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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by H.Upmann on August 14, 2006, at 19:49:15
It's extrodinarily frustrating the lack of expertise on these meds. Is there any authority you can point me to in order to answer a couple of questions. I understand that I need to take responsibility for myself and my decision to use this med (under a docs supervision), but honestly I can't find a doc or pharmacist who doesn't simply regurgitate old info on these drugs. I know they are ancient, but SOMEONE has to be studying them. Can someone point me to a good POC for these meds. I have a couple of questions nobody can answer. Thanks. Upmann
Posted by jedi on August 15, 2006, at 4:03:39
In reply to Are there any MAOI experts??!!??, posted by H.Upmann on August 14, 2006, at 19:49:15
> It's extrodinarily frustrating the lack of expertise on these meds. Is there any authority you can point me to in order to answer a couple of questions. I understand that I need to take responsibility for myself and my decision to use this med (under a docs supervision), but honestly I can't find a doc or pharmacist who doesn't simply regurgitate old info on these drugs. I know they are ancient, but SOMEONE has to be studying them. Can someone point me to a good POC for these meds. I have a couple of questions nobody can answer. Thanks. Upmann
Hi Upmann,
I don't have the name of a good PDOC for MAOIs. Here is a link that will point you to a lot of studies by researchers in the field. Some of it is dated, but like you said...
Jedi(Its a long link, hope it works.)
Link: Google Advanced Search
http://www.google.com/search?as_q=maoi&num=10&hl=en&btnG=Google+Search&as_epq=&as_oq=liebowitz+quitkin+stewart+rabkin+harrison+McGrath+Wager+Markowitz+Tricamo&as_eq=&lr=&as_ft=i&as_filetype=&as_qdr=all&as_nlo=&as_nhi=&as_occt=any&as_dt=i&as_sitesearch=&as_rights=&safe=images
Posted by H. Upmann on August 15, 2006, at 14:11:39
In reply to Re: Are there any MAOI experts??!!?? » H.Upmann, posted by jedi on August 15, 2006, at 4:03:39
Thanks Jedi,
You've been most helpful. I can't remember, but I think it was you who said you had a good doc when it came to MAOI's. Did you ever get a chance to ask him if smoking cigars (not inhaling or eating of course) would be a problem on an MAO. No pharmacist or doc has an answer for this one, and I don't want to find out the hard way. Cigars typically contain aged and fermented tobacco. I don't know if there would be any appreciable amount of tyramine that you could actually get into your system by smoking. Let me know if you get a chance. Thanks bro. Upmann
Posted by kimcrazylady on August 17, 2006, at 11:50:29
In reply to Re: Are there any MAOI experts??!!??, posted by H. Upmann on August 15, 2006, at 14:11:39
I'm no expert, but I've been on and off Parnate my whole life. I can tell you my experiences, and some things a friend experienced, but that's it.
I've had a few folks write to me and chat about things. Feel free to do the same.
Kim
Posted by H. Upmann on August 18, 2006, at 10:22:31
In reply to Re: Are there any MAOI experts??!!??, posted by kimcrazylady on August 17, 2006, at 11:50:29
Thanks again Kim.
Posted by markowitz on September 15, 2007, at 19:16:29
In reply to Are there any MAOI experts??!!??, posted by H.Upmann on August 14, 2006, at 19:49:15
My doctor, John Markowitz, is outstanding and has been treating me with Nardil for years.
Posted by Lebrada on September 16, 2007, at 8:39:08
In reply to Re: Are there any MAOI experts??!!??, posted by kimcrazylady on August 17, 2006, at 11:50:29
> I'm no expert, but I've been on and off Parnate my whole life. I can tell you my experiences, and some things a friend experienced, but that's it.
>
> I've had a few folks write to me and chat about things. Feel free to do the same.
>
> KimHi (would appreciate any help/feedback re real world experience with PARNATE & or NADIL) Cheers.
Been on and off NARDIL for a few years...tried Buspar, SSRIs and Benzos - I've felt worse while on those medications than when off.
BUT...
I find after 4 or so months on this medication/NARDIL that it starts to loose a great deal of its effectiveness (otherwise it's an absolute 'miracle drug' re SAD, GAD and Dysthymia).
