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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 Snell on May 12, 2014, at 7:05:08
I've taken all the antidepressants and am now working my way through the MAOIs. I started with Parnate and uptitrated to 60 mg by October 1, 2013. Now I'm having poop-out. I asked in another thread about augmenting with dopamine agonists (Requip, Mirapex) but here I am interested in people who have taken Nardil or Marplan.
It seems Nardil is the "high side effect MAOI". Is that true? I've also repeatedly heard that Parnate is activating while Nardil is sedating. That will be strange for me, as I found Parnate quite sedating, and had to take naps every afternoon to be able to function.
I keep hearing/reading good things about Marplan. Anyone taking that?
I'm super interested in your experiences!
Posted by tom2228 on May 12, 2014, at 13:30:11
In reply to Nardil or Marplan?, posted by Snell on May 12, 2014, at 7:05:08
I have been on all 3 and Marplan is my favorite.
Marplan makes me feel like myself (it is supposedly good for depersonalization/ dissociative symptoms) and allows me to be more in touch with memories of how I've felt throughout the years.
I consider Marplan to be the cleanest. In general I find it to be relatively low on side effects. Some do say that the other two have more "umph" for depression, but that's a matter of subjectivity.
- Mechanism wise it is the closest to a pure MAOI
--Nardil has effects on GABA transaminase and phenylethylamine as a metabolite;
--Parnate is stronger on MAOI-B and has an effect on GABA-B;
--Marplan has has less-pronounced effects on dopamine beta-hydroxylase and tryptophan metabolism, although it "feels" the closest to a pure MAOI)-whereas the other two can have sedation problems, Marplan seems to be neutral to some and activating to others (I find it pretty stimulating at 40mg and over)
-Marplan lacks, or is more forgiving in terms of the afternoon sleepiness you speak about
-Marplan tends to be weight-neutral (whereas Nardil is is known of weight gain)
-Sexual side-effects are not as bad a Nardil in my experience
-The insomnia is nowhere near the insomnia on Parnate, I've found.
Posted by SLS on May 12, 2014, at 14:37:20
In reply to Re: Nardil or Marplan?, posted by tom2228 on May 12, 2014, at 13:30:11
Nice synopsis, Tom.
- Scott
> I have been on all 3 and Marplan is my favorite.
>
> Marplan makes me feel like myself (it is supposedly good for depersonalization/ dissociative symptoms) and allows me to be more in touch with memories of how I've felt throughout the years.
>
> I consider Marplan to be the cleanest. In general I find it to be relatively low on side effects. Some do say that the other two have more "umph" for depression, but that's a matter of subjectivity.
>
> - Mechanism wise it is the closest to a pure MAOI
> --Nardil has effects on GABA transaminase and phenylethylamine as a metabolite;
> --Parnate is stronger on MAOI-B and has an effect on GABA-B;
> --Marplan has has less-pronounced effects on dopamine beta-hydroxylase and tryptophan metabolism, although it "feels" the closest to a pure MAOI)
>
> -whereas the other two can have sedation problems, Marplan seems to be neutral to some and activating to others (I find it pretty stimulating at 40mg and over)
>
> -Marplan lacks, or is more forgiving in terms of the afternoon sleepiness you speak about
>
> -Marplan tends to be weight-neutral (whereas Nardil is is known of weight gain)
>
> -Sexual side-effects are not as bad a Nardil in my experience
>
> -The insomnia is nowhere near the insomnia on Parnate, I've found.
>
Posted by tom2228 on May 12, 2014, at 14:46:35
In reply to Re: Nardil or Marplan?, posted by SLS on May 12, 2014, at 14:37:20
Posted by Snell on May 12, 2014, at 22:10:37
In reply to Thanks, Scott :) (nm) » SLS, posted by tom2228 on May 12, 2014, at 14:46:35
Yes, Tom, I found your reply to be very useful also. Thanks!
Snell
Posted by tom2228 on May 13, 2014, at 8:31:15
In reply to Re: Nardil or Marplan?, posted by SLS on May 12, 2014, at 14:37:20
I should also add that it doesn't really matter when you take the Marplan as long as it isn't too late in the day so as to avoid the insomnia. But it's not like Nardil and Parnate where you notice effects when you take the pill and when the non-MAOI effects "wear off". I take 20mg in the morning and 20mg at 2pm.
Posted by Snell on May 13, 2014, at 14:42:45
In reply to Re: Nardil or Marplan?, posted by tom2228 on May 13, 2014, at 8:31:15
Thank you; this is very helpful.
> I should also add that it doesn't really matter when you take the Marplan as long as it isn't too late in the day so as to avoid the insomnia. But it's not like Nardil and Parnate where you notice effects when you take the pill and when the non-MAOI effects "wear off". I take 20mg in the morning and 20mg at 2pm.
Posted by rose45 on June 3, 2014, at 18:55:35
In reply to Re: Nardil or Marplan?, posted by tom2228 on May 12, 2014, at 13:30:11
> I have been on all 3 and Marplan is my favorite.
