Psycho-Babble Medication Thread 6791

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Re: nardil/maoi

Posted by John on May 31, 1999, at 8:07:22

In reply to nardil/maoi, posted by any name on May 29, 1999, at 5:23:12

> I have suffered from depression all my life, but 10 years ago, had a complete breakdown. I was put on
> nardil 60 mg per day, which was then decreased to 45mg per day. It did get me out of my depression, but with the usual side effects ie manic tendencies, putting on weight etc. Last year , I managed to get the dose down to 30 mg per day, and felt great on that for 9 months, but then all the old symptoms started up again. The only way to feel better is to increase the dose up to 60mg for 2 months and then gradually decrease it again. In the past 10 years I have had to do this so many times.... Does anyone else have similar experiences, suggestions, or has anyone done well on nardil and then switched to another medication with better results? I would be really greatful for any feedback. Thanks. Any Name

Any Name, I have noticed the same tendency with every med I've tried (lots!), except none ever really got me that much better. I notice I actually feel best while titrating up, or down, but not when I'm at a steady dose. "Poop-out" is a similar experience with many. Stop it and restart it to make it work again, or continually up the dose. No one really knows why. Curiously though, there are subtle hints of bipolar in your descriptions, and a mood stabilizer would be worth discussing with your doc. Even in the absence of a bipolar diagnosis, mood stabilizers seem to help a lot of meds work better and keep them working. I'm the opposite of you, I've tried all the others with disappointment and am now looking at the MAOIs as my next step. When all else fails, they go to the MAOIs. You're already there. I don't know how it would be trying other meds after MAOIs. As you know, it is a unique experience for all of us, with no clear roadmaps. You're not alone. John.

 

Re: nardil/maoi

Posted by any name on May 31, 1999, at 19:39:28

In reply to Re: nardil/maoi, posted by John on May 31, 1999, at 8:07:22

> > I have suffered from depression all my life, but 10 years ago, had a complete breakdown. I was put on
> > nardil 60 mg per day, which was then decreased to 45mg per day. It did get me out of my depression, but with the usual side effects ie manic tendencies, putting on weight etc. Last year , I managed to get the dose down to 30 mg per day, and felt great on that for 9 months, but then all the old symptoms started up again. The only way to feel better is to increase the dose up to 60mg for 2 months and then gradually decrease it again. In the past 10 years I have had to do this so many times.... Does anyone else have similar experiences, suggestions, or has anyone done well on nardil and then switched to another medication with better results? I would be really greatful for any feedback. Thanks. Any Name
>
> Any Name, I have noticed the same tendency with every med I've tried (lots!), except none ever really got me that much better. I notice I actually feel best while titrating up, or down, but not when I'm at a steady dose. "Poop-out" is a similar experience with many. Stop it and restart it to make it work again, or continually up the dose. No one really knows why. Curiously though, there are subtle hints of bipolar in your descriptions, and a mood stabilizer would be worth discussing with your doc. Even in the absence of a bipolar diagnosis, mood stabilizers seem to help a lot of meds work better and keep them working. I'm the opposite of you, I've tried all the others with disappointment and am now looking at the MAOIs as my next step. When all else fails, they go to the MAOIs. You're already there. I don't know how it would be trying other meds after MAOIs. As you know, it is a unique experience for all of us, with no clear roadmaps. You're not alone. John.

Dear John,
Thanks for your message. It is very helpful. My
experience is that I feel best when titrating DOWN, but when titrating up, it feels reaally bad. In fact, you cannot really titrate up with the nardil in my experience, because I always have to increase the dose right up to 60 mg per day for 8 weeks and then gradually decrease it. The side effects for those 8 weeks are horrendous, but then suddenly I begin to feel better. My present psychiatrist has suggested taking lithium with it, but I have resisted doing that, because I prefer to keep things simple and just take one drug, which is bad enought. I feel it might be hard to keep track of all the side effects if I take more than one medications. This was something which was told to me by my previous psychiatrist for whom I had a lot of respect. I tried paxil 4 years ago, after I had taken myself off the nardil, but it had no effect on me at all. Approx. 30 years ago, I was put on a tricyclic, which really didn't do anything for me either. My mother was on an MAOI, so maybe there is a family gene.... anyway, I will be interested to hear how you do on an MAOI. One thing I do have to watch for is that it did make me very manic, especially the first years. I went around just spending all my money, etc... But it has not pooped out on me... and it has been nearly 10 years now. Do keep in touch. It is so helpful

 

Re: nardil/maoi -- mood stabilizer add-on?

