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Re: Parnate: weight gain, & the literature - Liz

Posted by Adam on December 14, 1999, at 22:06:45

In reply to Re: Parnate: weight gain, & the literature - Liz, posted by Zeke on December 14, 1999, at 11:25:55

> I'm not talking about people taking ecstasy every weekend at the local rave -- though that's the reason it's schedule 1. I'm talking about limited clinical use to augment therapy just as pindolol augments Prozac. When I say morality, I mean the government passing along research that supports its view and withholding research that doesn't, or even preventing research in the first place. I get upset when they rant that 'MDMA destroys serotonin neurons," but never mention that administration of an SSRI four hours later will block the uptake and damage. I'm sorry, I just get upset when moral prejudice strongarms block scientific discovery. And remember that many of these folks would like to cast all psych meds in to the sea -- ' and by God, you should just pull yourself up by your bootstraps!'
I had the opportunity to take MDMA not too long ago which I thankfully declined. Anyway, what I read lead me to believe that it takes very high doses of MDMA or chronic use to kill
brain cells. However, axonal damage might still be a problem at lower doses, and even though axons can grow back, it's tough to know how they will grow back, and in the mean time
the cell is out of comission. MDMA also stimulates excessive dopamine release, and reactive oxygen species produced during metabolism of dopamine by MAO have been implicated in
neurotoxicity. Addition of an SSRI might offer some protection, but its difficult to know how much and what neurons.

This may all be really nitpicky, though. I've become very casually aquainted with a couple fairly regular users, and it's hard to tell if "Adam" (gotta love _that_ nickname) is doing
them any real harm or not.

> > > IMHO Parnate is also mainly for refractory depression:
> > >
> > > "Tranylcypromine in high doses (20 to 30 mg po bid) is often effective for depression refractory to sequential trials of other antidepressants; it should be administered by physicians experienced in the use of MAOIs."
> > > --The Merck Manual
> >
> > True, that's what I use MAOIs for (haven't given tricyclics an adequate trial due to side effects, though).

I wonder what it takes before some people decide you are "refractory" enough and insist you consider an MAOI. I had one doctor keep me on Serzone for more than two months even though
I knew it wasn't working and started rapidly spiraling the drain while on it. I guess a quivering, weeping, suicidal state of frenzy is "refractory."

> Despite all the bliss, I think the side effects of SSRIs cause many to drop those too. I can't deal with higher doses of Luvox but use a lower dose and pindolol.
> >

I never got anywhere near bliss on an SSRI, but had a couple fun side effects for my troubles: a spare tire around the waist, anorgasmia, and loss of libido. Perhaps if I had
tried Prozac I could have been thin, asexual, and depressed. Will MAOIs never be a first or even second-line treatment again?




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