Psycho-Babble Medication Thread 6917

Shown: posts 1 to 21 of 21. This is the beginning of the thread.

 

MAOIs cause sexual dysfunction?

Posted by John on June 1, 1999, at 18:05:02

Hi all. I am considering an MAOI after trying lots of other stuff and counseling. I gather MAOIs are good for chronic stubborn melancholic depression like mine. Anyone who knows, two questions: 1)Are they good for melancholic depression (dysthymia/anhedonia)? 2)Most important, are they known to cause sexual dysfunctin with guys, specifically lack of interest, inability, or genital anesthesia, or all of the above? We all know the SSRIs almost universally cause sex problems, but what about MAOIs? Thank you for your time and replies. John.

 

Re: MAOIs cause sexual dysfunction?

Posted by anita on June 1, 1999, at 18:47:46

In reply to MAOIs cause sexual dysfunction?, posted by John on June 1, 1999, at 18:05:02

Hi John,

MAOIs are good for dysthymia and anhedonia, and can be good for melancholic depression (although
they are often esp. recommended for atypical depression). They seem to cause sexual side effects
for men and women at about the same rate as SSRIs. I've heard that Parnate tends to cause less sexual
dysfunction than nardil, but that's just anectodal.

anita

 

Re: MAOIs cause sexual dysfunction?

Posted by Ruth on June 2, 1999, at 7:24:04

In reply to MAOIs cause sexual dysfunction?, posted by John on June 1, 1999, at 18:05:02

John,

I'm not sure about the MAO's, but the tricyclic's
might be a good bet too. I was curious about
going on one of the older drugs b/c of so much
sexual frustration with the SSRI's and posted
about it--I got a few responses that said that
they didn't experience sexual dysfunction on
disipramine (a tricyclic), or the same SSRI apathy.
Of course everybody's different.
The standard word is that SSRI's have less side
effects, but studies show that the older ad's
work just as well, and that many of those horrible
side effects that the older ad's are famous for
aren't true for a lot of people. I remember
taking disipramine for a month or so and didn't
experience major side effects--I got dizzy every
once in awhile and felt prickly sensations on my
scalp, but it wasn't problematic for me, and it
probably would have went away with time. And I
don't remember having any sexual side effects.

 

Re: MAOIs cause sexual dysfunction?

Posted by Elizabeth on June 2, 1999, at 12:32:33

In reply to MAOIs cause sexual dysfunction?, posted by John on June 1, 1999, at 18:05:02

> 1)Are they good for melancholic depression (dysthymia/anhedonia)?

The answer is yes, although dysthymia isn't the same as melancholic depression.


> 2)Most important, are they known to cause sexual dysfunctin with guys, specifically lack of interest, inability, or genital anesthesia, or all of the above?

They can. I haven't had any problems, but then I'm not a guy. :-) (Also, I should mention that I didn't have any problems with Prozac, either.)

 

Re: MAOIs--types of depression/sexual side-effects

Posted by JD on June 3, 1999, at 7:32:44

In reply to MAOIs cause sexual dysfunction?, posted by John on June 1, 1999, at 18:05:02

Gee, John, if this is one person behind this myriad of postings you sure seem to be doing a thorough job of researching MAOIs! :-)
Who could blame you though--they're interesting meds (just as much for me too) and aren't as widely discussed as many others...

As for your questions, I'll throw in the following based upon what I've come across in what often seems like my own personal correspondance-course in pharmacology.:

(1) MAOIs have a pretty good reputation in chronic or longer-term depressive states that have been refractory to first-line treatments. As Elizabeth noted, melancholia and dysthymia are generally two pretty distinct things--the first usually refers to an acute syndrome of "classical" symptoms like guilt, despair, mournfulness, insomnia, lack of appetite, etc.; the second usually refers to a less acute but more chronic (and I can assure you, equally unpleasant!) pattern of lowered mood and anhedonia. This being said, I can imagine that certain aspects of both could present at the same time in complex ways. While there has been a lot of debate about whether MAOIs work best for a certain kind of patient, there's still no full consensus on this. Nonetheless, while MAOIs don't necessarily have a stunning track record in treating "simple" melancholia (they are rarely used for this nowadays anyhow), they are frequently said to work well in situations that feature so-called "atypical symptoms" (such as overeating, oversleeping, mood fluctuating in response to outside events) or, somewhat relatedly, in people who show "heightened interpersonal sensitivity" (fear of social rejection, etc.), often in a pattern that goes back to early childhood. (This is one of the reasons that MAOIs often work pretty well for people with social phobia. I should throw in anxiety and panic attacks too, as these symptoms will often respond well to MAOIs too, perhaps best of all with Nardil.) There is plenty of controversy on these issues, as some studies claim that SSRIs can work just as well in many of the above situations, but I think many would agree that for people who present complex depressive problems with chronic or semi-chronic histories (often seeming to blur into long-term personality traits), MAOIs can sometimes be the best bet. As I'm sure you've heard, in some cases the results can be very dramatic.

(2) As the other responders have said, MAOIs are known to cause sexual side effects as with most antidepressants. Whether it's as much as with SSRIs is something that I'm not really sure has been well studied. My guess is that while they probably cause their fair share of dysfunction (and then some perhaps), it may not be *as* bad as with SSRIs, since the dopamine-boosting effect of MAOIs may help to counteract some of the libidinal chilling associated with serotonin reuptake blockers. People's responses to meds are different though, so this can be very tough to predict and probably varies somewhat among the different MAOIs.

Best regards,
JD


> Hi all. I am considering an MAOI after trying lots of other stuff and counseling. I gather MAOIs are good for chronic stubborn melancholic depression like mine. Anyone who knows, two questions: 1)Are they good for melancholic depression (dysthymia/anhedonia)? 2)Most important, are they known to cause sexual dysfunctin with guys, specifically lack of interest, inability, or genital anesthesia, or all of the above? We all know the SSRIs almost universally cause sex problems, but what about MAOIs? Thank you for your time and replies. John.

 

Re: MAOIs--types of depression/sexual side-effects

Posted by Elizabeth on June 3, 1999, at 11:12:41

In reply to Re: MAOIs--types of depression/sexual side-effects, posted by JD on June 3, 1999, at 7:32:44

>Nonetheless, while MAOIs don't necessarily have a stunning track record in treating "simple" melancholia (they are rarely used for this nowadays anyhow), ....

Actually, my dx is major depressive disorder, recurrent, with melancholic features.

Early research on MAOIs in melancholic ("endogenous" or "major") depression suggested they didn't work very well, but used low doses (e.g., 45mg of phenelzine). This subtype of depression often requires high doses of whatever drug you end up using (Effexor, for example), so it's no surprise that those early studies got poor results.

More recent research using higher doses has suggested that MAOIs do indeed work very well in endogenous/melancholic depression. It doesn't seem to be the case that MAOIs work preferentially for atypical depression, but rather that tricyclics *don't* work very well in atypical depression.

 

Re: MAOIs--JD, Eliz, Dysthymia

Posted by John on June 3, 1999, at 19:15:35

In reply to Re: MAOIs--types of depression/sexual side-effects, posted by JD on June 3, 1999, at 7:32:44

Thanks all for responses. Yeah JD, I'm guilty, I have had a few postings recently. I am between medicines and researching hard before jumping again into the next move, whatever it is. According to your descriptions, I was wrong in categorizing myself as melancholic. My primary symptom, and it is big, is anhedonia/lowered mood/non-interest/non-joy. So I guess that's dysthymia. In any case, what a tough beast it is. Thanks Eliz for pointing out the difference. As lifelong medicine looks very likely to protect from the severe downs that overlap the dysthymia at times, it is crucial to find a med that will allow me to enjoy some kind of sex life the rest of my life, as I have an active wife who is patient, so far. How to beat dysthymia and retain a sex life. That's a tough one. John.
>
>
> > Hi all. I am considering an MAOI after trying lots of other stuff and counseling. I gather MAOIs are good for chronic stubborn melancholic depression like mine. Anyone who knows, two questions: 1)Are they good for melancholic depression (dysthymia/anhedonia)? 2)Most important, are they known to cause sexual dysfunctin with guys, specifically lack of interest, inability, or genital anesthesia, or all of the above? We all know the SSRIs almost universally cause sex problems, but what about MAOIs? Thank you for your time and replies. John.

