Posted by SLS on February 8, 2009, at 7:46:19
In reply to deciding between meds.I need a couse of action, posted by metamorphosis on February 7, 2009, at 14:01:34
People don't generally consider Parnate to be an anxiety medication, simply because it is "stimulant-like". Its metabolites may have "stimulants" in them (never isolated), or because there is nothing directly GABAergic about it, Parnate is rejected as the first choice to treat generalized anxiety disorder (GAD). Yet, this drug is almost as effective in treating social anxiety disorder (SAD) by itself. I like its side effect profile more than that of Nardil. The orthostatic hypotension disappeared completely for me after awhile. There are no sexual side effects beyond the first few weeks. It has less potential to produce difficulties with urination and edema. Just start low and titrate gradually, and you won't be blown away by it. You'll need at least 40mg to be insured a therapeutic effect.
Spontaneous hypertension occurs infrequently. Moving up the dosage should help protect you from this happening.
You might want to stay on Klonopin until you are settled in with Parnate to prevent any excess stimulation that you might experience during the first few weeks. This should disappear by itself at some point. You could then begin weaning off the Klonopin and look for a replacement drug if it is necessary. Lyrica or Buspar maybe?
If Neurontin did not work, there is still a possibility that Lyrica would too. You should know quickly, though.
You know, although long-term BZD usage can produce measurable changes in cognitive function, they usually aren't very apparent to the patient. I would research this thoroughly before discontinuing such an effective drug.
I think the bottom line is that traditional thought would place Nardil ahead of Parnate for the treatment of GAD and OCD. There is virtually no data on Parnate and these two conditions, and it might be worth a try if you find Nardil not to your current liking. You can alway switch. If I were in desperate shape, I would probably go with Nardil first, simply because I have personally seen it work for GAD and panic disorder (PD). If you feel that you have the luxury of time, which you apparently do as long as you continue with Klonopin, you can try to avoid the increased probability that Nardil has of producing the side effects that you are trying to avoid.
I don't think this post was particularly helpful, as you really did do your research on this one. If Parnate is as effective as Nardil for (SAD), then perhaps it has utility with GAD as well. I really don't know, and there is only one way to find out. You will be an explorer of sorts.