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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5 to 29 of 29. Go back in thread:
Posted by shasling on February 4, 2009, at 13:49:24
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by Phillipa on February 4, 2009, at 10:09:18
> I didn't know the MAOI's pooped out. What besides another med can you do about it? And then what meds do you go back to SSRI's or Snri's . Seriously don't know. Phillipa
Dont take this as a insult,i only am posting this because i seen a fellow babbler b-ocked in a previous thread in which i personaly felt was infair.Phillipa,i am confused why you are concerned with maois when you are not on one,and from your own mentioning dont plan to be on one?
Anyone sticking to the thread,i actualy saw a small study that used Nardil treatment prior to parnate to add to parnate im guessing a gabaergic affect.
Judging from that study,the results were fair,and you can imagine how there was no washout period.Parnate is actualy considered by some to be reversable opposed to irrevsable as noted.
I will find the link and post it if interest pervails.
I also find im augmenting Parnate due to what i guess is POOP OUR.A pharmicist who was filling in,an older gentleman once told me this when asking him why im taking more Parnate,
"your getting older,but the disease isnt,maois build a structure but if the chemicals arent there maois wont matter so taking more wont help"
What i got from that is maois have to be augmented after time with something to provide the chemicals for it to work better?
Posted by myco on February 4, 2009, at 14:26:38
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by shasling on February 4, 2009, at 13:49:24
> I also find im augmenting Parnate due to what i guess is POOP OUR.
Hey,How is the augmentation going shasling? What are you augmenting with? Why did you choose or how did you choose your augment med(s)? I'm on nardil and considering augmenting for improved AD response.
thnx
Posted by Jeroen on February 4, 2009, at 16:32:46
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by SLS on February 4, 2009, at 8:09:23
Seroquel Life saver ,pooped out on me too
my life is very poor health now, no way of getting better anymore
Posted by Jeroen on February 4, 2009, at 16:39:27
In reply to Seroquel Life saver ,pooped out on me too, posted by Jeroen on February 4, 2009, at 16:32:46
Schizophrenia - age 14 , suddenly from happy to nightmare world
Treatment started on risperidone on age 16, no effect
few years later, hospitalized and put on Zyprexa, NO EFFECT
few years later GEODON --> TARDIVE DYSKINESIA
5 years of depression, schizophrenia because of that, not getting a bit better
Lamictal Induced Psychosis - Severe psychosis
Currently, Schizophrenia, Psychosis, Tardive Dyskinesia, Pannick Disorder, Anxiety
some other things too propably
how sad .... when i came to this board by google i wanted to get better and not this ....
Posted by FrequentFryer on February 4, 2009, at 16:42:01
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by Phillipa on February 4, 2009, at 10:09:18
I have taken Nardil about 7 different times and after a month or two of the onset of action it dissipitates to the point where its not worth the side effects. But I have a strong tollerance to all chems it might probably last longer for you, then a dosage increase might make it last longer still hell I dunno maybe it wouldn't poop out on ya. I think the trick is with poop out is getting a good life going before she poops out. But my life is so messed up it takes me a bit longer then 1.5 months to get everything going, ie. Job place to live, a women.
Posted by FrequentFryer on February 4, 2009, at 16:51:10
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » FrequentFryer, posted by myco on February 4, 2009, at 11:18:28
I have taken Nardil about 7 different times and after a month or two of the onset of action it dissipitates to the point where its not worth the side effects. But I have a strong tollerance to all chems I usually take 90 mg but then I cant sh*t, sleep or get it up, I was thinking of taking 60mg this time then raising it to 105 when it poops out but I think cycling MAOIS might be a better option aslong as my BP stays within the limits.
What happens with yourself?
Is it at full swing after about a month then poops out at around 2 months then when dose it get better again?Also at about 3 months when its pooped the side effects subside for me so I could try raising the dose then, but then I reckon it will poop again after a month.
Posted by FrequentFryer on February 4, 2009, at 16:54:00
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by shasling on February 4, 2009, at 13:49:24
Yeah I agree I dont think keeping on increasing the dose will help much.
Posted by FrequentFryer on February 4, 2009, at 16:57:11
In reply to My Disorders, not getting better ..., posted by Jeroen on February 4, 2009, at 16:39:27
Sorry not sure how to help ya man..
have you tried a good antidepressant with lithium or abilify?
