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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by mmcasey on June 9, 2003, at 19:42:57
I saw my psychiatrist today and he prescibed Parnate. It's something we've discussed before, but I don't feel totally like I need to try it right away or anything. I've been on Lamictal for 5 weeks (I'm now up to 150mg) and I haven't noticed a huge difference in how I feel, but maybe slight - I seem to feel a bit calmer and less agitated. Not really less depressed though. Anyways, in some ways I want to wait and see with Lamictal to see if it will do more with an increased dose and more time by itself.... I also figure, hey what the hell, might as well start something else.
Anyways, the point is that I'm wondering about people's experiences with Parnate. And side effects, and the whole diet restriction thing.
Thanks. MMC
Posted by maxime on June 9, 2003, at 21:12:41
In reply to new to Parnate, posted by mmcasey on June 9, 2003, at 19:42:57
Hi there. IMHO you have been prescribed one of the best anti-depressants!
I am treatment-resistent bipolar 2 and have been on EVERY SSRI and several tricyclics. Parnate is the first med that has given me relief from the black hole of depression.
I take 80mgs of Parnate.
Every one is different of course, but the one side effects that most people experience is insomnia. Many people on Parnate take Trazadone at night to help them sleep.
Everytime I increased my dosage I experienced some nausea and dizziness, but that went away after 2 or 3 days. I also experienced extreme fatigue from the med even though it was causing insomnia. Unfortunately the fatigue stayed with me until I had been on the 80mgs for about 3 weeks or so.
The diet restriction have been the easy part for me because I am vegan. I have eaten some of the "no-no's" in moderation with no problems.
There are a few things to remember when you look online for tyramine
lists. First, any information before 1996 is old and mostly outdated.
They re-did many of the tests and found there are many more things we
can eat safely. Second, the generally acceptable levels are 1-4mg of
tyramine per serving, 4-6 can be dangerous, and over 6 should be
avoided.The main things to watch out for are aged items and things that can
contain molds. So, for example, draft beer is dangerous as some of the
hoses used to pour can contain mold spores (not worth the risk).
Bottled beer, from professional companies (not your friends), are safe.
Aged cheeses (like cheddar, Swiss, blue cheese, etc.) are not safe,
while "fresh" cheeses, like mozzarella, cream cheese, cottage cheese,
gruyere, muenster, feta, brie with rind removed, etc., are just fine.
Keep in mind, pizza is fine with mozzarella and parmesan, but not if
it's a mixed cheese as some are (like the Godfather's chain).Here is the best site:
http://www.vh.org/adult/provider/psychiatry/CPS/19.html
It is a definitive list of foods and their actual levels. Look down several pages and you'll see several lists of foods.
I hope that Parnate works for you. I call it the wonder drug! I had so many PDOCS tell me that I was going to have to live with depression and that I couldn't be helped.
And if the Parnate doesn't work, there are other MAOIs to try.
Keep us posted OK? I am a firm believer that MAOIs need some serious PR campaigns!! LOL!
Maxime
Posted by Questionmark on June 10, 2003, at 0:59:29
In reply to new to Parnate, posted by mmcasey on June 9, 2003, at 19:42:57
Parnate has potent antidepressant effects. i'm only on 20mg (about a month) and feel significantly less depressed-- i think. i really don't like some of its other psychological effects and side effects, but (that's just me and) the in-the-present antidepressive effects are pretty powerful. i highly recommend if not concerned with OC or anxiety problems-- and maybe even then.
The diet can't be fudged with much on Parnate-- esp w/ the absolute no-nos. It's not tOO bad, but the aged cheese avoidance can really be a b**ch-- esp when going out to eat. i miss tap beer, too. Other than that the diet is a sinch (sp?).
My side effects: sevERE insomnia (common), blood pressure fluctuations (seem to be diminishing), afternoon fatigue (common, and a real pain), agitation/irritability, increased anxiety (decreasing but still evident), increased obsessive-compulsiveness. i think that's it.