Posted by JD on June 1, 1999, at 6:17:11

In reply to Re: nardil/maoi, posted by any name on May 31, 1999, at 19:39:28

Any Name,
Though I haven't tried MAOIs, I can definitely sympathize with what you and John have to say about the difficulty of holding at a stable dosage... But your account leads me to wonder: if your Nardil tends to need frequent adjusting, and if you have a susceptibility to (hypo-)mania at dosages that "work", might it not be worthwhile to consider a mood stabilizer as an adjunct? I know that polypharmacy can open up a whole new can of worms, but perhaps it could help smooth some of those problems out a bit. (And perhaps there are ones other than Lithium that might be equally combinable with an MAOI--not sure on this though...)
Best to you,
JD
>>> One thing I do have to watch for is that it did make me very manic, especially the first years. I went around just spending all my money, etc... But it has not pooped out on me... and it has been nearly 10 years now. Do keep in touch. It is so helpful

 

Re: nardil/maoi -- mood stabilizer add-on?

Posted by anita on June 1, 1999, at 18:43:49

In reply to Re: nardil/maoi -- mood stabilizer add-on?, posted by JD on June 1, 1999, at 6:17:11

Personally, I found that adding lamictal (new mood stabilizer) to Nardil
helped stabilize my moods and allowed me to reduce my Nardil dosage from 60 to 45mg.
Lamictal didn't cause an increase in weight and had no side effects except mild headaches
at first for me, and I'm side effect-prone.

Both lamictal and neurontin are safe to use with MAOIs and I think they are
worth a shot. I believe they can help even if lithium doesn't (as was the case
with me).

anita

 

Re: nardil/maoi -- mood stabilizer add-on?

Posted by Bruce on June 1, 1999, at 21:33:15

In reply to Re: nardil/maoi -- mood stabilizer add-on?, posted by JD on June 1, 1999, at 6:17:11

I've been on Nardil for 14 Years. I was put on it for "Obsessive Compulsive Disorder," and it worked
I constantly have to adjust and readjust the dose from 30mg to 60mg. This helps, Though I've noted a swing to a Manic state at times going up. One thing I've done that is a no-no, Is , Istarted consuming coffee about ten years
ago, very small amounts at first. Now, I consume 6 to 13 cups of strong coffee per day. For some reason, It hightens the antidepresant effects. At bed time, I take Dyphenhydromine HCI or unisome. This is all bad, But I feel I'm Addicted to this combonation and no one seems to understand. Doctors only scof at me, smile or ignore my concern altogether.
I know so much about the affects, side affects and what foods do what, That I could Write A book about nardil. I've even had doctors profess ignorants to the med in face of my broad knowledge. It's all scary when you end up knowing more about the drug your taking than the person prescribing it. I'm very serious.
My suggestion would be to expierment with the dosage over several weeks per dosage. Keep a Journal of what events are taking place in your life as opposed tyo the dosage your on. Sometimes certain events can attack our mood and we tend to want to blame anything and everything but the actual cause and most of the
time it's the medications we take. A journal will help you to see (most times in hindsight) if it's the medication or some event going on that causing you to feel one way or the other.

 

Re: nardil/maoi -- and coffee!

Posted by John on June 2, 1999, at 11:20:21

In reply to Re: nardil/maoi -- mood stabilizer add-on?, posted by Bruce on June 1, 1999, at 21:33:15

> This nardil thread is really fascinating. I've never been on an MAOI, but, after seven years of only partial success with other antidepressants, may be starting a trial on an MAOI. What struck me about your comment, Bruce, was the mention of coffee, or rather, it made me aware of how little coffee is discussed in general with respect to depression on this site. When I first went into psychotherapy, my doctor noted that I stated that I found coffee to be the most effective antidepressant (non-prescription). Looking back, and even today, I realize that, in many respects, it still is. I drink quite a lot off coffee, and smoke cigarettes, unfortunately. Ican't quit them despite being on a high dose of prozac (nor when I tried other SSRI's or tricyclic.). I've noted also that coffee (by which I mean caffiene) gives me a tremendous mood lift, decidedly stronger than does alcohol. My doctors insist that drinking coffee is far less of a concern than drinking alcohol, which I found quite easy to quit altogether. (And no wonder, coffee gives me more of a buzz anyway). I've read on the subject, and found that, especially when coffee was first introduced and popularized into societies, studies showed that the psychological ramifications were quite dramatic, severe, and mostly bad. Lately, no one seems to take caffiene into account as a factor of sufficient weight. I'm with you, and I feel that coffee is an antidepressant medication of tremendous strength, and also of tremendous possible detriment and relief. Any other thoughts on this, anyone?