Posted by SLS on February 4, 2009, at 16:59:29
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » myco, posted by FrequentFryer on February 4, 2009, at 16:51:10
> Also at about 3 months when its pooped the side effects subside for me so I could try raising the dose then, but then I reckon it will poop again after a month.
Would you consider adding a TCA - either desipramine or nortriptyline? If it works, it probably won't poop-out. I recommend desipramine. It is more energizing and is less serotonergic. You might as well get more aggressive at this point.
I am currently on schedule for remission using a combination of Parnate + desipramine.
Currently:
Parnate 80mg
desipramine 200mg (to be increased)
Lamictal 200mg
Abilify 20mg
- Scott
Posted by myco on February 4, 2009, at 18:24:08
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » FrequentFryer, posted by SLS on February 4, 2009, at 16:59:29
> Would you consider adding a TCA - either desipramine or nortriptyline? If it works, it probably won't poop-out. I recommend desipramine. It is more energizing and is less serotonergic. You might as well get more aggressive at this point. Trying to get addition of tca by gp may be an issue but worth a shot.
>
> I am currently on schedule for remission using a combination of Parnate + desipramine.
>
> Currently:
>
> Parnate 80mg
> desipramine 200mg (to be increased)
> Lamictal 200mg
> Abilify 20mg
>
>
> - Scott
>Hey Scott,
By augmenting with a tca (you mention nortrip. or desip.) is it the NE of the maoi that you are increasing with them?..so the stimulation that makes you jump out of bed in the morning full of life even after a few hours of sleep is NE?...as well as (for me anyway) that strange feeling of stimulation in the major muscles that feels energizing...know what I mean? Thats part of what I notice really varies alot with nardil and seems to be dissapating over time (one of the parts that makes taking nardil enjoyable/looking forward to). Is that what you mean or are trying to do with the TCA? And you think adding that NE boost will keep away the "poop out", in this case relating to NE, and prevent loss of effect? And what do you think about amitrip instead of desip or nortrip?
thanks for helping out, means alot for me to get opinions and others experience during treatment.
myco
Posted by diego on February 4, 2009, at 20:17:01
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » SLS, posted by myco on February 4, 2009, at 18:24:08
One could also add an amphetamine, if used cautiously, carefully and judiciously.
1.25 mg Desoxyn and 10 mg Parnate taken simultaneously doesn't seem to alter my BP, but sure beats the Parnate alone.
Posted by Phillipa on February 4, 2009, at 20:30:53
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » Phillipa, posted by FrequentFryer on February 4, 2009, at 16:42:01
Thanks Frequent really wanted the ENSAM patch pdoc said no to stimulating so my interest in learning all I can about Maois Love Phillipa
Posted by myco on February 4, 2009, at 21:13:04
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by diego on February 4, 2009, at 20:17:01
> One could also add an amphetamine, if used cautiously, carefully and judiciously.
>
> 1.25 mg Desoxyn and 10 mg Parnate taken simultaneously doesn't seem to alter my BP, but sure beats the Parnate alone.
>
>
Hey, any ideas on how to convince a somewhat conservative gp about adding an amphetamine to nardil?...lol i can see his face already...simply the mere mention of benzos makes him turn his nose up although he will budge...but a stimulant i dought it. Id need to be real convincing.myco
Posted by shasling on February 5, 2009, at 7:26:55
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » shasling, posted by myco on February 4, 2009, at 14:26:38
Honestly as good as parnate is,i cant imagine taking it as just the med.Which is why what my pharmist said to me that day,even though i dont fully understand grabbed me so hard.
Yess i augment for 1.A more roubust AD effect,at times any one at all.
2.I also augment for various reasons such as ocd which parnate even when working doesent seem t help.
Im very exhausted with this fight,if there was ever a med i believed could be as effective for me as a primary i would switch,however due to nardils manf problem the once golden med now seems to be disappointing almost all the users i read on a nardil group.
I WILL SAY HOWEVER I NOTICE PARNATE TO BE MORE EFFECTIVE IN THE LATER AFTERNOON,THIS MIGHT BE A SOCIAL ISSUE AS LIFER SEEMS TO START MOVING THEN AND MORNINGS ARE ALWAYS JUST ROUGH FOR ME.
Posted by shasling on February 5, 2009, at 14:20:52
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by shasling on February 5, 2009, at 7:26:55
Here is just a snip of a case where Parnate and other stimulating maois were used as Pre treatment to the gaba effect of Nardil.