 

Re: MAOIs--JD, Eliz, Dysthymia

Posted by JD on June 4, 1999, at 8:43:28

In reply to Re: MAOIs--JD, Eliz, Dysthymia, posted by John on June 3, 1999, at 19:15:35

Hardly meant to make you feel "guilty", John, though I guess maybe this would put you a few notches back into the melancholia camp! ;-)

As for numerous postings, I'm hardly one to talk, though typically I'm shooting off my amateur-psychopharmacologist mouth to people like you to offset my own multiple frustrations over meds. Believe me when I say that I''m as interested in MAOIs as you are, and for many of the same reasons. Dysthymia is a "tough beast" indeed; fortunately it's starting to get some attention as its own entity and not just as a kind of "junior depression". MAOIs may well be worth a shot if you've been through some previous rounds without much success. There are also some newer meds that show promise in dysthymia but that haven't been released in the US yet: amisulpride, tianeptine, and reboxetine come to my mind, the last one hopefully to be available soon. I hope you find something that works for you, and that spares your sex life at the same time, of course!

Best wishes,
JD


> Thanks all for responses. Yeah JD, I'm guilty, I have had a few postings recently. I am between medicines and researching hard before jumping again into the next move, whatever it is. According to your descriptions, I was wrong in categorizing myself as melancholic. My primary symptom, and it is big, is anhedonia/lowered mood/non-interest/non-joy. So I guess that's dysthymia. In any case, what a tough beast it is. Thanks Eliz for pointing out the difference. As lifelong medicine looks very likely to protect from the severe downs that overlap the dysthymia at times, it is crucial to find a med that will allow me to enjoy some kind of sex life the rest of my life, as I have an active wife who is patient, so far. How to beat dysthymia and retain a sex life. That's a tough one. John.
> >
> >
> > > Hi all. I am considering an MAOI after trying lots of other stuff and counseling. I gather MAOIs are good for chronic stubborn melancholic depression like mine. Anyone who knows, two questions: 1)Are they good for melancholic depression (dysthymia/anhedonia)? 2)Most important, are they known to cause sexual dysfunctin with guys, specifically lack of interest, inability, or genital anesthesia, or all of the above? We all know the SSRIs almost universally cause sex problems, but what about MAOIs? Thank you for your time and replies. John.

 

dysthymia, melancholia

Posted by Elizabeth on June 5, 1999, at 13:28:24

In reply to Re: MAOIs--JD, Eliz, Dysthymia, posted by JD on June 4, 1999, at 8:43:28

I've been reading a book, _Dysthymia and the Spectrum of Chronic Depressions_, that I wholeheartedly recommend. It goes into all the different forms that chronic depression can take - sometimes it manifests as life-long low energy and disinterest, other times as chronic rejection-sensitivity and irritability. Dysthymics usually don't show the prominent "vegetative" (somatic) symptoms that you see in major depression, though I think that chronic sleep problems are probably common.

Usually there's at least some degree of mood reactivity (ability to be cheered up when good things happen) in chronic depression, whereas total anhedonia is the main defining feature of melancholia. FWIW, the other symptoms and associated features of melancholic depression (besides the general features of major depression that we all know and love :-P) are: waking up early in the morning ("terminal" insomnia - a rather scary-sounding name!), loss of appetite,
guilt (culture-bound?) or self-reproach, feeling worst first thing in the morning, and psychomotor changes (appearing slowed-down or agitated). It responds well to tricyclics and ECT, possibly not as well to SSRIs (although I wonder if high-dose SSRIs have been tested).

> As for numerous postings, I'm hardly one to talk, though typically I'm shooting off my amateur-psychopharmacologist mouth to people like you to offset my own multiple frustrations over meds.

You're a kindred spirit, JD.

