Posted by cubbybear on July 18, 2003, at 4:58:59
In reply to Re: Selecting an MAOI, posted by maxime on July 17, 2003, at 19:50:36
> Hi there. Usually a pdoc will prescribe Nardil if you have a lot of anxiety.
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> Parnate is more stimulating so it is good for the type of depression where you can barely get out of bed.
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> But there are always exceptions. Some people with high anxiety respond better to Parnate.
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> I guess because both Nardil and Parnate can cause high blood pressure that the stimulant effect of Parnate would raise your BP more than Nardil. But I don't know if that is true or not. I take Parnate and my BP has lowered.
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> Marplan isn't available in the U.S. so I really can't comment on that.
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> Max
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> > How does a psych doc go about selecting an MAOI for atypical (apathetic) depression?
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> > I have hard that Nardil is sedating and that Parnate is energising. Is that the main criterion for choosing between these two?
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> > The UK pharms guide for docs (the BNF) says this ... "Tranylcypromine (Parnate) is the most hazardous of the MAOIs because of its stimulant action. The drugs of choice are phenelzine (Nardil) or isocarboxazid (Marplan) which are less stimulant and therefore safer."
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> > Have they got it right? In what way do they mean that Parnate is dangerous on account of its stimulant action?
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> > What about Marplan (Isocarboxazid)? I don't hear much about this one. Is this because it is usually a very last choice?
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> > Is the preferred choice Nardil then Parnate then Marplan?
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> > I would welcome any info on the questions I have asked. Thank you.I've been taking Parnate for 20 years and would say first off, rule number one, that everyone is different from everyone else regarding their reactions to the ADs, including the MAOIs. Whereas most people have complained of weight loss from Parnate, I have gained weight from it. Some had complained of other problems with it that I never had. I always experienced low blood pressure during the first couple of weeks of starting it, but that side effect disappears so my blood pressure is consistently normal.
It also sounds to me like the BNF statement that Parnate is "the most hazadous of the MAOIs because of its stimulant action" is a lot of nonsense. Both Nardil and Parnate can be hazardous for patients who disregard the food and drug restrictions. Otherwise, I'd venture that Parnate is no more hazardous, and its stimulating qualities are wonderful.
I've experienced depression with high anxiety as well as depression that had me nearly immobilized and unable to function. Label it as you will, this drug has saved my life countless times, and the only way you'll know how any particular drug will affect you is to try it.cubbybear
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poster:cubbybear
thread:242996
URL: http://www.dr-bob.org/babble/20030718/msgs/243094.html