 

Re: nardil/maoi -- and coffee!

Posted by Sean on June 2, 1999, at 17:12:44

In reply to Re: nardil/maoi -- and coffee!, posted by John on June 2, 1999, at 11:20:21

> > This nardil thread is really fascinating. I've never been on an MAOI, but, after seven years of only partial success with other antidepressants, may be starting a trial on an MAOI. What struck me about your comment, Bruce, was the mention of coffee, or rather, it made me aware of how little coffee is discussed in general with respect to depression on this site. When I first went into psychotherapy, my doctor noted that I stated that I found coffee to be the most effective antidepressant (non-prescription). Looking back, and even today, I realize that, in many respects, it still is. I drink quite a lot off coffee, and smoke cigarettes, unfortunately. Ican't quit them despite being on a high dose of prozac (nor when I tried other SSRI's or tricyclic.). I've noted also that coffee (by which I mean caffiene) gives me a tremendous mood lift, decidedly stronger than does alcohol. My doctors insist that drinking coffee is far less of a concern than drinking alcohol, which I found quite easy to quit altogether. (And no wonder, coffee gives me more of a buzz anyway). I've read on the subject, and found that, especially when coffee was first introduced and popularized into societies, studies showed that the psychological ramifications were quite dramatic, severe, and mostly bad. Lately, no one seems to take caffiene into account as a factor of sufficient weight. I'm with you, and I feel that coffee is an antidepressant medication of tremendous strength, and also of tremendous possible detriment and relief. Any other thoughts on this, anyone?

SSRI's make me *crave* coffee and cigarettes. I
could not quit until I came off the meds. I think
something is going on with dopamine/epi/serotonin
ratios or something...

 

Re: coffee!

Posted by Dr. Bob on June 2, 1999, at 23:19:12

In reply to Re: nardil/maoi -- and coffee!, posted by John on June 2, 1999, at 11:20:21

> I feel that coffee is an antidepressant medication of tremendous strength, and also of tremendous possible detriment and relief. Any other thoughts on this, anyone?

Some more thoughts along these lines are at:

http://www.dr-bob.org/tips/split/Impact-of-caffeine.html

Bob

 

Re: nardil/maoi -- and coffee!

Posted by JD on June 3, 1999, at 5:58:40

In reply to Re: nardil/maoi -- and coffee!, posted by John on June 2, 1999, at 11:20:21

I believe that I've read somewhere that people who tend to (ab)use stimulants such as nicotine and caffeine for an anti-depressant effect often have a very positive response to MAOIs (and probably Parnate in particular). Not surprising given the general dopamine-stimulant connection, but food for thought nonetheless...
Best,
JD

> > This nardil thread is really fascinating. I've never been on an MAOI, but, after seven years of only partial success with other antidepressants, may be starting a trial on an MAOI. What struck me about your comment, Bruce, was the mention of coffee, or rather, it made me aware of how little coffee is discussed in general with respect to depression on this site. When I first went into psychotherapy, my doctor noted that I stated that I found coffee to be the most effective antidepressant (non-prescription). Looking back, and even today, I realize that, in many respects, it still is. I drink quite a lot off coffee, and smoke cigarettes, unfortunately. Ican't quit them despite being on a high dose of prozac (nor when I tried other SSRI's or tricyclic.). I've noted also that coffee (by which I mean caffiene) gives me a tremendous mood lift, decidedly stronger than does alcohol. My doctors insist that drinking coffee is far less of a concern than drinking alcohol, which I found quite easy to quit altogether. (And no wonder, coffee gives me more of a buzz anyway). I've read on the subject, and found that, especially when coffee was first introduced and popularized into societies, studies showed that the psychological ramifications were quite dramatic, severe, and mostly bad. Lately, no one seems to take caffiene into account as a factor of sufficient weight. I'm with you, and I feel that coffee is an antidepressant medication of tremendous strength, and also of tremendous possible detriment and relief. Any other thoughts on this, anyone?

