not have alot of dangerous side effects now, but who know what will be discovered after several years of use.

The doctors at McLean hospital (Harvard trained) in MA are the best and they use MAO's all the time, alone and in combination with other meds. They see the results for a select resistent group of patients and know that they work better than most of the other meds out there.

Years of drug trials for me were wasted on the newest stuff when the older MAO's were the only ones that worked. My pdoc knew this but felt that the newer drugs would work too but after years of taking them, I only had brief periods of stability, not long term.

Very few people have died as a result of taking MAO's incorrectly. I wonder about stats on the newer drugs. You don't find out for years after a drug is released about harmful or deadly SE's.

I have heard of someone formulating his own Nardil so it is not such a far out idea.

Stargazer


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