"The antidepressant/antipanic drug phenelzine (PLZ) is both an inhibitor of, and a substrate for, monoamine oxidase (MAO). PLZ also causes an elevation of brain levels of the amino acid neurotransmitter gamma-aminobutyric acid (GABA); this action can be reversed by ~pretreatment with the MAO inhibitor tranylcypromine (TCP)~, suggesting that the GABA-elevating effect is largely the result of a metabolite of PLZ formed by MAO. In the present report, rats were pretreated with the nonselective MAO inhibitor TCP, the MAO-A inhibitor clorgyline and the MAO-B inhibitor (-)-deprenyl: at the doses used, clorgyline and (-)-deprenyl caused selective inhibition of MAO-A and MAO-B, respectively. Both TCP and (-)-deprenyl caused a greater reduction in the GABA-elevating action of PLZ than did clorgyline, suggesting that MAO-B is more important than MAO-A in the formation of the active metabolite of PLZ. The results also suggest that an effect other than, or in addition to, inhibition of GABA transaminase by the metabolite may be important in the GABA-elevating action."
I find this odd since i recently read that parnate affects gaba b .Man making sense of any of it we need a chemisct here.
Here is the direct link,which again also includes other interesting links.
Posted by shasling on February 5, 2009, at 14:24:04
In reply to Re: ADVANCED WAYS TO FIGHT / A MUST READ, posted by shasling on February 5, 2009, at 14:20:52
This here is also the reason the U.S parnate seems dry and sometimes blah rough on the head for me personaly.
This is opposed to U.K goldsheild brand which are sugar coated,taste like candy and seem to me personaly to work smoother.
heres the link
Posted by bleauberry on February 5, 2009, at 17:55:14
In reply to ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by FrequentFryer on February 4, 2009, at 7:09:01
This answer probably won't fit what you were looking for. I do consider it an advanced strategy however because it is rarely used.
If you are doing ok at the moment on Nardil, then close the psychiatric chapter and set it on the shelf. Dive into life. Enjoy everything you can as much as you can. Forget psychiatry. Just take that little pill every day like it was a vitamin, forget anything was ever wrong, and live. That kind of retraining will bolster your neurochemical pathways and the med so it may never ever poop out.
If, and only if, it shows clear signs of pooping out for longer than 2 weeks in a row, then, and only then, re-open the psychiatry chapter and ask your question again.
For now, it's over. Retrain the mind to move on and forget it. There are better things to focus on than what was or what might be.
Weird I know. But really.
Posted by SLS on February 6, 2009, at 9:08:23
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » FrequentFryer, posted by bleauberry on February 5, 2009, at 17:55:14
Woohoo!
Bleuberry - Bullseye.
Man, you come up with good stuff.
One of the reasons some people breakthrough their medications or relapse after drug discontinuation is that there is too much negative and not enough positive conscious experience. If one reduces psychosocial stress, there will be a greater chance to avoid poop-out or otherwise relapse. There is definite physiological data to support this.
To accomplish the dimunition of psychosocial stress, psychotherapy is usually a good way to accomplish this.
OF COURSE, the most well-adjusted of people who experience the least psychosocial stress can still suffer antidepressant poop-out and relapse. It is the nature of the beast.
- Scott
************************************************
> This answer probably won't fit what you were looking for. I do consider it an advanced strategy however because it is rarely used.
>
> If you are doing ok at the moment on Nardil, then close the psychiatric chapter and set it on the shelf. Dive into life. Enjoy everything you can as much as you can. Forget psychiatry. Just take that little pill every day like it was a vitamin, forget anything was ever wrong, and live. That kind of retraining will bolster your neurochemical pathways and the med so it may never ever poop out.
>
> If, and only if, it shows clear signs of pooping out for longer than 2 weeks in a row, then, and only then, re-open the psychiatry chapter and ask your question again.
>
> For now, it's over. Retrain the mind to move on and forget it. There are better things to focus on than what was or what might be.
>
> Weird I know. But really.
Posted by bulldog2 on February 6, 2009, at 17:12:17
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » FrequentFryer, posted by bleauberry on February 5, 2009, at 17:55:14
> This answer probably won't fit what you were looking for. I do consider it an advanced strategy however because it is rarely used.