 

Re: nardil/maoi -- and coffee!

Posted by Elizabeth on June 3, 1999, at 10:54:25

In reply to Re: nardil/maoi -- and coffee!, posted by JD on June 3, 1999, at 5:58:40

Caffeine and nicotine don't work like the standard psychostimulants (amphetamines, Ritalin).

But anyway, I've found the MAOIs work pretty well for me (now using Parnate, moderate dose (30mg) with augmentation), but I had a horrible reaction to Ritalin. Never tried amphetamine. Cylert was okay. So is caffeine, though I've never dared to drink it in coffee-like quantities.

 

Re: coffee!

Posted by Steve on June 3, 1999, at 21:47:00

In reply to Re: coffee!, posted by Dr. Bob on June 2, 1999, at 23:19:12

> > I feel that coffee is an antidepressant medication of tremendous strength, and also of tremendous possible detriment and relief. Any other thoughts on this, anyone?
>
> Some more thoughts along these lines are at:
>
> http://www.dr-bob.org/tips/split/Impact-of-caffeine.html
>
> Bob

FWIW There was a report in the literature some years back of an Italian woman who developed an intractable case of mania that lasted for 6 years,
until some brighter doc asked her about her coffee intake. Apparently she had resorted to drinking 15 or more cappucinos a day to
counteract the fatigue she felt was induced by the stress of her divorce. When she stopped the coffee, the mania remitted.

 

Re: nardil/maoi -- and coffee!

Posted by JD on June 4, 1999, at 8:22:12

In reply to Re: nardil/maoi -- and coffee!, posted by Elizabeth on June 3, 1999, at 10:54:25

Ah, Elizabeth... Good to be reminded that there are people out there who know this stuff better than I do! ;-)

You're right that caffeine and nicotine work differently from standard stimulants--Come to think of it, the "stimulant responder-->MAOI responder" thing I cited might have been referring specifically to the latter (e.g., amphetamines and stuff)... But I think that both caffeine and nicotine have important *indirect* effects on the dopamine system, too. It's often said (and lately, I guess, often repeated by me) that Parnate is quite amphetamine-like in certain respects. I've wondered if the subjective effects of Nardil strike people as being totally different--Though I'm getting closer to trying an MAOI, I can't say I'm much of a stimulant-lover myself, perhaps cuz I tend to be so hypersensitive to them across the board.

Best,
JD

> Caffeine and nicotine don't work like the standard psychostimulants (amphetamines, Ritalin).
>
> But anyway, I've found the MAOIs work pretty well for me (now using Parnate, moderate dose (30mg) with augmentation), but I had a horrible reaction to Ritalin. Never tried amphetamine. Cylert was okay. So is caffeine, though I've never dared to drink it in coffee-like quantities.

 

MAOIs, stimulants, and other things

Posted by Elizabeth on June 4, 1999, at 11:41:23

In reply to Re: nardil/maoi -- and coffee!, posted by JD on June 4, 1999, at 8:22:12

> Ah, Elizabeth... Good to be reminded that there are people out there who know this stuff better than I do! ;-)

Jeez, I didn't mean for it to come out like *that*! :-)

> I think that both caffeine and nicotine have important *indirect* effects on the dopamine system, too.

Probably - who knows? It seems to me that all those neurotransmitter/neuromodulator systems are hopelessly entangled. If we ever sort them all out, it will be quite a feat.

>It's often said (and lately, I guess, often repeated by me) that Parnate is quite amphetamine-like in certain respects.

What, like the molecule looks almost exactly like amphetamine? :-) Seriously, I heard that rumor too, that Parnate or one of its metabolites has amphetamine-like activity. Nobody's ever really put much effort into investigating it, although whenever they autopsy a Parnate OD, they always seem to look for amphetamines. (Oops, that was kind of morbid.)

>I've wondered if the subjective effects of Nardil strike people as being totally different--Though I'm getting closer to trying an MAOI, I can't say I'm much of a stimulant-lover myself, perhaps cuz I tend to be so hypersensitive to them across the board.

