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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by myco on March 16, 2009, at 11:43:15
Can you parnate users (past/present) tell me what the major sides for you have been while starting and maintaining therapy...I know obviously insomnia is one. I'm primarily interested in the bp issues though. Nardil has the notoriety of hypotension during startup and the occasional hypotensive surprise (which I dont mind usually as they are mild)...is this the same for parnate? I'm a lil concerned, well lets say it worries me lol, about the spontaneous hypertensive episodes...is that common? It wont put me off trying the med I just like to know all my cards before thinking about starting. Nardil had my bp running at below my norm (was high end of average then with nardil it's totally average). Does parnate give you sustained higher bp?
myco
Posted by diego on March 16, 2009, at 12:02:03
In reply to Tell me about PARNATE's BP issues please., posted by myco on March 16, 2009, at 11:43:15
In my experience the incidence of postural hypotension is lower with Parnate vs. Nardil.
My BP is normally very low and a month on Parnate didn't affect standing BP at all.
I've only had one hypertensive episode on an MAOI, and that was Nardil+salami.
I'm currently on 20 mg Parnate/day. A couple nights ago I ate a cheese sauce containing ½ cup aged parmesan. Whoops! Not a good idea. No reaction, though.
One doc told me that hypertensive episodes usually occur within a few hours of combining the tyramine and the MAOI, so if you haven't taken your meds in a few hours there's a lower chance it will occur. Don't know whether that's true or not -- he said he read it in a journal somewhere -- but it's an interesting data point.
Posted by myco on March 16, 2009, at 12:28:56
In reply to Re: Tell me about PARNATE's BP issues please., posted by diego on March 16, 2009, at 12:02:03
What's your dx diego?
I'm trying to assess this med as a good option for me: atypical depression, gad, sad. Nardil works well for these mabye parnate will?
myco----------------------------
> In my experience the incidence of postural hypotension is lower with Parnate vs. Nardil.
>
> My BP is normally very low and a month on Parnate didn't affect standing BP at all.
>
> I've only had one hypertensive episode on an MAOI, and that was Nardil+salami.
>
> I'm currently on 20 mg Parnate/day. A couple nights ago I ate a cheese sauce containing ½ cup aged parmesan. Whoops! Not a good idea. No reaction, though.
>
> One doc told me that hypertensive episodes usually occur within a few hours of combining the tyramine and the MAOI, so if you haven't taken your meds in a few hours there's a lower chance it will occur. Don't know whether that's true or not -- he said he read it in a journal somewhere -- but it's an interesting data point.
>
>
>
>
Posted by Phillipa on March 16, 2009, at 12:35:04
In reply to Re: Tell me about PARNATE's BP issues please. » diego, posted by myco on March 16, 2009, at 12:28:56
Isn't parnate more of a stimulant. Sorry myco haven't taken it but curious. Love Phillipa gonna goggle differences now.
Posted by myco on March 16, 2009, at 12:40:20
In reply to Re: Tell me about PARNATE's BP issues please. » myco, posted by Phillipa on March 16, 2009, at 12:35:04
I think so ya...that might play a good role. I do find the nardil stimulation helpful...wonder if parnate stimulation is much more intense in comparison
myco
-------------------
> Isn't parnate more of a stimulant. Sorry myco haven't taken it but curious. Love Phillipa gonna goggle differences now.
Posted by Phillipa on March 16, 2009, at 12:51:33
In reply to Re: Tell me about PARNATE's BP issues please. » Phillipa, posted by myco on March 16, 2009, at 12:40:20
Well here's something. Phillipa
Efficacy and tolerability of tranylcypromine versus phenelzine:
a double-blind study in antidepressant-refractory depressed inpatients
by
Birkenhager TK, van den Broek WW,
Mulder PG, Bruijn JA, Moleman P.
