# Parnate anyone ?



## metamorphosis (Dec 18, 2008)

So, I am planning on finally doing a trial run on Parnate for many reasons. I have SAD, GAD, atypical depression.
I have used:
-Lexapro and 2 other SSRI's. After 2 yrs on lexapro, it has lost it's efficacy, and I believe it has caused frontal lobe atrophy to some extent. And chronic sexual dysfunction is a possibility.
-Wellbutrin XR, as an adjunct to lexapro as a stimulating AD and the counteractions of SSRI side effects. I can no longer order the XL and have had issues with the SR as far as dosing and increased anxiety.
-Lamictal, as a mood stabilizer and AD that I plan on keeping on board.
-Klonopin, for anxiety and will also keep on board for a time with plans of titrating off.
-Modafinil, which has helped with motivation, and general well being. Pdoc does not want to keep it on board but we will see. I would like to.
As far as other meds,
-Atypicals, I have used Saphris, which made me feel like crap. Plus, I am not ready to roll the dice on possible T.D., weight gain, and developing diabetes. Everyone I have known with SAD that has tried any atypical or straight anti-psychotics have stopped for the reasons stated above.
[TCA's, I have had some intolerable side effects such as weight gain, somnolence and the basic principle that they are not terribly effective for my condition, IMHO.
-SNRI's- are pretty much what I was taking with the wellbutrin and lexapro combination. Plus, Effexor was not effective for me.
Various other meds. like Remeron= 'Shawn Of The Dead' and various complimentary anxiolytics- Buspar, Lyrica, Neurontin which are not long term solutions on their own.

I decided on Parnate because of the side effect profile compared to Nardil. Nardil, tends to cause serious weight gain. Usually, causes lethargy and sexual dysfunction. Whereas Parnate is a strong AD for atypical depression and tends to be more stimulating. The trade off being the stronger anxiolytic properties of Nardil and the seemingly more forgiving chance of hypertension, even with the updated food/drug list.

Out of all of the classes of psychotropics available. I consider the MAOI's to require the most lifestyle adjustments and a strict and careful adherence to guidelines avoiding the interactions. Not only with food in general, but eating out. And sacrificing some foods that may be a stable for many. I use cliff bars while biking, but have heard of interactions because of the soy products in them.
Even more dangerous is the med interactions including otcs. and supplements.
I will use some form of anxiolytics as needed and address sleep issues as they arise. So, any feedback would be appreciated from all. Hopefully some Parnate users will come out of the woodwork and weigh in. And Nardil users past and present as well!
There are important sacrifices to be made for these meds. but the positives can outweigh the negatives. Plus some of the restrictions are actually for foods and meds. that can be unhealthy options.
I still am weary, but I can always opt. out at any time. And my pdoc and myself , both believe I have the knowledge and fortitude to stay on course. Strictly speaking to not slip up.
As one psychiatrist said, " MAOI's work 90% of the time and 80% of the time patients stop using them because of the side effects."

Any comments, suggestions, ideas, and anecdotal reports are greatly appreciated! So, please weigh in.


----------



## yourfavestoner (Jan 14, 2010)

Glad to see another person making the MAOI jump.

I'm starting Nardil in thirty days. Parnate was the other MAOI I had thought about, but I'm gonna roll with Nardil. Hope it works for you bud.


----------



## metamorphosis (Dec 18, 2008)

yourfavestoner said:


> Glad to see another person making the MAOI jump.
> 
> I'm starting Nardil in thirty days. Parnate was the other MAOI I had thought about, but I'm gonna roll with Nardil. Hope it works for you bud.


Yeah, I can see the pro's and con's in both. For me they are both neck and neck. I am hoping the Parnate, with it's more favorable side effect profile, can be effective. Either using an additional anxiolytic or perhaps eventually on it's own. Realizing, I can always jump to the other after a good trial run. I just read a lot of Nardil threads, which are very helpful. And I would like some Parnate users or those who have tried both to weigh in. Any comments, knowledge, or general observations on the topic, with a focus on Parnate would help.
I am in the enviable position where my pdoc is letting me chose. He respects my knowledge and judgement. We have a good rapport I like to research psychotropics and especially the more interesting and challenging ones. This website is my SAD/mental illness home site. And I respect the opinions of the members on this forum. So any responses are much appreciated.


----------



## billyho (Apr 12, 2010)

I've tried Parnate on 2 occasions I believe. Pretext, I am a very slow metaboliser so I can get away with much lower doses of some medications once they build up on my system. With that being said, the highest I got on parnate was 10 mgs 3x per day and wasn't really feeling much of anything accept dizziness and fatigue immediately after taking the dose. So, I started titrating down my dose and found a sweet spot around 10-15 mgs which I would talk all at night with some ambien. I don't remember why I stopped at this point, I think it was too stimulating and making ocd worse. I've read that sometimes if you can't find your sweet spot and you are on the max dose then it is best to do a slow titration down and you may be able to hit the sweet spot.
2nd time i tried it, I made it up to 10 mgs 2x per day before I had to decrease my dose. I was down to one pill a day at bedtime w ambien. I felt stimulated and good, but there were side effects which were intolerable.. currently not using it anymore.

hope this helps!