I'm apparently hypersensitive to amphetamines, or at least to Ritalin - it made me feel really freaked out, and I kept thinking there were bugs crawling on my skin. Caffeine is okay, as is Cylert. I've never smoked a cigarette or anything like that. I did try nicotine chewing gum once (don't ask!), and it did make me extremely jittery, but that is probably just because it's intended for people who have some tolerance to the stuff.

Nardil is better for anxiety in my experience, and suspiciously enough, unlike Parnate it increases GABA concentrations. I think that's the main difference. I don't find Parnate actively "speedy." Oh, of course, one other thing - Nardil never caused "auto-hypertensive" reactions for me - the occasional occurence of such reactions is another thing that's been used to justify the claim that Parnate works like amphetamine (if this were true, it would mean that when you take it, you're basically mixing a MAOI and a small amount of speed).

Now, *selegiline*, on the other hand, was jittery. Contrary to claims that have been made for it, I didn't find it as easy to tolerate as the other two MAOIs I've tried. (And it turns out that selegiline *does* have amphetamine metabolites - I even tested positive for them (how embarrassing).)

 

MAOIs, stimulants, and other things

Posted by Elizabeth on June 4, 1999, at 11:49:27

In reply to Re: nardil/maoi -- and coffee!, posted by JD on June 4, 1999, at 8:22:12

> Ah, Elizabeth... Good to be reminded that there are people out there who know this stuff better than I do! ;-)

Jeez, I didn't mean for it to come out like *that*! :-)

> I think that both caffeine and nicotine have important *indirect* effects on the dopamine system, too.

Probably - who knows? It seems to me that all those neurotransmitter/neuromodulator systems are hopelessly entangled. If we ever sort them all out, it will be quite a feat.

>It's often said (and lately, I guess, often repeated by me) that Parnate is quite amphetamine-like in certain respects.

What, like the molecule looks almost exactly like amphetamine? :-) Seriously, I heard that rumor too, that Parnate or one of its metabolites has amphetamine-like activity. Nobody's ever really put much effort into investigating it, although whenever they autopsy a Parnate OD, they always seem to look for amphetamines. (Oops, that was kind of morbid.)

>I've wondered if the subjective effects of Nardil strike people as being totally different--Though I'm getting closer to trying an MAOI, I can't say I'm much of a stimulant-lover myself, perhaps cuz I tend to be so hypersensitive to them across the board.

I'm apparently hypersensitive to amphetamines, or at least to Ritalin - it made me feel really freaked out, and I kept thinking there were bugs crawling on my skin. Caffeine is okay, as is Cylert. I've never smoked a cigarette or anything like that. I did try nicotine chewing gum once (don't ask!), and it did make me extremely jittery, but that is probably just because it's intended for people who have some tolerance to the stuff.

Nardil is better for anxiety in my experience, and suspiciously enough, unlike Parnate it increases GABA concentrations. I think that's the main difference. I don't find Parnate actively "speedy." Oh, of course, one other thing - Nardil never caused "auto-hypertensive" reactions for me - the occasional occurence of such reactions is another thing that's been used to justify the claim that Parnate works like amphetamine (if this were true, it would mean that when you take it, you're basically mixing a MAOI and a small amount of speed).

Now, *selegiline*, on the other hand, was jittery. Contrary to claims that have been made for it, I didn't find it as easy to tolerate as the other two MAOIs I've tried. (And it turns out that selegiline *does* have amphetamine metabolites - I even tested positive for them (how embarrassing).)

 

Re: MAOIs, stimulants, and other things

Posted by JD on June 4, 1999, at 12:36:43

In reply to MAOIs, stimulants, and other things, posted by Elizabeth on June 4, 1999, at 11:49:27

Totally just kidding before--You do certainly know your stuff though!

Caffeine and nicotine apparently cause dopamine release through their antagonist actions at some other receptor (adenosine?). As for Parnate being "amphetamine-like", you're right, this one's been going on for a long time. For example, check out:

Is tranylcypromine really metabolized to amphetamine?
J Clin Psychiatry. 1992 Dec;53(12):450-1.