Departments of Psychiatry,
Erasmus Medical Centre, Rotterdam,
The Netherlands.
t.birkenhager@erasmusmc.nl
J Clin Psychiatry. 2004 Nov;65(11):1505-10ABSTRACT
BACKGROUND: The aim of this study was to examine whether phenelzine is a suitable alternative to tranylcypromine in antidepressant-resistant depression. METHOD: A total of 77 severely depressed in-patients, meeting the DSM-IV criteria for major depressive disorder, who failed to respond to fixed plasma level treatment with either tricyclic antidepressants or fluvoxamine were withdrawn from psychotropic medication and included in a double-blind flexible-dose 5-week comparison of tranylcypromine and phenelzine. RESULTS: Of the 77 patients, 67 (87%) completed the trial, of whom 35 (52%) responded. No significant differences in response between both drugs were observed. Seventeen (44%) of 39 patients responded to tranylcypromine and 18 (47%) of 38 to phenelzine (> or = 50% reduction in Hamilton Rating Scale for Depression [HAM-D] score). The mean reduction in HAM-D score was 10.4 8.3 for the tranylcypromine sample versus 8.3 8.4 for the phenelzine-treated patients. Only a few patients (10%) used concomitant psychotropic medication. A substantial number of patients experienced severe side effects, mainly dizziness, agitation, and insomnia; the incidence was the same in both samples (21%). CONCLUSION: No difference in efficacy was observed between both monoamine oxidase inhibitors in a sample of patients with severe antidepressant-refractory depression. Phenelzine appears to be a suitable alternative to tranylcypromine
Posted by shasling on March 16, 2009, at 13:17:24
In reply to Re: Tell me about PARNATE's BP issues please. » diego, posted by myco on March 16, 2009, at 12:28:56
> What's your dx diego?
>
> I'm trying to assess this med as a good option for me: atypical depression, gad, sad. Nardil works well for these mabye parnate will?I believe atypical is its claim to fame,i found them both to be quite different,as i did also liquid deprenyl,but i could not have been on nardil long enough,or perhaps theres something to the whole OLD-NEW nardil issues,i do not differances from glaxcos parnate to that of goldshield.
Then again many find the two,parnate and nardil the same,so go figure im just glad they are still options,both of them.
>
>
> myco
>
> ----------------------------
> > In my experience the incidence of postural hypotension is lower with Parnate vs. Nardil.
> >
> > My BP is normally very low and a month on Parnate didn't affect standing BP at all.
> >
> > I've only had one hypertensive episode on an MAOI, and that was Nardil+salami.
> >
> > I'm currently on 20 mg Parnate/day. A couple nights ago I ate a cheese sauce containing ½ cup aged parmesan. Whoops! Not a good idea. No reaction, though.
> >
> > One doc told me that hypertensive episodes usually occur within a few hours of combining the tyramine and the MAOI, so if you haven't taken your meds in a few hours there's a lower chance it will occur. Don't know whether that's true or not -- he said he read it in a journal somewhere -- but it's an interesting data point.
> >
> >
> >
> >
>
>
Posted by myco on March 16, 2009, at 13:18:13
In reply to Re: Tell me about PARNATE's BP issues please., posted by Phillipa on March 16, 2009, at 12:51:33
oooo thanks hun, you rock :o)
good study pick-------------
> Well here's something. Phillipa
>
> Efficacy and tolerability of tranylcypromine versus phenelzine:
> a double-blind study in antidepressant-refractory depressed inpatients
> by
> Birkenhager TK, van den Broek WW,
> Mulder PG, Bruijn JA, Moleman P.
> Departments of Psychiatry,
> Erasmus Medical Centre, Rotterdam,
> The Netherlands.