>
> Marplan makes me feel like myself (it is supposedly good for depersonalization/ dissociative symptoms) and allows me to be more in touch with memories of how I've felt throughout the years.
>
> I consider Marplan to be the cleanest. In general I find it to be relatively low on side effects. Some do say that the other two have more "umph" for depression, but that's a matter of subjectivity.
>
> - Mechanism wise it is the closest to a pure MAOI
> --Nardil has effects on GABA transaminase and phenylethylamine as a metabolite;
> --Parnate is stronger on MAOI-B and has an effect on GABA-B;
> --Marplan has has less-pronounced effects on dopamine beta-hydroxylase and tryptophan metabolism, although it "feels" the closest to a pure MAOI)
>
> -whereas the other two can have sedation problems, Marplan seems to be neutral to some and activating to others (I find it pretty stimulating at 40mg and over)
>
> -Marplan lacks, or is more forgiving in terms of the afternoon sleepiness you speak about
>
> -Marplan tends to be weight-neutral (whereas Nardil is is known of weight gain)
>
> -Sexual side-effects are not as bad a Nardil in my experience
>
> -The insomnia is nowhere near the insomnia on Parnate, I've found.
>
Thank you Tom for the information. Im wondering how long were you on Parnate and Nardil, and why did you stop them ?Are you currently on Marplan ? Do you need to take sleeping meds with it?
I was on Nardil for 23 years, until it stopped working. I managed to sleep most of the time without sleeping pills. I am now on parnate, which has helped get rid of the anxiety and depression, but I am also very tired on it, and have total insomnia and the sleeping pills are a problem, because here in the uk,gps are instructed not to give out sleeping pills for longer than a certain period.I went to see a new psychiatrist yesterday, who is supposedly an expert in maois, and he was surprised that i found parnate to be energising in that it causes insomnia, but at the same time, makes me so tired during the day. Here, on psychobabble, I have read several people who have similar experiences with parnate.
Also I have not put on weight with parnate, but I put on a lot of weight with nardil. I have read that marplan is more similar to nardil. Would you agree? Did it create weight issues for you?
I would really appreciate getting answers to the above, because I have to take the decision on whether to stop the parnate, and try marplan, and changing drugs involves so much pain and is so problematic, it would be nice to have an idea re. whether it would be worth it.
Posted by tom2228 on June 6, 2014, at 9:35:47
In reply to Re: Nardil or Marplan? » tom2228, posted by rose45 on June 3, 2014, at 18:55:35
> > I have been on all 3 and Marplan is my favorite.
> >
> > Marplan makes me feel like myself (it is supposedly good for depersonalization/ dissociative symptoms) and allows me to be more in touch with memories of how I've felt throughout the years.
> >
> > I consider Marplan to be the cleanest. In general I find it to be relatively low on side effects. Some do say that the other two have more "umph" for depression, but that's a matter of subjectivity.
> >
> > - Mechanism wise it is the closest to a pure MAOI
> > --Nardil has effects on GABA transaminase and phenylethylamine as a metabolite;
> > --Parnate is stronger on MAOI-B and has an effect on GABA-B;
> > --Marplan has has less-pronounced effects on dopamine beta-hydroxylase and tryptophan metabolism, although it "feels" the closest to a pure MAOI)
> >
> > -whereas the other two can have sedation problems, Marplan seems to be neutral to some and activating to others (I find it pretty stimulating at 40mg and over)
> >
> > -Marplan lacks, or is more forgiving in terms of the afternoon sleepiness you speak about
> >
> > -Marplan tends to be weight-neutral (whereas Nardil is is known of weight gain)
> >
> > -Sexual side-effects are not as bad a Nardil in my experience
> >
> > -The insomnia is nowhere near the insomnia on Parnate, I've found.
> >
> Thank you Tom for the information. Im wondering how long were you on Parnate and Nardil, and why did you stop them ?
>
> Are you currently on Marplan ? Do you need to take sleeping meds with it?
>
> I was on Nardil for 23 years, until it stopped working. I managed to sleep most of the time without sleeping pills. I am now on parnate, which has helped get rid of the anxiety and depression, but I am also very tired on it, and have total insomnia and the sleeping pills are a problem, because here in the uk,gps are instructed not to give out sleeping pills for longer than a certain period.I went to see a new psychiatrist yesterday, who is supposedly an expert in maois, and he was surprised that i found parnate to be energising in that it causes insomnia, but at the same time, makes me so tired during the day. Here, on psychobabble, I have read several people who have similar experiences with parnate.
>
> Also I have not put on weight with parnate, but I put on a lot of weight with nardil. I have read that marplan is more similar to nardil. Would you agree? Did it create weight issues for you?
>
> I would really appreciate getting answers to the above, because I have to take the decision on whether to stop the parnate, and try marplan, and changing drugs involves so much pain and is so problematic, it would be nice to have an idea re. whether it would be worth it.
