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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Ilene on January 31, 2004, at 9:52:25
I took my last tricyclic (desipramine) today. I'm entering the drug washout period. Then I will start an MAOI. Which one should I take? I think choices in the US are limited to Nardil and Parnate. Thoughts:
Parnate seems to have fewer SEs, but it's stimulating, and I've acquired a sensitivity to stimulants. I even have to seriously limit my coffee intake.
Psychobabblers have complained that the "new" Nardil is less effective than the old stuff.
My blood pressure falls under certain circumstances. I think Nardil is more likely to cause hypotension. On the other hand, I have script for Florinef (causes salt retention) and I was okay with the desipramine.
SSRIs caused anorgasmia. Desipramine less so.
Thanks in advance,
I.
Posted by Sad Panda on January 31, 2004, at 13:08:09
In reply to Which MAOI?, posted by Ilene on January 31, 2004, at 9:52:25
> I took my last tricyclic (desipramine) today. I'm entering the drug washout period. Then I will start an MAOI. Which one should I take? I think choices in the US are limited to Nardil and Parnate. Thoughts:
>
> Parnate seems to have fewer SEs, but it's stimulating, and I've acquired a sensitivity to stimulants. I even have to seriously limit my coffee intake.
>
> Psychobabblers have complained that the "new" Nardil is less effective than the old stuff.
>
> My blood pressure falls under certain circumstances. I think Nardil is more likely to cause hypotension. On the other hand, I have script for Florinef (causes salt retention) and I was okay with the desipramine.
>
> SSRIs caused anorgasmia. Desipramine less so.
>
> Thanks in advance,
> I.Have your tried adding Serzone, Remeron or Wellbutrin to reverse SSRI induced anorgasmia?
Cheers,
Panda.
Posted by oskarsmom on January 31, 2004, at 13:47:54
In reply to Re: Which MAOI? » Ilene, posted by Sad Panda on January 31, 2004, at 13:08:09
Marplan is another MAOI available in the US. I just started taking it a week ago and so far no side effects (except a new sensitivity to chocolate, I got quite a buzz). I drink one cup of coffee a day with no problem. So add this med to the possilities for you.
Good luck!
Posted by Ilene on January 31, 2004, at 15:26:53
In reply to Re: Which MAOI? » Ilene, posted by Sad Panda on January 31, 2004, at 13:08:09
> > I took my last tricyclic (desipramine) today. I'm entering the drug washout period. Then I will start an MAOI. Which one should I take? I think choices in the US are limited to Nardil and Parnate. Thoughts:
> >
> > Parnate seems to have fewer SEs, but it's stimulating, and I've acquired a sensitivity to stimulants. I even have to seriously limit my coffee intake.
> >
> > Psychobabblers have complained that the "new" Nardil is less effective than the old stuff.
> >
> > My blood pressure falls under certain circumstances. I think Nardil is more likely to cause hypotension. On the other hand, I have script for Florinef (causes salt retention) and I was okay with the desipramine.
> >
> > SSRIs caused anorgasmia. Desipramine less so.
> >
> > Thanks in advance,
> > I.
>
> Have your tried adding Serzone, Remeron or Wellbutrin to reverse SSRI induced anorgasmia?
>
> Cheers,
> Panda.
>
>
Yes. I tried Wellbutrin. It didn't work; incompatible w/ MAOI's, anyway.I.
Posted by stoked on January 31, 2004, at 15:27:39
In reply to Which MAOI?, posted by Ilene on January 31, 2004, at 9:52:25
I don't know much about Nardil, except that I hear it works for more people. My friend loves Parnate, because with his depression he couldn't get out of bed in the mornings. Now he just takes two of them when he wakes up, and like half an hour later he feels like he can get out of bed and do stuff. So he says the stimulant effect is really good for him.
If you're not like that Nardil might be better, because I hear it works more often, and if you can't drink much coffee the Parnate might give you too much of a buzz.
I don't know anything, really, though. That's just a thought.
Posted by Ilene on January 31, 2004, at 15:29:02
In reply to Re: Which MAOI?, posted by oskarsmom on January 31, 2004, at 13:47:54
> Marplan is another MAOI available in the US. I just started taking it a week ago and so far no side effects (except a new sensitivity to chocolate, I got quite a buzz). I drink one cup of coffee a day with no problem. So add this med to the possilities for you.
>
> Good luck!I thought Marplan wasn't being sold anymore. How does it compare to Parnate and Nardil in terms of SEs? Stimulation, weight gain, hypotension, anorgasmia, etc?
I.
Posted by Sad Panda on January 31, 2004, at 15:59:53
In reply to Re: Which MAOI? » Sad Panda, posted by Ilene on January 31, 2004, at 15:26:53
> > > I took my last tricyclic (desipramine) today. I'm entering the drug washout period. Then I will start an MAOI. Which one should I take? I think choices in the US are limited to Nardil and Parnate. Thoughts:
> > >
> > > Parnate seems to have fewer SEs, but it's stimulating, and I've acquired a sensitivity to stimulants. I even have to seriously limit my coffee intake.
