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Re: Residual anhedonia on Parnate

Posted by pedr on November 13, 2017, at 10:55:01

In reply to Re: Residual anhedonia on Parnate pedr, posted by SLS on November 12, 2017, at 21:06:05

> My personal experience with MAOIs is that Parnate can leave residual anhedonia, even at high dosages. Nardil is a stronger mood-brightener and is better at treating anhedonia. I found that adding nortriptyline helps with anhedonia when added to Parnate. Desipramine did not. However, it often happens that someone is inadequately treated with Parnate and never reaches a therapeutic level. You will find some variability in the literature, but I would say that the dosage range lies between 40-80 mg/day. You really can't evaluate the amount of residual anhedonia that Parnate leaves until it is titrated to a dosage that gives maximal effect, even if only a partial response. I'm sorry that your doctor is resistant to adding a stimulant. You could try to find literature that suggests that adding either nortriptyline or desipramine is not only safe to add to a MAOI, but might even mitigate the tryramine pressor response. Try Google or PubMed.
> - Scott

Scott, thanks so much for the post. I was on Nardil a few years ago and liked it except for the daytime somnolence that I just couldn't shake. I literally fell asleep at my desk on a number of occasions, even after being on Nardil for over a year.

I will try and get Nortriptyline added. This will mean finding a new PDoc as there's zero chance my current one will see past his "MAOI+TCA=instant death" mantra. I've shown him the literature and he's not budging. Sigh.


I love the smell of Abilify in the morning. The smell, you know that chemical smell. Smells like victory. Some day this war's gonna end...
Atypical Depression, OCD, IBS-C, GERD since '96




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