 

Re: Dysthymia Book

Posted by John on June 5, 1999, at 14:34:53

In reply to dysthymia, melancholia, posted by Elizabeth on June 5, 1999, at 13:28:24

> I've been reading a book, _Dysthymia and the Spectrum of Chronic Depressions_, that I wholeheartedly recommend. It goes into all the different forms that chronic depression can take - sometimes it manifests as life-long low energy and disinterest, other times as chronic rejection-sensitivity and irritability. Dysthymics usually don't show the prominent "vegetative" (somatic) symptoms that you see in major depression, though I think that chronic sleep problems are probably common.
>
> Usually there's at least some degree of mood reactivity (ability to be cheered up when good things happen) in chronic depression, whereas total anhedonia is the main defining feature of melancholia. FWIW, the other symptoms and associated features of melancholic depression (besides the general features of major depression that we all know and love :-P) are: waking up early in the morning ("terminal" insomnia - a rather scary-sounding name!), loss of appetite,
> guilt (culture-bound?) or self-reproach, feeling worst first thing in the morning, and psychomotor changes (appearing slowed-down or agitated). It responds well to tricyclics and ECT, possibly not as well to SSRIs (although I wonder if high-dose SSRIs have been tested).
>
Dysthymia and the Spectrum of Chronic Depression is indeed an interesting book, though I find I have to re-read parts to understand and abosrb. I don't think I fit any particular diagnosis, which is pretty much what the book says anyway, that they are kind of mixed and ever-changing states. I've been to that hellhole of deep suicidal psychotic depression, and maybe 4 days a year actually feel wonderful, perhaps too wonderful, but most often am just totally anhedonic without many other depressive symptoms. I would pay a million $$$ to have joy/interest/pleasure. Others take those feelings for granted. Anyway, according to the book, a mood stabilzer seems warranted, perhaps one of the newer ones that are claimed to have marked antidepressent properties, and I'm still leaning toward MAOI. I live 4 hours from Canada and may go there to get some Moclobemide. We'll see. Would be nice to have a good doc, like the ones I read about here, to lead me on this journey, but they don't exist around here. I'm kinda on my own, and maybe off to Canada for a day. Any doc I see is fairly perplexed and perfectly willing to write a prescrip for whatever I want. Gotta take care of myself I guess. Hey, I rambling. Nice to hear from you. I'll look for your postings which are always interesting. John.

 

Re: Dysthymia -- Elizabeth/John

Posted by JD on June 8, 1999, at 8:02:34

In reply to Re: Dysthymia Book, posted by John on June 5, 1999, at 14:34:53

Thanks for the tip, folks--I will have to check the book out... I'm assuming it features much of the stuff that's been floating around lately (on this site and off) about early-onset mood problems, "soft" bipolar signs, etc... The more I consider it, the more I feel sort of like a textbook example of these issues: very early onset in childhood, atypical symptoms, mood reactivity and widely varying social impairment for as long as I can remember (sometimes just fine, most often not). As with John I've had a few major depressions thrown in, but these days mostly range between 95% dysthymia and 5% euthymia to mild hypomania. Needless to say, I try to take advantage of that 5%, but it's largely unpredictable and all too brief! All of which probably makes me sound like a great candidate for an MAOI, which in fact will probably be my next stop. (Given my ridiculous hypersensitivity to meds, though, especially serotonergic and/or dopaminergic ones, these are hardly a sure bet. I've tried mood stabilizers and have personally found them unhelpful.) In my experience, doctors are at a loss over what to do with "complicated" patients--as with you John, I usually feel like I'm writing my own prescriptions, which doesn't inspire great confidence in the profession after a while. BTW, I'm curious that you'd "go international" to get moclobemide before say Nardil, Parnate, or Marplan--I know it's technically a "safe" MAOI, but I believe it's only MAO-A inhibiting and generally not as impressive in refractory cases as the old-line irreversible ones. But hey, within certain limits of course, my motto has basically become "Try everything"--It can only increase your odds of finding something that works.
Best,
JD