>I am currently taking Marplan 40mg. While I don't need to take sleeping meds for it, I am currently taking desipramine as well, which is mildly mildly sedating and helps with my sleep. I have been on Marplan without other sleep-aiding medications without much problems, as long as I take the second set of pills before 4-5pm (I take them in the morning and at 2pm). I would say that while everyone is different, for me the insomnia is nowhere near that of Parnate and isn't as bad as, but similar to, Nardil.
I stopped taking Nardil due to sedation mainly, also weight gain, sexual dysfunction, and only having a partial response up to 75mg. At that dose I had trouble staying awake during the day or keeping my eyes open at times. Although it was nice for my anxiety, social and generalized, and had a nice effect on my depression albeit not up to my standard of Marplan.
Parnate was more effective than Nardil for my depression (up to 60mg), but the two reasons I stopped were side-effects and to go back to Marplan. The side-effects I experienced were sedation (different from the Nardil but still troublesome), tension, and insomnia (I needed sleep aids for a while), and some anxiety. You are definitely not alone in finding Parnate energizing yet sedating. In my experience and what I've read, that is fairly common and characteristic of Parnate actually!
Earlier of last year I had been off MAOIs for a couple months and needed to get back on them. After trialing Nardil and next retrying Parnate, I started to realize what I really needed to do was go back to my Marplan. I had taken Marplan for 3 years to good effect on my depression and anxiety. I had established a sense of self on Marplan and wanted dearly to get back to it and continue where I left off so to speak. On Marplan I am closest to my true emotions and feel more present in my life -- it helps with dissociation/ depersonalization/ derealization that I sometimes experience especially when on meds that are not Marplan -- who I consider myself to really be. Thus my anxiety is best on Marplan. My depression is only responding partially this time, so I am taking a tricyclic (desipramine) with it along with other meds.
Marplan is qualitatively different from Nardil. But it is more similar to Nardil than Parnate, in my opinion. Unlike Nardil it is weight-neutral (at least for me). I find it has the fewest side effects in general, very few.
Whether it is worth it to switch is entirely up to you and your doctor (which is partly based on what you tell him, of course). What about trying Nardil again but adding nortriptyline or desipramine (desipramine leads to less weight gain)? They are indeed safe with MAOIs, although your doctor may not agree. I have tried both with Marplan and they have greatly helped me respond to treatment again and retain the "feeling" of being on the MAOI that I like the best.
Hope this helps, and best of luck to you,
Tom
Posted by Snell on June 6, 2014, at 10:19:51
In reply to Re: Nardil or Marplan?, posted by tom2228 on June 6, 2014, at 9:35:47
This is helpful and detailed--thank you, Tom.
Posted by rose45 on June 8, 2014, at 17:13:25
In reply to Re: Nardil or Marplan?, posted by Snell on June 6, 2014, at 10:19:51
Thanks Tom, very helpful. I forgot to ask you, how long does marplan take to work? In my case, Nardil took 8 painful weeks, whereas Parnate took only 2 or 3 weeks. Would I have to go off parnate for 2 weeks before starting on marplan?
I consulted a psychiatrist who is supposedly expert in maois - He suggested I could try nardil again, which I thought was a strange idea, since I had been on it for over 20 yrs when it stopped working.. he didnt say much about marplan - I suppose because it was taken off the market for a while, fewer people are taking it, and maybe there is a risk they will take it off again ??? He also suggested that I could try a low dose of olanzapine for sleep, but I had such an awful experience on seroquel, I dont like the idea of taking another anti-psychotic.... its so hard to know what to do. Its easy for psychiatrists to make suggestions, and say try this or that, but when I am unwell, I am totally non-functional and suicidal and I just cant bear to go through that again - also people who have helped in the past, including my family, got pretty fed up with it,when I was finally switched to parnate one year ago and I couldnt ask them for help again.
Posted by rose45 on June 8, 2014, at 17:28:08
In reply to Re: Nardil or Marplan?, posted by tom2228 on June 6, 2014, at 9:35:47
just saw the last part of your post which I missed on first reading.What would be the point of taking noritryptiline or desipramine with the nardil? Would it be for sleep? In any case, I doubt that the psychiatrist would agree to prescribe them for me. He read a letter I received from Ken Gillman suggesting I take doxepin with the parnate, and his response was that there was no way he would take that risk!! He didnt agree with some other of Ken Gillman's suggestions either, and told me that it is not a good idea to get too many opinions ! Easy for him to say of course !
Posted by rose45 on August 16, 2014, at 6:07:15
In reply to Re: Nardil or Marplan?, posted by rose45 on June 8, 2014, at 17:28:08
Tom,
There is one important question I forgot to ask.
How long does it take marplan to work?For me Nardil took 8 really painful weeks before working. Parnate was much easier. It began to work within 2 weeks, and there was none of the mental pain I had getting onto Nardil
I do need to know about Marplan, because if I decide to switch, Id like to know for how long I might be out of action, before it works.
Thank you.
This is the end of the thread.
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