Q. Does Parnates effects compare (re Genaralized Socail Anxiety in particular)?
Q. Does Parnates anti-anxiety effects drop away like Nardils does?
Q. How does Parnate affect memory, concentration, sleep, sexual function etc??
Q. Can you/do you augment Parnate with any other medication too improve it's effectiveness?
Q. Does it require any adherance to a special diet? (I never have while on 90mg NARDIL - with never a problem)
Q. Why did you opt for/end up on Parnate as opposed to Nardil?
P.S. I get Viagra via India at 50c a day - dysfunction no-longer a side-effect but more of a pro-effect as I can go for hours on end...(if that's of any help for anyone)
Posted by psychobot5000 on September 18, 2007, at 10:41:46
In reply to Re: Are there any MAOI experts??!!??, posted by Lebrada on September 16, 2007, at 8:39:08
I'll take a shot at trying to answer your questions. I have experience with Nardil and Parnate, but every individual's is different. I don't think the result you might get with one drug versus the other is very predictable. Nevertheless, some experiences are more likely with one than the other.
> Hi (would appreciate any help/feedback re real world experience with PARNATE & or NADIL) Cheers.
>drug' re SAD, GAD and Dysthymia).
>
> Q. Does Parnates effects compare (re Genaralized Socail Anxiety in particular)?Some few people seem to feel that Parnate is better for anxiety than Nardil - just their reaction to it. Nevertheless, Nardil is generally considered the better drug for GAD or social anxiety. Parnate is also more likely to cause anxiety.
>
> Q. Does Parnates anti-anxiety effects drop away like Nardils does?I never got an anti-anxiety effect from Parnate in the first place, so it's hard for me to say.
>
> Q. How does Parnate affect memory, concentration, sleep, sexual function etc??
>Parnate has stimulant qualities in additon to being an MAOi, so that tends to help compensate for those problems. It is probably less bad for concentration, memory, sex, etc. However, it may be worse for sleep than the other MAOis (all MAOis suppress REM, as far as I know).
> Q. Can you/do you augment Parnate with any other medication too improve it's effectiveness?
This is a subject of controversy - try searching the archives. The official (medical liability oriented) response is that you basically can't mix them with any other antidepressant. But the sources I trust say you can augment Parnate or other MAOis with modafinil/Provigil, tricyclics other-than clomipramine and imipramine, and stimulants, as long as you start the dose low, raise them slowly, and observe heartrate and blood-pressure carefully.
> Q. Does it require any adherance to a special diet? (I never have while on 90mg NARDIL - with never a problem)
The diet issues are unpredictable. That said, Parnate is considerably more dangerous in that way than any of the other MAOis. It causes a much higher rate of hyper-tensive crisis. Personally, I would stick to the diet if taking Parnate, even if you haven't had trouble with the others.
>
> Q. Why did you opt for/end up on Parnate as opposed to Nardil?
>
Nardil made my head all fuzzy (mental fog - not a common side-effect, but one I experienced). Parnate does less of that, though it's a problem on both meds. But otherwise, Parnate seems to be more energizing, which I prefer. Nardil made me sluggish.Hope that's helpful!
Posted by sadone on September 21, 2007, at 1:40:34
In reply to Re: Are there any MAOI experts??!!??, posted by psychobot5000 on September 18, 2007, at 10:41:46
I am just about to start parnate - after I wean off Effexor - any feedback on Parnate and its side effects would be great - concerned about weight gain
Posted by Jedi on September 21, 2007, at 11:39:19
In reply to Re: Are there any MAOI experts??!!??, posted by sadone on September 21, 2007, at 1:40:34
> I am just about to start parnate - after I wean off Effexor - any feedback on Parnate and its side effects would be great - concerned about weight gain
Hi Sadone,
Weight gain on Parnate is not nearly as bad as on Nardil. In fact I lost weight on Parnate. It was working for me somewhat but I had a spontaneous hypertensive reaction, so I had to go back to Nardil. Hypertensive problems seem to be more common on Parnate, so watch your blood pressure. Parnate does not seem to work as well on social phobia as Nardil, probably because of the effect on GABA of Nardil. While on Parnate I had to increase my clonazepam dosage from 1mg to 2mg. Again, probably because of GABA. Clonazepam effects the GABA receptors also.
