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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by tygereyes on September 29, 2005, at 12:19:52
After having exhausted entire classes of medications (SSRIs/SSNRIs, anti-convulsants, tricyclics, atypical antipsychotics), I am moving into the world of MAOIs. Specifically, Parnate. My primary dx is borderline personality disorder, and I'm intrigued by the prospect of "reduced rejection sensitivity" as well as (obviously) reduced mood lability.
However, as someone who has spent years being warned about MAOIs (and as someone completely unfamiliar with their effects), I do have some questions.
1. What side effects have you experienced on Parnate? What are its effects on weight & appetite? (I'm in recovery from anorexia nervosa so this is a big concern for me.) Did you notice any effects on urinary output? (I have Interstitial Cystitis and most psych meds have an adverse effect on my bladder, many of them even causing enuresis.) Any cognitive impairment?
2. What dosage did you find to be the most effective and what symptoms were you specifically trying to medicate?
3. Drug-drug interactions: Is fish oil okay to take? How about anti-histamines like Benadryl and Vistaril? Any vitamins or minerals I should avoid?
4. What's with the rumor about Parnate being metabolized to amphetamine? How "abusable" is it? How high does the dose have to be before a noticable psychoactive effect is observed? (I'm a recovering drug addict and I have abused every drug under the sun, so the fact that abuse has been reported makes me VERY nervous.)
5. In Glaxo-Smith Klein's full prescribing information, it says that Parnate enhances the effects of serotonin, norephinephrine, and epinephrine. What about dopamine?!
(My remaining questions are about the MAOI diet; I was able to find the answers to many questions in the archives, but some of these remain unanswered.)
5. How MUCH caffeine is okay (both in one sitting AND throughout the day)? I generally drink about 6 cups of coffee a day (down from 12 to 14 cups a day!). Clearly, this presents a potential problem.
6. Peanut butter. I eat this about six times a day (specifically, peanut butter & co's white chocolate peanut butter). Again, if spread out over the day, is this amount okay, as long as I don't eat 6 tbsp in one sitting?
7. I also eat yogurt frequently. How far away from the expiration date is considered acceptable when it comes to yogurt?
8. I will only eat lite breads. Most lite breads have soy lechiten (spelling?), soy fiber, and soybeans as listed ingredients. Does this automatically blacklist them? Can you recommend any lite breads that are okay to eat?
9. I'm a vegetarian, and limiting yogurt/cheese and completely outlawing soy products (not to mention granola bars, which are a staple of my diet!) is a big problem, clearly. Can you recommend any good sources of vegetarian protein (besides eggs, which I will begin eating more often)?
10. Though I'm not recovered enough from anorexia (yet) to eat in restaurants, Indian food used to be my favorite food. Seeing as I have NO idea what is in most of the sauces of my favorite dishes (vegetarian vindaloo, spicy vegetable curry), can you tell me if Indian is okay to eat on a vegetarian diet?
Thanks SO much.
Posted by tygereyes on September 29, 2005, at 12:22:14
In reply to PARNATE questions!, posted by tygereyes on September 29, 2005, at 12:19:52
<< can you tell me if Indian is okay to eat on a vegetarian diet? >>
Oops ... I mean, on a MAOI diet.
Posted by fires on September 29, 2005, at 15:12:01
In reply to PARNATE questions!, posted by tygereyes on September 29, 2005, at 12:19:52
> 1. What side effects have you experienced on Parnate? What are its effects on weight & appetite? (I'm in recovery from anorexia nervosa so this is a big concern for me.) Did you notice any effects on urinary output? (I have Interstitial Cystitis and most psych meds have an adverse effect on my bladder, many of them even causing enuresis.) Any cognitive impairment?
Orthostatic hypotension is a major side effect of Parnate. It also gives many a "sweet tooth" which can cause weight gain.
> 2. What dosage did you find to be the most effective and what symptoms were you specifically trying to medicate?70 mg for Dep.
>
> 3. Drug-drug interactions: Is fish oil okay to take? How about anti-histamines like Benadryl and Vistaril? Any vitamins or minerals I should avoid?
>No antihistamines. I think fish oil and vits/mins are OK.
> 4. What's with the rumor about Parnate being metabolized to amphetamine? How "abusable" is it? How high does the dose have to be before a noticable psychoactive effect is observed? (I'm a recovering drug addict and I have abused every drug under the sun, so the fact that abuse has been reported makes me VERY nervous.)
My doc said 0 abuse potential and it is NOT metablolized to an amphetamine.
>
> 5. In Glaxo-Smith Klein's full prescribing information, it says that Parnate enhances the effects of serotonin, norephinephrine, and epinephrine. What about dopamine?!don't know.
>
> (My remaining questions are about the MAOI diet; I was able to find the answers to many questions in the archives, but some of these remain unanswered.)