>
> If you are doing ok at the moment on Nardil, then close the psychiatric chapter and set it on the shelf. Dive into life. Enjoy everything you can as much as you can. Forget psychiatry. Just take that little pill every day like it was a vitamin, forget anything was ever wrong, and live. That kind of retraining will bolster your neurochemical pathways and the med so it may never ever poop out.
>
> If, and only if, it shows clear signs of pooping out for longer than 2 weeks in a row, then, and only then, re-open the psychiatry chapter and ask your question again.
>
> For now, it's over. Retrain the mind to move on and forget it. There are better things to focus on than what was or what might be.
>
> Weird I know. But really.Yes I believe you have the answer. Your mind as currently constructed is fighting for homeostatis. I believe anxiety and stress proceed depression in many cases. The stress will eventually deplete your neurotransmitters and the maoi has nothing to work with.
If you are experiencing anxiety psychotherapy and or a benzo may help. Also eat well with plenty of fish oil. Lots of good quality protein.Moderate exercise may help. Too much may burn you out.Possibly add nac and or deplin.
Yes and as Bleauberry stated retrain your mind to be happy.
Posted by FrequentFryer on February 7, 2009, at 16:59:56
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » FrequentFryer, posted by SLS on February 4, 2009, at 16:59:29
> > Also at about 3 months when its pooped the side effects subside for me so I could try raising the dose then, but then I reckon it will poop again after a month.
>
> Would you consider adding a TCA - either desipramine or nortriptyline? If it works, it probably won't poop-out. I recommend desipramine. It is more energizing and is less serotonergic. You might as well get more aggressive at this point.
>
> I am currently on schedule for remission using a combination of Parnate + desipramine.
>
> Currently:
>
> Parnate 80mg
> desipramine 200mg (to be increased)
> Lamictal 200mg
> Abilify 20mg
>
>
> - Scott
>MMM I would , I wanna , I might its just that I have done allot of dodgy things with MAOIS and ow my blood preasure and pulse are messed up, (hopefully I would be able to fix it through exercize eating right etc but I would definatly have to go inhouse unless I shopped around for the desipramine.
Thanks heaps though I will save this page, good to hear your doing well.
Dou you know of any medical extracts or data that would make him more comfortable in perscribing it for me in the futre?
Posted by FrequentFryer on February 7, 2009, at 17:04:08
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » SLS, posted by myco on February 4, 2009, at 18:24:08
> > Would you consider adding a TCA - either desipramine or nortriptyline? If it works, it probably won't poop-out. I recommend desipramine. It is more energizing and is less serotonergic. You might as well get more aggressive at this point. Trying to get addition of tca by gp may be an issue but worth a shot.
> >
> > I am currently on schedule for remission using a combination of Parnate + desipramine.
> >
> > Currently:
> >
> > Parnate 80mg
> > desipramine 200mg (to be increased)
> > Lamictal 200mg
> > Abilify 20mg
> >
> >
> > - Scott
> >
>
> Hey Scott,
>
> By augmenting with a tca (you mention nortrip. or desip.) is it the NE of the maoi that you are increasing with them?..so the stimulation that makes you jump out of bed in the morning full of life even after a few hours of sleep is NE?...as well as (for me anyway) that strange feeling of stimulation in the major muscles that feels energizing...know what I mean? Thats part of what I notice really varies alot with nardil and seems to be dissapating over time (one of the parts that makes taking nardil enjoyable/looking forward to). Is that what you mean or are trying to do with the TCA? And you think adding that NE boost will keep away the "poop out", in this case relating to NE, and prevent loss of effect? And what do you think about amitrip instead of desip or nortrip?
>
> thanks for helping out, means alot for me to get opinions and others experience during treatment.
>
> mycoYeah I find at the moment while Im good on 45 mg I get about 6 hours sleep and I like it cos I got more time to do stuff. When the Phenelzine Wheres off I sleep for 10 hours & don't wanna get out of bed, thats whay a NA - TCA might help maybe
Posted by FrequentFryer on February 7, 2009, at 17:09:01
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by diego on February 4, 2009, at 20:17:01
> One could also add an amphetamine, if used cautiously, carefully and judiciously.
>
> 1.25 mg Desoxyn and 10 mg Parnate taken simultaneously doesn't seem to alter my BP, but sure beats the Parnate alone.