Current opinion, including a 1999 review of MAOI metabolism, seems to rule this out, but I guess this doesn't preclude Parnate from behaving "kind of like" amphetamine in some respects. (And it's certainly got an "upper-ish" reputation.) And yeah, as you note, selegiline definitely has an amphetamine metabolite. Perhaps this is one of the reasons I went for an unprecedented ten-mile run a few hours after trying a sensible eighth of a 5mg dose. (Can you say dopaminergic supersensitivity?) That one was a very short trial, even by my standards... Just another factor making me lean much more toward Nardil and/or Marplan if I ever try to join the MAOI big leagues. :-)

Best,
JD


> > Ah, Elizabeth... Good to be reminded that there are people out there who know this stuff better than I do! ;-)
>
> Jeez, I didn't mean for it to come out like *that*! :-)
>

> >It's often said (and lately, I guess, often repeated by me) that Parnate is quite amphetamine-like in certain respects.
>
> What, like the molecule looks almost exactly like amphetamine? :-) Seriously, I heard that rumor too, that Parnate or one of its metabolites has amphetamine-like activity. Nobody's ever really put much effort into investigating it, although whenever they autopsy a Parnate OD, they always seem to look for amphetamines. (Oops, that was kind of morbid.)
>

> Now, *selegiline*, on the other hand, was jittery. Contrary to claims that have been made for it, I didn't find it as easy to tolerate as the other two MAOIs I've tried. (And it turns out that selegiline *does* have amphetamine metabolites - I even tested positive for them (how embarrassing).)

 

Re: MAOIs, stimulants, and other things

Posted by Judy on June 4, 1999, at 15:09:37

In reply to Re: MAOIs, stimulants, and other things, posted by JD on June 4, 1999, at 12:36:43

Does Parnate, with it's amphetamine properties, cause less weight gain than Nardil?

Is one able to get a night's sleep with Parnate?

How about sexual dysfunction with Parnate. I am numb from the waist down on Nardil.

Anyone have experience with both so they can compare side effects?

 

Parnate - Judy

Posted by Elizabeth on June 5, 1999, at 12:49:18

In reply to Re: MAOIs, stimulants, and other things, posted by Judy on June 4, 1999, at 15:09:37

> Does Parnate, with it's amphetamine properties, cause less weight gain than Nardil?

Yes, it does. I've never heard of Parnate causing weight gain, actually.

I don't find Parnate to be subjectively "amphetamine-like," though.

> Is one able to get a night's sleep with Parnate?

I can't. Couldn't with Nardil either.

> How about sexual dysfunction with Parnate. I am numb from the waist down on Nardil.

I don't have this problem, but then, I didn't have it with Nardil, Effexor, Prozac, etc. either.

> Anyone have experience with both so they can compare side effects?

Yeah - is there anything specific you'd like to know about besides the above? Mostly I'd say they have been similar, except no weight gain with Parnate and no spontaneous hypertension with Nardil.

 

Elizabeth please answer

Posted by Erin on June 5, 1999, at 23:25:00

In reply to Parnate - Judy, posted by Elizabeth on June 5, 1999, at 12:49:18

Elizabeth-

After reading some of your posts about MAOI's, it seems that you know quite a bit about both Parnate and Nardil. I will soon be switching from Paxil to Parnate and am a bit anxious about it. My biggest fear is that Parnate won't work and that I'll be back at ground zero again. I was wondering what success stories you have heard about Parnate as a successful treatment for atypical depression. Thank you for any feedback - I really need some hope back in my life again.

Sincerely,
Erin

 

Parnate - Erin

Posted by Elizabeth on June 6, 1999, at 7:53:37

In reply to Elizabeth please answer, posted by Erin on June 5, 1999, at 23:25:00

Hi Erin.

Some other people might be better able to answer this, but my impression is that it's very rare for someone with atypical depression not to do well on MAOIs, even if SSRIs (Paxil, etc.) didn't work. Some people augment the MAOI with a stimulant (such as Ritalin) or a mood stabilizer (lithium, Depakote, Lamictal) or some such if it isn't enough by itself, so that's something to consider as well. (Regarding mood stabilizers, some researchers think that atypical depression is related to bipolar II disorder.)

Good luck - I hope this med does the trick for you!

 

Re: Parnate - Elizabeth

Posted by Judy on June 6, 1999, at 10:58:40

In reply to Parnate - Judy, posted by Elizabeth on June 5, 1999, at 12:49:18

I can't tell you how much I envy the fact that your "Big O" Seratonin receptor hasn't been switched off by Nardil! You should really consider yourself fortunate in that respect!