> > I've been reading a book, _Dysthymia and the Spectrum of Chronic Depressions_, that I wholeheartedly recommend. It goes into all the different forms that chronic depression can take - sometimes it manifests as life-long low energy and disinterest, other times as chronic rejection-sensitivity and irritability. Dysthymics usually don't show the prominent "vegetative" (somatic) symptoms that you see in major depression, though I think that chronic sleep problems are probably common.
> >
> > Usually there's at least some degree of mood reactivity (ability to be cheered up when good things happen) in chronic depression, whereas total anhedonia is the main defining feature of melancholia. FWIW, the other symptoms and associated features of melancholic depression (besides the general features of major depression that we all know and love :-P) are: waking up early in the morning ("terminal" insomnia - a rather scary-sounding name!), loss of appetite,
> > guilt (culture-bound?) or self-reproach, feeling worst first thing in the morning, and psychomotor changes (appearing slowed-down or agitated). It responds well to tricyclics and ECT, possibly not as well to SSRIs (although I wonder if high-dose SSRIs have been tested).
> >
> Dysthymia and the Spectrum of Chronic Depression is indeed an interesting book, though I find I have to re-read parts to understand and abosrb. I don't think I fit any particular diagnosis, which is pretty much what the book says anyway, that they are kind of mixed and ever-changing states. I've been to that hellhole of deep suicidal psychotic depression, and maybe 4 days a year actually feel wonderful, perhaps too wonderful, but most often am just totally anhedonic without many other depressive symptoms. I would pay a million $$$ to have joy/interest/pleasure. Others take those feelings for granted. Anyway, according to the book, a mood stabilzer seems warranted, perhaps one of the newer ones that are claimed to have marked antidepressent properties, and I'm still leaning toward MAOI. I live 4 hours from Canada and may go there to get some Moclobemide. We'll see. Would be nice to have a good doc, like the ones I read about here, to lead me on this journey, but they don't exist around here. I'm kinda on my own, and maybe off to Canada for a day. Any doc I see is fairly perplexed and perfectly willing to write a prescrip for whatever I want. Gotta take care of myself I guess. Hey, I rambling. Nice to hear from you. I'll look for your postings which are always interesting. John.

 

Re: Dysthymia -- Elizabeth/John

Posted by John on June 9, 1999, at 3:44:04

In reply to Re: Dysthymia -- Elizabeth/John, posted by JD on June 8, 1999, at 8:02:34