Posted by cubbybear on June 10, 2003, at 5:04:27
In reply to new to Parnate, posted by mmcasey on June 9, 2003, at 19:42:57
You probably don't know how lucky you are to have a pdoc who evidently prescribed this drug without having been begged for it. For the past 18 years, it has been my salvation. I tried some of the newer ADs such as Remeron (which quit on me after 6 months) and Zoloft (which I disliked for a number of reasons), and even Aurorix, which is an MAOI that you can't obtain in the U.S. and I wound up in the depths of depression--only to return to Parnate, which is like a miracle drug.
I'm a bit unlike most people in that I experience INCREASED appetite and weight.while on Parnate, however that was important to me since I was starting to look like a scarecrow from not eating.
My side effects have always been: low pressure and lightheatedness at the beginning, decreased need for sleep, and dry mouth at the beginning.
To counteract the sleep difficulty, I've paired up the Parnate with Klonopin.
I don't mind sacrificing enjoyment of certain foods and I can get by without cold and cough medicines if I get a cold. The only time I've run into a problem is at the dentist, where you need to request pain injections WITHOUT EPINEPHRINE, and in my opinion, those injections do little if anything to ease the pain of dental work.
If you do your homework and feel you can handle these restrictions, I don't think you'll ever regret taking Parnate, because it can blow the worst depression clear out the window.
Posted by indivmed on June 10, 2003, at 9:31:57
In reply to Re: new to Parnate » mmcasey, posted by cubbybear on June 10, 2003, at 5:04:27
I agree with the others in that you are very lucky to have your pdoc prescribe parnate. I myself had to beg for it and even then I had to kind of *prove* myself and my knowledge of the drug, it's side effects, and really push the amount of research I had done on it--it was like I was giving a presentation to my pdoc on why it is time to finally try an MAOI (I don't know, maybe because none of the other f***ing meds work? As you can see, one thing Parnate has not done is helped with my bitter, sarcastic humor...then again, mental illness tends to prime one for such an outlook) But honestly, I have been on everything...and this goes way beyond just anti-depressants and combinations of drugs.
I would say Parnate has really jerked my ass out of depression quick--moreso than anything else I have taken--I've had a lot of symptoms disappear--no body dysmorphia, a general sense of confidence, not beating myself up constantly for past failures, and actually getting up before 3 pm (actually getting up at 6 am--i don't know what that's all about).
I will say that I had a significant amount of lethargy the first couple of days and seem to be hypertensive at times (and I'm 25) but that is going away over time--as is the lethargy. And be careful with the whole tyramine deal--I accidentally ate some cured turkey yesterday and my pulse raced and I could actually feel the blood against my arterial walls! But I'll take an episode here and there for the benefits...god knows the other drugs were awful with side effects.
Good luck to you. And I wouldn't hesitate another day--I'd be popping that Parnate like Pez.
Rick
Posted by mmcasey on June 10, 2003, at 10:10:05
In reply to Re: new to Parnate » mmcasey, posted by indivmed on June 10, 2003, at 9:31:57
Posted by maxime on June 10, 2003, at 11:06:33
In reply to how long does it take to kick in? (nm), posted by mmcasey on June 10, 2003, at 10:10:05
I felt a positive effect after 4 days. I felt like I had more energy. With every increase I felt better. The depression was the last thing to go though. While I was still increasing my dose I was still severely depressed but my concentration had improved 100 percent as did my thought process. I called it the Mary Poppins effect! You know in the movie where she is cleaning up the children's room and everything is flying into its proper place? That is what it felt like my brain was doing. Thoughts becoming organised!
For me the most tell tale sign that something is working is when people tell me that they have noticed a change in me. That my tone of voice becomes lighter and more lyrical.
You should keep a mood journal while you are Parnate! I find them to be helpful both in writing them and later reading them.
I hope you feel a positive effect soon.
Max
Posted by mmcasey on June 10, 2003, at 11:25:53
In reply to Re: how long does it take to kick in?, posted by maxime on June 10, 2003, at 11:06:33
Thanks for everyone's input.
What about...
yogurt, sour cream, mayonaise, canned tuna, bottled beer and malt liquors??That's all I can think of now - the lists seem kind of confusing about certain items.
Posted by denise528 on June 10, 2003, at 11:51:26
In reply to Re: Parnate, posted by Questionmark on June 10, 2003, at 0:59:29
Hi,
I tried Nardil and didn't like it, it didn't lift my depression. I was wondering if any of you had tried both Nardil and Parnate and how they compare.