As Imentioned in my other post, I am literally NUMB from the waist down on Nardil - not just sexually. Takes me at least 20 minutes in the bathroom and then I have to (trying to put this delicately) *visually* check to make sure I've completed any biological functions - no sensation at all. The Nardil works so damn well for my depression, I keep going back to it and putting up with this other misery for awhile; but it always chases me away eventually in search of another med when I can't stand the side effectst any longer.

Since this isn't one of your side effects, I guess I can't ask you if there is any way to counteract this - ginkgo or something. Maybe someone else out there has experienced this phenomenon and has a suggestion.

As for Parnate, could you explain what you mean by spontaneous hypertention? I've been very susceptible to the 'jitters' caused by some other AD's (Wellbutrin almost did me in!) and I don't like the sound of this. Also, does Parnate cause the same lowered blood pressure 'woosies' as Nardil when you stand up too quickly?

What have you heard about Marplan - do you think it might provide a "happy medium" between Nardil and Parnate?

Any suggestions you or others may have will be gratefully appreciated.

 

Re: Parnate - Erin

Posted by Erin on June 6, 1999, at 15:18:44

In reply to Parnate - Erin, posted by Elizabeth on June 6, 1999, at 7:53:37

Elizabeth-

Thanks so much for your reply- it was just what I needed to hear!

Erin

 

Re: Parnate - Erin

Posted by JD on June 8, 1999, at 5:44:48

In reply to Parnate - Erin, posted by Elizabeth on June 6, 1999, at 7:53:37

Erin, I ditto Elizabeth's sentiments, even if I haven't tried MAOIs myself (the time may be coming though!). They probably have the best reputation for stubborn atypical depression. Keep in mind that there are other ones besides Parnate, too! Hope things go well for you,
JD


>
> Some other people might be better able to answer this, but my impression is that it's very rare for someone with atypical depression not to do well on MAOIs, even if SSRIs (Paxil, etc.) didn't work. Some people augment the MAOI with a stimulant (such as Ritalin) or a mood stabilizer (lithium, Depakote, Lamictal) or some such if it isn't enough by itself, so that's something to consider as well. (Regarding mood stabilizers, some researchers think that atypical depression is related to bipolar II disorder.)
>
> Good luck - I hope this med does the trick for you!

 

Re: Parnate - Erin

Posted by Erin on June 8, 1999, at 20:36:55

In reply to Re: Parnate - Erin, posted by JD on June 8, 1999, at 5:44:48

Thanks for the support JD-

I hope your medical quest ends soon- I know I'm ready for a permanent depression reprieve.

Best wishes-
Erin

 

? for Elizabeth

Posted by Dwight on June 11, 1999, at 15:06:35

In reply to Re: Parnate - Erin, posted by Erin on June 8, 1999, at 20:36:55

Elizabeth,

I'm thinking about getting off Nardil and trying something else. What do think might work well for social phobia and atypical depression? Are there any combinations of drugs that might have the same effect as Nardil does? or that would work on the brain in a similar way? Haven't tried Remeron or Celexa or Wellbutrin. HAve had limited success with SSRI's. Effexor made me too nervous to give it more than two weeks.

 

Dwight - ideas

Posted by Elizabeth on June 12, 1999, at 22:36:21

In reply to ? for Elizabeth, posted by Dwight on June 11, 1999, at 15:06:35

Kind of depends why you're interested in switching meds. There's always Marplan - that would be my first choice. (In fact, I *have* thought about trying it myself.)

Another option is the SSRIs. I think Luvox would be my first choice for social phobia, anxiety, and nervousness because it doesn't seem to be as activating as the others; don't be afraid to push the dose up, and add Wellbutrin if the sex thing becomes a problem. Another idea would be Wellbutrin by itself. Or you could try high-dose Buspar - by high-dose, I mean up to 90mg/day (in three divided doses). (Effective doses for depression are higher than those for anxiety.) Finally, there's Effexor XR - perhaps starting at a very low dose of the immediate release stuff and then increasing slowly as tolerated. (This is the usual way of going about these things if a med makes you nervous at first - it's common with the SSRIs.)

Remeron is supposed to be good for "anxiety" but I think that's just because it's sedating. I haven't heard anything about it being useful in social phobia or atypical depression in particular.


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