Good Luck,
Jedi
Posted by Enigma on September 22, 2007, at 6:45:57
In reply to Are there any MAOI experts??!!??, posted by H.Upmann on August 14, 2006, at 19:49:15
> It's extrodinarily frustrating the lack of expertise on these meds. Is there any authority you can point me to in order to answer a couple of questions. I understand that I need to take responsibility for myself and my decision to use this med (under a docs supervision), but honestly I can't find a doc or pharmacist who doesn't simply regurgitate old info on these drugs. I know they are ancient, but SOMEONE has to be studying them. Can someone point me to a good POC for these meds. I have a couple of questions nobody can answer. Thanks. Upmann
I agree. I'm frustrated (and I'm being nice) by pdocs in general. I do all the drug research, and many times I find myself telling THEM what drugs to try next.
Even though the MAOI info might be dated, that's no cause for alarm, as these drugs are dated. The info isn't new, as not much has changed with these meds in many years, to my knowledge anyway (minus Emsam maybe - but all that changed there was the delivery mechanism).
Not sure about other locales, but in the U.S., fear of lawsuits I believe, keeps MAOI's "down", even though they are the only drug that works on certain peoples' depression.
Rant: I used to be a software engineer, before my depression buried my career. Anyway, when an engineer didn't know something, even something outside of software engineering (but say, pertaining to the subject matter of the problem we were trying to solve), we had no choice but to go research and learn what we didn't know. It was an ongoing affair.. constant research, constant learning, keeping up on emerging technologies, etc. All of us had a bevy of books at our disposal, let alone web resources.
pdocs on the other hand, out of all of 7-10 I've seen over the years never did a drop of research on <anything>. I know that for a fact, as I'd ask again (and again), at my next visit, about a drug (or other treatment) to see if the doc looked into any drugs they were unfamiliar with, and side-effect. Nope, nada, 0. It took 3 visits to finally get one doc off his duff and make a simple 5 min phone call to a pharmacist, to see if a Selegiline was still available in tablet form...and THAT took arm-twisting (as he seemed convinced the drug was no longer available).
Don't docs WANT to do a better job? Especially to help their patients? I haven't found any that will work on your "case" if it falls outside of the measly 20 min appt time.
If I knew what a cushy job being a pdoc was, I would have steered clear of Software and gone for my Phd. Although, I'd STILL do research when I could better myself as a doctor, and that translates to being more helpful to my patients.
End rant.
Posted by rina on September 22, 2007, at 12:56:36
In reply to Re: Are there any MAOI experts??!!??, posted by Enigma on September 22, 2007, at 6:45:57
Rasagiline (Azilect) belongs to a class of drugs called monoamine oxidase (MAO) inhibitors. These drugs slow the breakdown of dopamine that occurs naturally in the brain and dopamine produced from levodopa. This one has been getting a bit of attention lately.
Posted by elanor roosevelt on September 22, 2007, at 21:38:33
In reply to Re: Are there any MAOI experts??!!?? » sadone, posted by Jedi on September 21, 2007, at 11:39:19
I lost weight on Parnate.
It was not a success in the end but I have kept off 10 of the 15 pounds I lost. And it wasn't just being concerned about my diet. It made me "able" to lose some of my med weight gain.
good luck> > I am just about to start parnate - after I wean off Effexor - any feedback on Parnate and its side effects would be great - concerned about weight gain
>
> Hi Sadone,
> Weight gain on Parnate is not nearly as bad as on Nardil. In fact I lost weight on Parnate. It was working for me somewhat but I had a spontaneous hypertensive reaction, so I had to go back to Nardil. Hypertensive problems seem to be more common on Parnate, so watch your blood pressure. Parnate does not seem to work as well on social phobia as Nardil, probably because of the effect on GABA of Nardil. While on Parnate I had to increase my clonazepam dosage from 1mg to 2mg. Again, probably because of GABA. Clonazepam effects the GABA receptors also.
> Good Luck,
> Jedi
>
Posted by reese7194 on September 26, 2007, at 0:03:44
In reply to Re: Are there any MAOI experts??!!??, posted by elanor roosevelt on September 22, 2007, at 21:38:33
i wish i could tell you something brilliant. i went on nardil a long time ago and parnate as well. the only thing i can tell you is that it really seems to effect each person differently. i would say as much or more so than the rest of the club of "anti-depressants"
i've been lucky with weight. except with zyprexa and seroquel. zyprexa was hell.
i'm on emsam now. wow. isn't that fascinating.
hope it goes okay
This is the end of the thread.
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