>
> 5. How MUCH caffeine is okay (both in one sitting AND throughout the day)? I generally drink about 6 cups of coffee a day (down from 12 to 14 cups a day!). Clearly, this presents a potential problem.I suggest 0 coffee or 0 Parnate. I can't help much with the rest of your diet questions.
>
> 6. Peanut butter. I eat this about six times a day (specifically, peanut butter & co's white chocolate peanut butter). Again, if spread out over the day, is this amount okay, as long as I don't eat 6 tbsp in one sitting?
>
> 7. I also eat yogurt frequently. How far away from the expiration date is considered acceptable when it comes to yogurt?
>
> 8. I will only eat lite breads. Most lite breads have soy lechiten (spelling?), soy fiber, and soybeans as listed ingredients. Does this automatically blacklist them? Can you recommend any lite breads that are okay to eat?
>
> 9. I'm a vegetarian, and limiting yogurt/cheese and completely outlawing soy products (not to mention granola bars, which are a staple of my diet!) is a big problem, clearly. Can you recommend any good sources of vegetarian protein (besides eggs, which I will begin eating more often)?
>
> 10. Though I'm not recovered enough from anorexia (yet) to eat in restaurants, Indian food used to be my favorite food. Seeing as I have NO idea what is in most of the sauces of my favorite dishes (vegetarian vindaloo, spicy vegetable curry), can you tell me if Indian is okay to eat on a vegetarian diet?
>
> Thanks SO much.
Posted by linkadge on September 29, 2005, at 16:03:09
In reply to Re: PARNATE questions! » tygereyes, posted by fires on September 29, 2005, at 15:12:01
I eat little and ate much less on parnate, you may want to try nardil instead.
Parnate can be stimulating.
Unfortunately I never experienced reduced rejection sensitivity on parnate. I cared more about what people thought on parnate than I did on the SSRIs.
Linkadge
Posted by djmmm on September 29, 2005, at 17:30:44
In reply to PARNATE questions!, posted by tygereyes on September 29, 2005, at 12:19:52
> After having exhausted entire classes of medications (SSRIs/SSNRIs, anti-convulsants, tricyclics, atypical antipsychotics), I am moving into the world of MAOIs. Specifically, Parnate. My primary dx is borderline personality disorder, and I'm intrigued by the prospect of "reduced rejection sensitivity" as well as (obviously) reduced mood lability.
>
> However, as someone who has spent years being warned about MAOIs (and as someone completely unfamiliar with their effects), I do have some questions.
>
> 1. What side effects have you experienced on Parnate? What are its effects on weight & appetite? (I'm in recovery from anorexia nervosa so this is a big concern for me.) Did you notice any effects on urinary output? (I have Interstitial Cystitis and most psych meds have an adverse effect on my bladder, many of them even causing enuresis.) Any cognitive impairment?--my side effects have been minimal, insomnia, weight loss, anorexia... Parnate is probably not the medication you want to be on if you have had an eating disorder. I have not experienced any urinary retention, etc.
>
> 2. What dosage did you find to be the most effective and what symptoms were you specifically trying to medicate?-- 40-50mg, I use Parnate for Social Phobia and depression
>
> 3. Drug-drug interactions: Is fish oil okay to take? How about anti-histamines like Benadryl and Vistaril? Any vitamins or minerals I should avoid?There are many potential drug interactions, I have never had an adverse reaction. I have used (over the years) fish oil, benadryl, albuterol, pseudofed, klonopin, hydrocodone, alcohol, various antibiotics, and every amino acid...never had a problem. Everyone reacts differently, however.
>
> 4. What's with the rumor about Parnate being metabolized to amphetamine? How "abusable" is it? How high does the dose have to be before a noticable psychoactive effect is observed? (I'm a recovering drug addict and I have abused every drug under the sun, so the fact that abuse has been reported makes me VERY nervous.)--There is some posibility that Parnate is metabolized into amphetamine, but I believe this has only been seen at very high doses (overdose). I can't imagine anyone "abusing" Parnate, however, when I hear of some people "needing" 140, 160mg, etc. It certainly makes me wonder. The drug is stimulating, and I believe it is contraindicated in patients with a history of drug abuse.
>
> 5. In Glaxo-Smith Klein's full prescribing information, it says that Parnate enhances the effects of serotonin, norephinephrine, and epinephrine. What about dopamine?!--Dopamine, norepinephrine, and epinephrine are all intimately connected
http://www.pharmacorama.com/en/Sections/images/Catecholamines_3_clip_image002.gifParnate increases dopamine via full MAO-B inhibition
>
> (My remaining questions are about the MAOI diet; I was able to find the answers to many questions in the archives, but some of these remain unanswered.)