> Thanks for the tip, folks--I will have to check the book out... I'm assuming it features much of the stuff that's been floating around lately (on this site and off) about early-onset mood problems, "soft" bipolar signs, etc... The more I consider it, the more I feel sort of like a textbook example of these issues: very early onset in childhood, atypical symptoms, mood reactivity and widely varying social impairment for as long as I can remember (sometimes just fine, most often not). As with John I've had a few major depressions thrown in, but these days mostly range between 95% dysthymia and 5% euthymia to mild hypomania. Needless to say, I try to take advantage of that 5%, but it's largely unpredictable and all too brief! All of which probably makes me sound like a great candidate for an MAOI, which in fact will probably be my next stop. (Given my ridiculous hypersensitivity to meds, though, especially serotonergic and/or dopaminergic ones, these are hardly a sure bet. I've tried mood stabilizers and have personally found them unhelpful.) In my experience, doctors are at a loss over what to do with "complicated" patients--as with you John, I usually feel like I'm writing my own prescriptions, which doesn't inspire great confidence in the profession after a while. BTW, I'm curious that you'd "go international" to get moclobemide before say Nardil, Parnate, or Marplan--I know it's technically a "safe" MAOI, but I believe it's only MAO-A inhibiting and generally not as impressive in refractory cases as the old-line irreversible ones. But hey, within certain limits of course, my motto has basically become "Try everything"--It can only increase your odds of finding something that works.
> Best,
> JD
>
>
> > > I've been reading a book, _Dysthymia and the Spectrum of Chronic Depressions_, that I wholeheartedly recommend. It goes into all the different forms that chronic depression can take - sometimes it manifests as life-long low energy and disinterest, other times as chronic rejection-sensitivity and irritability. Dysthymics usually don't show the prominent "vegetative" (somatic) symptoms that you see in major depression, though I think that chronic sleep problems are probably common.
> > >
> > > Usually there's at least some degree of mood reactivity (ability to be cheered up when good things happen) in chronic depression, whereas total anhedonia is the main defining feature of melancholia. FWIW, the other symptoms and associated features of melancholic depression (besides the general features of major depression that we all know and love :-P) are: waking up early in the morning ("terminal" insomnia - a rather scary-sounding name!), loss of appetite,
> > > guilt (culture-bound?) or self-reproach, feeling worst first thing in the morning, and psychomotor changes (appearing slowed-down or agitated). It responds well to tricyclics and ECT, possibly not as well to SSRIs (although I wonder if high-dose SSRIs have been tested).
> > >
> > Dysthymia and the Spectrum of Chronic Depression is indeed an interesting book, though I find I have to re-read parts to understand and abosrb. I don't think I fit any particular diagnosis, which is pretty much what the book says anyway, that they are kind of mixed and ever-changing states. I've been to that hellhole of deep suicidal psychotic depression, and maybe 4 days a year actually feel wonderful, perhaps too wonderful, but most often am just totally anhedonic without many other depressive symptoms. I would pay a million $$$ to have joy/interest/pleasure. Others take those feelings for granted. Anyway, according to the book, a mood stabilzer seems warranted, perhaps one of the newer ones that are claimed to have marked antidepressent properties, and I'm still leaning toward MAOI. I live 4 hours from Canada and may go there to get some Moclobemide. We'll see. Would be nice to have a good doc, like the ones I read about here, to lead me on this journey, but they don't exist around here. I'm kinda on my own, and maybe off to Canada for a day. Any doc I see is fairly perplexed and perfectly willing to write a prescrip for whatever I want. Gotta take care of myself I guess. Hey, I rambling. Nice to hear from you. I'll look for your postings which are always interesting. John.


JD, I've considered Moclobemide because of its "relatively" benign side effect profile. The others do look better, on paper, but you know how that is. Gotta try it to know for sure. Canada is a one day round trip for me, good excuse to visit, might as well take advantage. Research in the Dysthymia book used moclobemide and was equal to other ADs, with 70% response, and the easiest side effect profile. I meet with my psych. this Friday, and who knows what the outcome will be. A follow-up comment on "John" postings, those aren't all mine. There are a lot of Johns at this site, about 1/4 of the postings are mine. My questions are still...do MAOIs cause sexual dsyfunction, and is Zoloft with Buspar magical as claimed? Nice to talk with you. Hang in there, best wishes, John.

 

Re: Dysthymia -- Elizabeth/John

Posted by JD on June 9, 1999, at 7:15:22

In reply to Re: Dysthymia -- Elizabeth/John, posted by John on June 9, 1999, at 3:44:04

Don't worry--I was only counting the *John* postings that pretty clearly came from the same person (on MAOIs, etc.). Didn't mean to give you a hang up at all... hardly what this board is for! :-)

Hope things go well w/you... You're certainly right that moclobemide (Aurorix in Canada?) has a cleaner side-effect profile and might be worth a shot. Keep us posted...
Best,
JD

>
>
>. A follow-up comment on "John" postings, those aren't all mine. There are a lot of Johns at this site, about 1/4 of the postings are mine. My questions are still...do MAOIs cause sexual dsyfunction, and is Zoloft with Buspar magical as claimed? Nice to talk with you. Hang in there, best wishes, John.

 

Re: Choice of MAOI / sexual dysfunction

Posted by Seamus on June 9, 1999, at 12:06:28

In reply to Re: Dysthymia -- Elizabeth/John, posted by John on June 9, 1999, at 3:44:04

John,

I was on Nardil for years and switched to Parnate because of the anorgasmia at doses higher than 45 mg/day. No such reaction on Parnate at 30 mg/day.