Denise
Posted by MelD on June 10, 2003, at 19:36:02
In reply to food questions, posted by mmcasey on June 10, 2003, at 11:25:53
> All of the things you mentioned are no problem, as long as they are fresh. Anything you think might be getting old should be avoided. I just want to add that, like the others, Parnate worked to knock out my depression like nothing else has, and i have tried many, many meds over the years.
Thanks for everyone's input.
>
> What about...
> yogurt, sour cream, mayonaise, canned tuna, bottled beer and malt liquors??
>
> That's all I can think of now - the lists seem kind of confusing about certain items.
Posted by cubbybear on June 10, 2003, at 21:02:41
In reply to how long does it take to kick in? (nm), posted by mmcasey on June 10, 2003, at 10:10:05
Always remember that everyone's different, and the general rule of thumb is that every AD should be given 4-6 weeks. But for me, I discovered that Parnate took about one month to kick in when I went back on it several years ago. Later I stopped taking it, then resumed taking it this year and it took only 3 weeks this time. That's my experience. It seems to kick in faster than all the other stuff I tried.
Posted by cubbybear on June 10, 2003, at 21:10:50
In reply to new to Parnate, posted by mmcasey on June 9, 2003, at 19:42:57
Dear MM,
Since you were able to get a doctor who's a believer in Parnate, can you tell us where you live? If in the L.A. Cal. area, what is the doctor's name and locaiton, etc.? I will be returning to the U.S. later this year and will need to find a pdoc who will readily prescribe it without a struggle.
Posted by lr on June 10, 2003, at 22:19:07
In reply to Re: new to Parnate, posted by maxime on June 9, 2003, at 21:12:41
you have been prescribed one of the best anti-depressants!
I SECOND THISCOMPLETELY.
> I take 80mgs of Parnate.
i TAKE 110 MGS.
> Every one is different of course, but the one side effects that most people experience is insomnia. Many people on Parnate take Trazadone at night to help them sleep.
>
SO DO I
> The diet restriction . . . any information before 1996 is old and mostly outdated.
> The main things to watch out for are aged items and things that can
> contain molds.WHICH ARE ABOUT ALL I AVOID. FOR 7 YRS, NO PROBLEM.
> I am a firm believer that MAOIs need some serious PR campaigns!> Maxime
I SECOND MAXIME 100%, GOOD LUCK.
Posted by cybercafe on June 11, 2003, at 2:37:12
In reply to Re: how long does it take to kick in? » mmcasey, posted by cubbybear on June 10, 2003, at 21:02:41
> Always remember that everyone's different, and the general rule of thumb is that every AD should be given 4-6 weeks. But for me, I discovered that Parnate took about one month to kick in when I went back on it several years ago. Later I stopped taking it, then resumed taking it this year and it took only 3 weeks this time. That's my experience. It seems to kick in faster than all the other stuff I tried.
i think the stimulant effects kick in right away... then they die out... then the MAOI antidepressant effects kick in
Posted by mmcasey on June 11, 2003, at 9:21:52
In reply to Re: how long does it take to kick in? » mmcasey, posted by cybercafe on June 11, 2003, at 2:37:12
Posted by cubbybear on June 11, 2003, at 9:44:36
In reply to Is caffeine/coffee okay? (nm), posted by mmcasey on June 11, 2003, at 9:21:52
It's not one of those "forbidden foods" which could create a harmful reaction, but since many people complain about insomnia from Parnate, and caffeine is a stimulant, I would consider it foolish to ingest caffeine any time past the afternoon if you develop an insomnia problem. Excessive amounts of caffeine are not recommended in any case. I'm not much of a coffee lover, so I can settle for the decaffeinated stuff. What's more important to me is a good donut..
Posted by mmcasey on June 11, 2003, at 11:34:36
In reply to Re: new to Parnate » mmcasey, posted by cubbybear on June 10, 2003, at 21:10:50
Well, I live in North Carolina, so unless you are planning to come over this way, unfortunately I don't think he'll be able to prescribe it for you.
This is the end of the thread.
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