>
>VERY small doses of Amhet with small doses might be ok but I had to go to hospital from 20mg of Dex with 90mg of Nardil (throwing up felt lke my head was gonna pop, sick for weeks) I wouldn't recomend strong stims with MAOI's to anyone
Posted by diego on February 8, 2009, at 12:33:41
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by FrequentFryer on February 7, 2009, at 17:09:01
I don't think 20 mg qualifies as cautious, careful OR judicious.
What *were* you thinking?
Posted by JadeKelly on February 8, 2009, at 18:27:24
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!! » FrequentFryer, posted by bleauberry on February 5, 2009, at 17:55:14
> This answer probably won't fit what you were looking for. I do consider it an advanced strategy however because it is rarely used.
>
> If you are doing ok at the moment on Nardil, then close the psychiatric chapter and set it on the shelf. Dive into life. Enjoy everything you can as much as you can. Forget psychiatry. Just take that little pill every day like it was a vitamin, forget anything was ever wrong, and live. That kind of retraining will bolster your neurochemical pathways and the med so it may never ever poop out.
>
> If, and only if, it shows clear signs of pooping out for longer than 2 weeks in a row, then, and only then, re-open the psychiatry chapter and ask your question again.
>
> For now, it's over. Retrain the mind to move on and forget it. There are better things to focus on than what was or what might be.
>
> Weird I know. But really.Bleauberry,
I loved this answer. I've been thinking about this and discussing it with others; how will I live when I get well? I've learned to live in a depressed state for over 2 years. I am well on my way to recovery: I sang kareoke at my brother's yesterday and a strange thing happened. By the 3rd song, I was belting it out with confidence, and it hit me. I was living again. I wasn't at home under my covers for another canceleled get together.
Anyway, as I have been feeling my feelings again I decided to start therapy, which I had not intended to do. I realized, I've developed very bad habits that need to be recognized and changed. If you keep living the way you were living in depression, I fully agree you could stall your recovery or even backslide.
I think this point is not only relevant but should be screamed from the rooftops.
Whats the saying? "Insanity is when you keep doing what you've been doing and expect a different outcome"
~Jade
Posted by JadeKelly on February 9, 2009, at 4:49:29
In reply to Re: ADVANCED WAYS TO FIGHT / REDUCE MAOI POOP OUT!!!!!, posted by shasling on February 4, 2009, at 13:49:24
>
>
> Dont take this as a insult,i only am posting this because i seen a fellow babbler b-ocked in a previous thread in which i personaly felt was infair.
>
> Phillipa,i am confused why you are concerned with maois when you are not on one,and from your own mentioning dont plan to be on one?
>
> Anyone sticking to the thread,i actualy saw a small study that used Nardil treatment prior to parnate to add to parnate im guessing a gabaergic affect.
>
> Judging from that study,the results were fair,and you can imagine how there was no washout period.Parnate is actualy considered by some to be reversable opposed to irrevsable as noted.
>
> I will find the link and post it if interest pervails.
>
> I also find im augmenting Parnate due to what i guess is POOP OUR.A pharmicist who was filling in,an older gentleman once told me this when asking him why im taking more Parnate,
>
> "your getting older,but the disease isnt,maois build a structure but if the chemicals arent there maois wont matter so taking more wont help"
>
> What i got from that is maois have to be augmented after time with something to provide the chemicals for it to work better?
>Hi Shasling,
Sounds like a wise old man, lol
So you think what he meant was that once Parnate is working at lets say 80mg day, and that poops out, its time to augment, not increase dose?
How long have you been on Parnate?
Dose? Augmnent? s/e's?Have you responded as you had hoped? Not sure what your dx is. Sorry if any of this repeat.
Mine:
Excellent PDoc btw, 10yrs exp w/ MAOIs and augments.
80mg day (40mg 2x day)
Augment 40mg Ritalin (20mg 2x day)
I have to take my BP 15min before dose, 15min after dose, 30min after doseI have a chart, if my numbers dont stay within that chart I have to page him immediately. He's an excellent PDoc in my opinion. I am so lucky I found him. I am well on my way out of a nightmare depression. He says to expect 80-85% remission and the rest he feels will come from therapy.
btw- I see him every 2 weeks and per his request therapy every 2 weeks. Therapist changed it to once a week.....ouch, haha.
Oh-dx MDD
Let me know about your experience so far.
Thanks,
~Jade ps-I know you have concerns about combining ritalin with Parnate, but my BP is MUCH better with the Ritalin. I was so fatigued by low BP it didnt matter that I felt better cause I was too tired to do anything!!
This is the end of the thread.
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