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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by UgottaHaveHope on January 11, 2007, at 22:19:06
I am taking Emsam right now. It definitely increases my energy, but for the same reasons does not help my anxiety. I told my pdoc I have read on this board how Nardil is a little more sedating and may help anxiety, while also treating depression. She said Emsam and Nardil are basically the same.
IS THAT TRUE?
Posted by Quintal on January 12, 2007, at 10:56:29
In reply to What is the difference btw Emsam and Nardil?, posted by UgottaHaveHope on January 11, 2007, at 22:19:06
EMSAM and Nardil are distinctly different drugs - there's no way you can truly say they're the same. My guess is that she means they are both categorized as being MAOI antidepressants, which is a very vague and lazy way of defining their mode of action. Nardil and EMSAM even act on MAO in different ways at different doses and have different metabolites which also play an important role in their therapeutic effect. Many pdocs don't seem to be aware of this - my last pdoc for example gave me a script for isocarboxazid (Marplan) and thought he had prescribed Parnate (tranylcypromine).
Nardil has a metabolite called 'phenylethylidenehydrazine' which increases GABA throughout the brain and is most likely responsible for Nardil's calming anxiolytic effect. EMSAM has some amphetamine metabolites but they are thought to be inactive.
I've taken four MAOIs and all had a different 'feel' as well as having important pharmacological differences.
Q
Posted by Phillipa on January 12, 2007, at 11:34:26
In reply to Re: What is the difference btw Emsam and Nardil? » UgottaHaveHope, posted by Quintal on January 12, 2007, at 10:56:29
Plus the dietary restrictions. Love Phillipa
Posted by UgottaHaveHope on January 12, 2007, at 11:39:47
In reply to Re: What is the difference btw Emsam and Nardil? » UgottaHaveHope, posted by Quintal on January 12, 2007, at 10:56:29
Q, how did you feel different on each of the four, if you dont mind sharing?
Ive only taken Emsam, and it gives me a little more energy and doesnt do much for anxiety. Thanks, Michael
Posted by Quintal on January 12, 2007, at 12:09:58
In reply to Re: Quintal, how did you feel on each of the four?, posted by UgottaHaveHope on January 12, 2007, at 11:39:47
Parnate: Made me feel more depressed at low doses (30mg) so I raised the dose myself as high as 120mg and at those levels (80-120mg) it seemed to act as a euphoric stimulant, like coke or meth. I was also taking it with Klonopin, so it was more like an upper/downer combo. Very effective, but my pdoc would not prescribe more than 30mg.
Marplan: Lowered my blood pressure. That was about the only effect I noticed. I took 30mg.
Moclobemide: Gave me insomnia at first, but after that nothing; no effect at all.
Oral Selegiline (active ingredient in EMSAM patch): Made me feel 'raw' and overexposed somehow. Did not seem to lift my mood. I took 10mg.
I'm thinking about trying Nardil for its anxiolytic effect. Nardil and Parnate are generally considered the most effective MAOIs.
Q
Posted by SLS on January 12, 2007, at 19:19:11
In reply to Re: What is the difference btw Emsam and Nardil? » UgottaHaveHope, posted by Quintal on January 12, 2007, at 10:56:29
> Nardil has a metabolite called 'phenylethylidenehydrazine' which increases GABA throughout the brain and is most likely responsible for Nardil's calming anxiolytic effect. EMSAM has some amphetamine metabolites but they are thought to be inactive.
Selegiline (the parent compound) may be producing its energizing effects through pro-catecholaminergic activity seperate from MAO inhibition.
http://www.dr-bob.org/babble/20061028/msgs/699270.html
- Scott
Posted by Huckleberry on January 13, 2007, at 10:13:57
In reply to Re: What is the difference btw Emsam and Nardil?, posted by SLS on January 12, 2007, at 19:19:11
I understand that Marplan is now approved to 60mg a day.With more dosage room - perhaps a better effect
This is the end of the thread.
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