> t.birkenhager@erasmusmc.nl
> J Clin Psychiatry. 2004 Nov;65(11):1505-10
>
> ABSTRACT
> BACKGROUND: The aim of this study was to examine whether phenelzine is a suitable alternative to tranylcypromine in antidepressant-resistant depression. METHOD: A total of 77 severely depressed in-patients, meeting the DSM-IV criteria for major depressive disorder, who failed to respond to fixed plasma level treatment with either tricyclic antidepressants or fluvoxamine were withdrawn from psychotropic medication and included in a double-blind flexible-dose 5-week comparison of tranylcypromine and phenelzine. RESULTS: Of the 77 patients, 67 (87%) completed the trial, of whom 35 (52%) responded. No significant differences in response between both drugs were observed. Seventeen (44%) of 39 patients responded to tranylcypromine and 18 (47%) of 38 to phenelzine (> or = 50% reduction in Hamilton Rating Scale for Depression [HAM-D] score). The mean reduction in HAM-D score was 10.4 8.3 for the tranylcypromine sample versus 8.3 8.4 for the phenelzine-treated patients. Only a few patients (10%) used concomitant psychotropic medication. A substantial number of patients experienced severe side effects, mainly dizziness, agitation, and insomnia; the incidence was the same in both samples (21%). CONCLUSION: No difference in efficacy was observed between both monoamine oxidase inhibitors in a sample of patients with severe antidepressant-refractory depression. Phenelzine appears to be a suitable alternative to tranylcypromine
Posted by Phillipa on March 16, 2009, at 13:26:17
In reply to Re: Tell me about PARNATE's BP issues please. » Phillipa, posted by myco on March 16, 2009, at 13:18:13
Really I finally did something right? Love Jan glad I could help.
Posted by myco on March 16, 2009, at 13:29:54
In reply to Re: Tell me about PARNATE's BP issues please. » myco, posted by Phillipa on March 16, 2009, at 13:26:17
Oh dont be hard on yourself :oP
> Really I finally did something right? Love Jan glad I could help.
Posted by myco on March 16, 2009, at 13:35:36
In reply to Re: Tell me about PARNATE's BP issues please., posted by shasling on March 16, 2009, at 13:17:24
It's a relief to know there is a second, well tried and effective treatment. I was thinking Nardil was a "special" case, a one-of-kind treatment for atyp dep that you don't run across again when you leave it. When you leave MAOI's seems like it's a vast med wasteland of obscurity when trying to treat atyp dep with major anxiety.
> I believe atypical is its claim to fame,i found them both to be quite different,as i did also liquid deprenyl,but i could not have been on nardil long enough,or perhaps theres something to the whole OLD-NEW nardil issues,i do not differances from glaxcos parnate to that of goldshield.
>
> Then again many find the two,parnate and nardil the same,so go figure im just glad they are still options,both of them.
>
Posted by JadeKelly on March 16, 2009, at 18:08:25
In reply to Tell me about PARNATE's BP issues please., posted by myco on March 16, 2009, at 11:43:15
> Can you parnate users (past/present) tell me what the major sides for you have been while starting and maintaining therapy...I know obviously insomnia is one. I'm primarily interested in the bp issues though. Nardil has the notoriety of hypotension during startup and the occasional hypotensive surprise (which I dont mind usually as they are mild)...is this the same for parnate? I'm a lil concerned, well lets say it worries me lol, about the spontaneous hypertensive episodes...is that common? It wont put me off trying the med I just like to know all my cards before thinking about starting. Nardil had my bp running at below my norm (was high end of average then with nardil it's totally average). Does parnate give you sustained higher bp?
>
> mycoHey myco,
I had what I thought was a spontaneous hyprtensive problem in the very beginning of Parnate, I suspect now it was a med I was taking that was ok'd by my Doc. I saw later, it was contraindicated.
Since then low bp all the way until I augmented with ritalin by my PDoc. It was exhausting. My BP is normal now, off every now and then, NEVER high.
Try to find out how you are going to keep your BP up now, while you have some energy. And by the way, Gatorade and salt tablets may help a little, not much tho. I love the ritalin because it is so synergistic with Parnate AND at the right dose, BP is exactly normal.Good Luck to you ;-)
~Jade
Posted by diego on March 19, 2009, at 11:41:18
In reply to Re: Tell me about PARNATE's BP issues please. » diego, posted by myco on March 16, 2009, at 12:28:56
uni-polar MDD; don't know if it's atypical or not. (What's the criteria for that, anyway?)
No GAD, plenty of SAD.
From what I've read, comorbid GAD would probably respond to Nardil better than Parnate.
> What's your dx diego?
>
> I'm trying to assess this med as a good option for me: atypical depression, gad, sad. Nardil works well for these mabye parnate will?
>
>
> myco
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