>
> 5. How MUCH caffeine is okay (both in one sitting AND throughout the day)? I generally drink about 6 cups of coffee a day (down from 12 to 14 cups a day!). Clearly, this presents a potential problem.-- the amount of caffeine you are able to consume is highly individual...I would imagine you would find it very difficult to sleep combining that much coffee with parnate
>
> 6. Peanut butter. I eat this about six times a day (specifically, peanut butter & co's white chocolate peanut butter). Again, if spread out over the day, is this amount okay, as long as I don't eat 6 tbsp in one sitting?-- Peanut butter is fine.
>
> 7. I also eat yogurt frequently. How far away from the expiration date is considered acceptable when it comes to yogurt?-- as far as yogurt, I have no Idea. I don't eat milk products. Generally, you should be cautious of anything "aged" or fermented, again, it depends on the person (I drink beer, and don't have a problem)
>
> 8. I will only eat lite breads. Most lite breads have soy lechiten (spelling?), soy fiber, and soybeans as listed ingredients. Does this automatically blacklist them? Can you recommend any lite breads that are okay to eat?-- The only bread I have heard about being contraindicated is sourdough--although, I eat it all the time, and have never heard of any adverse reaction to bread. I have had soy milk, and other soy products without incident.
>
> 9. I'm a vegetarian, and limiting yogurt/cheese and completely outlawing soy products (not to mention granola bars, which are a staple of my diet!) is a big problem, clearly. Can you recommend any good sources of vegetarian protein (besides eggs, which I will begin eating more often)?-- to be honest, I dont beieve you will have a problem with the type of food you eat. I think the fact that you were anorexic is far more of a concern, since Parnate tends to cause loss of appetite and weight loss. Also, those with eating disorders tend to have a lower seizure threshold. Parnate may increase you risk of having a seizure.
>
> 10. Though I'm not recovered enough from anorexia (yet) to eat in restaurants, Indian food used to be my favorite food. Seeing as I have NO idea what is in most of the sauces of my favorite dishes (vegetarian vindaloo, spicy vegetable curry), can you tell me if Indian is okay to eat on a vegetarian diet?
>
> Thanks SO much.-- Have you considered Nardil?
Posted by fires on September 29, 2005, at 18:07:39
In reply to Re: PARNATE questions!, posted by djmmm on September 29, 2005, at 17:30:44
> --There is some posibility that Parnate is metabolized into amphetamine, but I believe this has only been seen at very high doses (overdose).
I disagree. I don't believe that Parnate can be metabolized into amphetamine -- you can't get blood from a turnip. (I'm willing to bet that someone will say that it is metabolized into an amphetamine like substance -- whatever that is).
Posted by djmmm on September 29, 2005, at 19:03:17
In reply to Re: PARNATE questions! » djmmm, posted by fires on September 29, 2005, at 18:07:39
> > --There is some posibility that Parnate is metabolized into amphetamine, but I believe this has only been seen at very high doses (overdose).
>
> I disagree. I don't believe that Parnate can be metabolized into amphetamine -- you can't get blood from a turnip. (I'm willing to bet that someone will say that it is metabolized into an amphetamine like substance -- whatever that is).Well, I has been documented, in an overdose, as I stated.
Posted by fires on September 29, 2005, at 19:31:11
In reply to Re: PARNATE questions!, posted by djmmm on September 29, 2005, at 19:03:17
> > > --There is some posibility that Parnate is metabolized into amphetamine, but I believe this has only been seen at very high doses (overdose).
> >
> > I disagree. I don't believe that Parnate can be metabolized into amphetamine -- you can't get blood from a turnip. (I'm willing to bet that someone will say that it is metabolized into an amphetamine like substance -- whatever that is).
>
> Well, I has been documented, in an overdose, as I stated.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9153786&query_hl=2
"The urine was positive for methamphetamine which has been a suspected metabolite.""Suspected" seems to be the key word.
Also, support for no amphetamine metabolites in usual doses:
http://www.biopsychiatry.com/tranylcypromine.html
Posted by tygereyes on September 29, 2005, at 22:02:21
In reply to Re: PARNATE questions!, posted by djmmm on September 29, 2005, at 17:30:44
Thank you SO much for your answers to my questions.
<< -- Have you considered Nardil? >>
Truthfully, I am far more concerned about weight gain than weight loss.
Posted by Jedi on October 1, 2005, at 4:38:31
In reply to PARNATE questions!, posted by tygereyes on September 29, 2005, at 12:19:52
>
> 5. How MUCH caffeine is okay (both in one sitting AND throughout the day)? I generally drink about 6 cups of coffee a day (down from 12 to 14 cups a day!). Clearly, this presents a potential problem.Hi,
Unless you really like to feel buzzed, you probably won't be able to drink much coffee on Parnate. During my Parnate trial I found it difficult to drink a single cup of coffee. On Nardil, I drink as much as I wan't, and use it as a mild stimulant.
Good luck with your trial. I wish Parnate would have worked for me.
Take care,
Jedi
This is the end of the thread.
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