Seamus

 

Re: Seamus Question

Posted by John on June 9, 1999, at 17:46:49

In reply to Re: Choice of MAOI / sexual dysfunction, posted by Seamus on June 9, 1999, at 12:06:28

> John,
>
> I was on Nardil for years and switched to Parnate because of the anorgasmia at doses higher than 45 mg/day. No such reaction on Parnate at 30 mg/day.
>
> Seamus

Seamus, thanks for response. I am familiar with the sexual problems you describe on Nardil, as I've experienced the same on SSRIs. Personally I don't mind taking forever to finish an intimite encounter, but I do mind a lot when I just have no interest, no arousal. Do you find your libido is strong with Parnate, neutral, or dead? That is my main concern, will I lose sexual interest? Has Parnate done that to you? Thanks! John.

 

Re: Seamus Question

Posted by Seamus, on June 9, 1999, at 19:02:10

In reply to Re: Seamus Question, posted by John on June 9, 1999, at 17:46:49

Seamus,

I have exactly the same questions as John plus a couple more: How does Parnate compare to Nardil in other aspects besides sexual? Same relief from depression? Are you more hyper/anxious on Parnate? Any wieght gain with either drug?

I'd be one happy camper if I could switch to Parnate and lose the anorgasmia (I'm assuming the effect is the same for men as it is for women since it's a Seraton receptor that's switched off by Nardil and the other SSRI's.)

BUT, I'd like some assurance that I would feel as well on Parnate as I do on Nardil before making a change.

Thanks.

Judy

 

Re: Seamus Question

Posted by Judy on June 9, 1999, at 20:01:54

In reply to Re: Seamus Question, posted by Seamus, on June 9, 1999, at 19:02:10

Sorry for signing my own post above with your name. Apparently I got a little confused!

Judy

 

Re: Seamus Nardil vs. Parnate

Posted by Seamus on June 11, 1999, at 10:19:57

In reply to Re: Seamus Question, posted by John on June 9, 1999, at 17:46:49

>>Do you find your libido is strong with Parnate, neutral, or dead?>will I lose sexual interest?>Has Parnate done that to you? >How does Parnate compare to Nardil in other aspects besides sexual?>Same relief from depression?
Are you more hyper/anxious on Parnate?>Any wieght gain with either drug?<<
Not per se, because of the anorectic properites of Parnate I've developed a nasty habit of going for quick calories when I absolutely have to eat. That or the onset middle age (I'm 38) has added fifteen pounds or so over the course of the last three years.

Seamus

 

Re: Seamus Nardil vs. Parnate redux

Posted by Seamus on June 11, 1999, at 10:35:28

In reply to Re: Seamus Nardil vs. Parnate, posted by Seamus on June 11, 1999, at 10:19:57

Damn thing ate most of my reply. I'll try once more...

>>Do you find your libido is strong with Parnate, neutral, or dead?
Same as it ever was. The trick to Parnate is consistency: the same doses, the same time of day. Libido may increase if you cut the dose due to (I assume) some sort of cholinergic rebound. But you don't want to do that because the AD effect wanes just as quickly.

>will I lose sexual interest? Nah
>Has Parnate done that to you? Nah

>How does Parnate compare to Nardil in other aspects besides sexual?
Onset of action is a week or less. Stimulating side effect 2 hrs post dosing; caffeine can make this much worse. (I have a startle reflex from Hell) No constipation, urinary hesitancy or carbo cravings. Tyramine reaction much more noticeable, but your mileage may vary.

>Same relief from depression?
Same relief, but the quality differs. I recall I was more "content" on Nardil, but on Parnate my drive is higher. I sleep less, too.

> Are you more hyper/anxious on Parnate?
I'm very consistent w/ my dosing so I can't really tell. I think I'm pretty hyper to begin with. I'll take 0.025 -- 0.5 mg Xanax if I get really jumpy.

>Any wieght gain with either drug?<<
Not per se, because of the anorectic properites of Parnate I've developed a nasty habit of going for quick calories when I absolutely have to eat. That or the onset middle age (I'm 38) has added fifteen pounds or so over the course of the last three years.