> > >
> > > Psychobabblers have complained that the "new" Nardil is less effective than the old stuff.
> > >
> > > My blood pressure falls under certain circumstances. I think Nardil is more likely to cause hypotension. On the other hand, I have script for Florinef (causes salt retention) and I was okay with the desipramine.
> > >
> > > SSRIs caused anorgasmia. Desipramine less so.
> > >
> > > Thanks in advance,
> > > I.
> >
> > Have your tried adding Serzone, Remeron or Wellbutrin to reverse SSRI induced anorgasmia?
> >
> > Cheers,
> > Panda.
> >
> >
> Yes. I tried Wellbutrin. It didn't work; incompatible w/ MAOI's, anyway.
>
> I.
>Parnate for atypical depression, Nardil for eveything else is the norm I think. Parnate is also extremely cheap if that is a consideration. I think you will still have anorgasmia since they both increase Serotonin, just in a different way to SSRI's
Cheers,
Panda.
Posted by Ilene on January 31, 2004, at 16:55:45
In reply to Re: Which MAOI? » Ilene, posted by Sad Panda on January 31, 2004, at 15:59:53
> Parnate for atypical depression, Nardil for eveything else is the norm I think. Parnate is also extremely cheap if that is a consideration. I think you will still have anorgasmia since they both increase Serotonin, just in a different way to SSRI's
>
> Cheers,
> Panda.
>
>
That's interesting. I thought all MAOIs were supposed to be better for atypical depression than other ADs. Maybe because Parnate stimulates you to get off your butt?I.
Posted by bipolarspectrum on January 31, 2004, at 17:41:34
In reply to Re: Which MAOI?, posted by Ilene on January 31, 2004, at 16:55:45
Hi,
My advice is to WAIT!! A brand-new MAOI may (I stress may) be approved by the FDA tomorrow (Feb.1)!!! This is the transdermal selegiline patch and provides (supposedly) much of the anti-depressant benefits WITHOUT the dietary restrictions!!
However, you may have to wait a couple weeks for the company to distribute the product, although I believe it won't take long as they will want to take advantage of the hype surrounding a new anti-depressant release!
Posted by Ilene on January 31, 2004, at 21:45:47
In reply to WAIT before deciding on a MAOI!!!, posted by bipolarspectrum on January 31, 2004, at 17:41:34
> Hi,
> My advice is to WAIT!! A brand-new MAOI may (I stress may) be approved by the FDA tomorrow (Feb.1)!!! This is the transdermal selegiline patch and provides (supposedly) much of the anti-depressant benefits WITHOUT the dietary restrictions!!
> However, you may have to wait a couple weeks for the company to distribute the product, although I believe it won't take long as they will want to take advantage of the hype surrounding a new anti-depressant release!
Unfortunately, selegiline gets points for being "better than placebo" but not much more.I.
Posted by stoked on February 1, 2004, at 0:18:30
In reply to WAIT before deciding on a MAOI!!!, posted by bipolarspectrum on January 31, 2004, at 17:41:34
Hey. I'm sorry I don't know much about this, but I heard that this stuff came in pills for a while now. If its such a good antidepressant, why aren't people taking it already?
Thanks
Posted by bipolarspectrum on February 1, 2004, at 2:26:57
In reply to Re: WAIT before deciding on a MAOI!!! » bipolarspectrum, posted by Ilene on January 31, 2004, at 21:45:47
> > Hi,
> > My advice is to WAIT!! A brand-new MAOI may (I stress may) be approved by the FDA tomorrow (Feb.1)!!! This is the transdermal selegiline patch and provides (supposedly) much of the anti-depressant benefits WITHOUT the dietary restrictions!!
> > However, you may have to wait a couple weeks for the company to distribute the product, although I believe it won't take long as they will want to take advantage of the hype surrounding a new anti-depressant release!
>
>
> Unfortunately, selegiline gets points for being "better than placebo" but not much more.
>
> I.Ilene,
Your comment about transdermal selegiline contains, in my opinion, a common fallacy... Often we, as follows of the psychopharm industry, forget that the studies comment upon how a drug affects a large group of people, while saying nothing about how a drug affects an individual!
For example, the study that u base your opinion of the selegiline patch upon says that in over 100 people, the patch was 'only' a little better than placebo.. However, I have heard more than one testimony from individual subjects in the study who loved the patch!!
Posted by Ilene on February 1, 2004, at 6:58:54
In reply to Re: WAIT before deciding on a MAOI!!!, posted by bipolarspectrum on February 1, 2004, at 2:26:57
> > Unfortunately, selegiline gets points for being "better than placebo" but not much more.
> >
> > I.
>
> Ilene,
> Your comment about transdermal selegiline contains, in my opinion, a common fallacy... Often we, as follows of the psychopharm industry, forget that the studies comment upon how a drug affects a large group of people, while saying nothing about how a drug affects an individual!
> For example, the study that u base your opinion of the selegiline patch upon says that in over 100 people, the patch was 'only' a little better than placebo.. However, I have heard more than one testimony from individual subjects in the study who loved the patch!!If there was some way to know that I was one of the few people who was going to benefit I would try it. As it is, I am severely depressed and I've gone through over a dozen drugs. Waiting for a drug to work (or not) is just agony. I want one that has the best chance of working.
