Posted by silvercoin on August 15, 2006, at 13:14:56
In reply to Which MAOI?, posted by Check on August 14, 2006, at 18:23:26
> I am currently thinking about trying an MAOI for my treatment-resistant, atypical depression and I am wondering if anyone has any advice as to which one would be best. I have tried lexapro, zoloft, wellbutrin, cymbalta, adderall, and effexor to no avail. I am nervous and depressed most of the day and have obsessive tendencies. So far (correct me if I'm wrong) it seems that:
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> Nardil has the best reputation for one such as myself, but since it was reformulated in 03 there are doubts about its efficacy. It also is the most sedating MAOI but the best for social anxiety (which I have). I have also read that its hydrazine group makes it very hard on the liver.
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> Parnate is metabolized into amphetamine and is the most activating of the MAOIs. It doesn't cause weight gain, but can cause agitation and is the touchiest about tyramine rxns.
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> Marplan seems to be the middle of the road drug lacking the more extreme pros and cons of the other two.
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> I've read a little about moclobemide and selegline, but they don't seem to pack the same punch as the older MAOIs. So far I'm thinking about marplan. Any advice would be much appreciated.
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> Thanks
I am currently taking Marplan and have tried both Nardil (only the newer version) and Parnate. I tend to recommend Nardil out of all of these because it is more widely used than Marplan, and there is more data and experience regarding dosage. Both of these drugs are hydrazine derivatives that can cause hepatotoxicity, but this is relatively rare. I think both of them also have some tendency to induce weight gain, but not everyone will experience this. All of the MAOIs have a tendency to cause insomnia, and Parnate is probably the worst one. My experience has been that if MAOI insomnia is not dealt with, severe afternoon drowsiness can result. I have had pretty good luck with Seroquel but also require a particular sleep/relaxation CD in order to get any amount of sleep.Todd
poster:silvercoin
thread:676429
URL: http://www.dr-bob.org/babble/20060810/msgs/676713.html