Seamus

 

Re: Seamus Nardil vs. Parnate redux

Posted by Judy on June 11, 1999, at 11:16:19

In reply to Re: Seamus Nardil vs. Parnate redux, posted by Seamus on June 11, 1999, at 10:35:28

Thanks, Seamus - Great answers - Just the ones I wanted to hear!

If you don't mind, would you provide just a little more clarification of your comparison of Parnate to Nardil:

>>Do you find your libido is strong with Parnate, neutral, or dead?
>> Same as it ever was. Will I lose sexual interest? Nah
Was your libido/sexual interest affected by Nardil?

>>I was more "content" on Nardil, but on Parnate my drive is higher.
Is a "higher drive" a good thing for you? Is there a sense of "discontent" with Parnate?

>>I sleep less, too.
Do you miss the sleep or do you feel just as refreshed by less sleep. (I sleep much less on Nardil, but I find I don't miss it at all.) I take 1 mg of Xanax to get to sleep with Nardil. Ever tried that with Parnate?

>>Stimulating side effect 2 hrs post dosing; caffeine can make this much worse.
This one scares me - HOW "stimulating"? How long does the stimulation last?

>>No constipation, urinary hesitancy or carbo cravings.
Did you suffer these side effects on Nardil but not Parnate?

One more question: Every tried Marplan? If not, would you consider it, or are you happy with Parnate?

Thanks, Seamus, for your patience. By the way, 5 pounds a year is no big deal - Nardil can add 5 pounds a month for me if I don't constantly deny my cravings and the feeling that I'm starving to death!

Judy

 

Re: Seamus Nardil vs. Parnate redux

Posted by Seamus on June 13, 1999, at 23:50:41

In reply to Re: Seamus Nardil vs. Parnate redux, posted by Judy on June 11, 1999, at 11:16:19

> Thanks, Seamus - Great answers - Just the ones I wanted to hear!
>
> If you don't mind, would you provide just a little more clarification of your comparison of Parnate to Nardil:
>
> >>Do you find your libido is strong with Parnate, neutral, or dead?
> >> Same as it ever was. Will I lose sexual interest? Nah

Nah, in my definition, means No.
> Was your libido/sexual interest affected by Nardil?

Nah. In my defintion this means No.
>
> >>I was more "content" on Nardil, but on Parnate my drive is higher.
> Is a "higher drive" a good thing for you? Is there a sense of "discontent" with Parnate?

"Higher drive" is not in the strict sexual sense, more the sublimated sense... I seem to have more initiative, rather than feel content with things as they are. Xanax (and the SSRI's, from what I've read) tend to do this.

> >>I sleep less, too.
> Do you miss the sleep or do you feel just as refreshed by less sleep. (I sleep much less on Nardil, but I find I don't miss it at all.) I take 1 mg of Xanax to get to sleep with Nardil. Ever tried that with Parnate?

1 mg Xanax would floor me for 36 hours. Parnate seems to potentiate my response to Xanax. 0.5 mg HS leaves me w/ a hangover.

>
> >>Stimulating side effect 2 hrs post dosing; caffeine can make this much worse.
> This one scares me - HOW "stimulating"? How long does the stimulation last?

How stimulating for YOU is a good question. For me, it depends whether I take it with coffee or not. You'll have to figure that out for yourself once you try Parnate.


> >>No constipation, urinary hesitancy or carbo cravings.
> Did you suffer these side effects on Nardil but not Parnate?

Yes.

>
> One more question: Every tried Marplan? If not, would you consider it, or are you happy with Parnate?

It took me six or seven years to switch from Nardil to Parnate. As I see it, Marplan was dropped from lack of demand. Despite the marketing efforts which may or may have not been behind it, in the final analysis it wasn't prescribed as often as Parnate or Nardil. I assume this to consumer demand, BEFORE the marketing of AD's went mainstream w/ the internet. My Parnate pre$cription has increased %50 in the last two years...

>
> Thanks, Seamus, for your patience. By the way, 5 pounds a year is no big deal - Nardil can add 5 pounds a month for me if I don't constantly deny my cravings and the feeling that I'm starving to death!

Thanks for the reassurance. Please remember my note re anorexia and the search for "easy calories".

JIm


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