I.
Posted by gardenergirl on February 1, 2004, at 10:28:05
In reply to Re: WAIT before deciding on a MAOI!!! » bipolarspectrum, posted by Ilene on February 1, 2004, at 6:58:54
It's my understanding that selegiline is a selective MAO B inhibitor. I'm not sure that MAO B is implicated in depression. It is used mainly for Parkinsonian symptoms. Of course use as an antidepressant may be off-label.
Regards,
gg
Posted by Ilene on February 1, 2004, at 13:18:59
In reply to Re: WAIT before deciding on a MAOI!!!, posted by gardenergirl on February 1, 2004, at 10:28:05
> It's my understanding that selegiline is a selective MAO B inhibitor. I'm not sure that MAO B is implicated in depression. It is used mainly for Parkinsonian symptoms. Of course use as an antidepressant may be off-label.
>
> Regards,
> ggI think you are right about that. AFAIK, it has shown some potency as an AD, but at higher doses than used for Parkinson's.
Lots of psychiatric drugs are prescribed off-label, such as Neurontin and Klonopin. If we stuck to only what the FDA had approved, the drug kit would be a lot smaller.
gg, what are you getting your degree in?
I.
Posted by cybercafe on February 1, 2004, at 13:29:06
In reply to Re: Which MAOI? » Ilene, posted by Sad Panda on January 31, 2004, at 15:59:53
> > > > I took my last tricyclic (desipramine) today. I'm entering the drug washout period. Then I will start an MAOI. Which one should I take? I think choices in the US are limited to Nardil and Parnate. Thoughts:
> > > >
> > > > Parnate seems to have fewer SEs, but it's stimulating, and I've acquired a sensitivity to stimulants. I even have to seriously limit my coffee intake.
> > > >
> > > > Psychobabblers have complained that the "new" Nardil is less effective than the old stuff.
> > > >
> > > > My blood pressure falls under certain circumstances. I think Nardil is more likely to cause hypotension. On the other hand, I have script for Florinef (causes salt retention) and I was okay with the desipramine.
> > > >
> > > > SSRIs caused anorgasmia. Desipramine less so.
> > > >
> > > > Thanks in advance,
> > > > I.
> > >
> > > Have your tried adding Serzone, Remeron or Wellbutrin to reverse SSRI induced anorgasmia?
> > >
> > > Cheers,
> > > Panda.
> > >
> > >
> > Yes. I tried Wellbutrin. It didn't work; incompatible w/ MAOI's, anyway.
> >
> > I.
> >
>
> Parnate for atypical depression, Nardil for eveything else is the norm I think. Parnate is also extremely cheap if that is a consideration. I think you will still have anorgasmia since they both increase Serotonin, just in a different way to SSRI's
>
> Cheers,
> Panda.
>
>
parnate does not cause anorgasmia
certainly not like SSRIs paxil, celexa, etc
it probably does the opposite
Posted by gardenergirl on February 1, 2004, at 13:38:53
In reply to Selegilene » gardenergirl, posted by Ilene on February 1, 2004, at 13:18:59
I,
My degree will be a PsyD in clinical psychology. Only dissertation and internship to go after this semester. Whoopee (said in a more resigned, worn out fashion).You are right about off label. I just don't know much about selegiline uses other than FDA approved. If only we knew exactly what receptors were implicated in depression, it would be so easy! (sigh) The brain is such a complex and wondrous thing. Probably too complex for our brains to figure out...
gg
Posted by oskarsmom on February 2, 2004, at 14:53:30
In reply to Re: Selegilene » Ilene, posted by gardenergirl on February 1, 2004, at 13:38:53
All I know is that Marplan is still available, in the U.S. at least. Apparently it was taken off of the market for awhile but it's back now. Anyway, I don't know much about the SE profiles compared to Nardil and Parnate. All I know is that my pdoc said that he likes it because it is a "middle of the road MAOI". Less weight gain and fewer stimulating effects. I'm new to the MAOI world but I've ramped up to 20 mg and so far no noticible side effects.
Posted by oskarsmom on February 2, 2004, at 15:21:40
In reply to Which MAOI?, posted by Ilene on January 31, 2004, at 9:52:25
Here's the link:
http://www.oxfordpharm.com/Healthcare.htm
Your Doctor can get the med within 24 hours by calling (toll free) 877-284-9120
Hope this helps with SE info.
Posted by Ilene on February 4, 2004, at 13:45:18
In reply to Marplan Monograph, posted by oskarsmom on February 2, 2004, at 15:21:40
> Here's the link:
>
> http://www.oxfordpharm.com/Healthcare.htm
>
> Your Doctor can get the med within 24 hours by calling (toll free) 877-284-9120
>
> Hope this helps with SE info.Thanks so much for posting this! My pdoc couldn't find Marplan info in the PDR so I am making a copy for her. I also gave her the phone number. Is it hard to get Marplan in a pharmacy?
Ilene
This is the end of the thread.
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