----------



## metamorphosis (Dec 18, 2008)

Thanks, billyho
Of course most of the anecdotal reports and pdocs are more inclined to lean towards Nardil initially in the case of SA. The obvious reason being it's GABAergic effects. Whereas Parnate is used for depression, atypical or otherwise, for those patients main disorder. It has more stimulating and amphetamine like qualities. Which can cause an increase in anxiety in many. But does wonders for major depression or those in a steadydysthemic state. And as a strong weapon in atypical. It would seem Nardil would be a slam dunk, as far as SA and anxiety are concerned.
Although, the side effect profile of tranylcypromine is more appealing or a bonus for myself. I would rather not have any more weight gain and suffer with sexual dysfunction along with some other S.E. That are more prevalent with phenelzine. Many of the side effects are dose dependent for phenelzine. Which, from what I am gathering so far, is often titrated up to 60-80mg and then reduced to around 30mg as a maintenance level. Which can be increased when more of the anxiolytic effects are needed. This "manipulating" of dosage not only keeps the "poop out" effect at bay, but can limit side effects at higher doses. I have read that some pdocs and patients believe that a steady dose should be maintained, once the sweet spot is found. I have read quite the opposite on websites 
Drugs.com


> Maintenance dose-
> After maximum benefit from NARDIL is achieved, dosage should be reduced slowly over several weeks. Maintenance dose may be as low as one tablet, 15 mg, a day or every other day, and should be continued for as long as is required.


Which is a plus, at least in some level, to control side effects and tolerance.

Tranylcypromine appears to be used at a more level dosing schedule. Even with it's lack of affinity for GABA. It still is used effectively for SA and anxiety for many, though to a lesser degree. As far as side effects, the stimulating, weight neutral or weight loss, and far less sexual dysfunction (sometimes increased sex drive) is a plus. Also, certain meds. can be used with care and in the knowledgeable hands of pdocs and patients. That would not even be considered heroic combinations when used in precise measures.
Of course the less poly-pharmacy used, the better, IMHO.

I know that it will basically come down to pick one and make sure I give it a fair chance. And in the case of MAOI's, we are talking months. Which can be a rollercoaster ride at certain points.

Again, I would love for any Parnate users, former or current, to chime in!

Also, posts by those who have used both Nardil and Parnate would be greatly appreciated!

I have yet to look at any substantial studies yet. As, I have to really submerge myself to start investigating studies on pubmed, medscape, cms et al. I will get to that after using some ibuprofen, as headaches will almost be a given.


----------



## metamorphosis (Dec 18, 2008)

:cig


----------



## Fed91 (Apr 18, 2012)

Long time reader of SAS, first time poster. But, I thought I'd finally chime in since I recently started taking Parnate. Like many, I have also been on the medication roller coaster for the past 15 years. Been on Zoloft, Wellbutrin, Cymbalta, Paxil, Remeron, Stablon, and probably some others I can't think of now. All of these to no avail, of course. Gave up on medication for awhile, except for self-medicating with benzos at times. However, I recently decided to give it one more shot, but only if I could find a doc who would prescribe me an MAOI since it is the one medication I believe could actually be effective for my condition given the reports I have read. Well, I was lucky enough to find that doc. Anyway, like you, my doctor gave me the option of trying Parnate or Nardil. My doc preferred Parnate because of the more appealing side effect profile, and after much deliberation, I agreed, and went with the Parnate. I've been on it for almost 3 months now. Unfortunately, I don't have much to report yet. This is most likely due to the fact that we've been taking it very slow with the dosage increases. Started out on just 10mg/day for a month and have been increasing it 10mg/day about every month. I just increased it again today and am at 40mg/day. So far, I have perceived very little effect from it yet, positive or negative. My doc says it seems, due to my history of resistance to the effects of medication, I'll likely have to hit at least 60mg/day to get any therapeutic effect. I have been less depressed lately, but I believe that has more to do with the fact a I am actively pursuing a remedy for my SA once again and have the tiniest bit of hope that this course of action will reap results, than any anti-depressive effect from the Parnate. But who knows, the Parnate may be subtly be taking effect. However, I am still suffering from low mood, anhedonia/very low motivation, the same level of SA, etc. The only side effect I've noticed so far is the slightest bit of postural hypotension and some mild tinnitus. As far as the diet is concerned, it hasn't been much of a concern so far. I've been pretty careful with it, but have tested some items from the restricted list and have had no adverse effects. I am mostly vegetarian and eat a lot of soy, and have had no problem with it. I've read conflicting reports about soy and MAOI's. Some say avoid it altogether, others say just avoid fermented soy (i.e. tempeh, miso). Like I said, I haven't had a problem with it. Like you, I eat a lot of Cliff bars (almost everyday), so hopefully it wouldn't be a concern for you. Now this could very well be due to the fact the Parnate hasn't taken it's full effect yet, and I'll probably have to be more careful with my diet as my dose increases. Just have to wait and see. Sorry I don't have mush insight to share regarding Parnate, yet. Hope to soon, though. Good luck in whatever you choose, and your questions are always welcome.


----------



## metamorphosis (Dec 18, 2008)

Fed91 said:


> Long time reader of SAS, first time poster. But, I thought I'd finally chime in since I recently started taking Parnate. Like many, I have also been on the medication roller coaster for the past 15 years. Been on Zoloft, Wellbutrin, Cymbalta, Paxil, Remeron, Stablon, and probably some others I can't think of now. All of these to no avail, of course. Gave up on medication for awhile, except for self-medicating with benzos at times. However, I recently decided to give it one more shot, but only if I could find a doc who would prescribe me an MAOI since it is the one medication I believe could actually be effective for my condition given the reports I have read. Well, I was lucky enough to find that doc. Anyway, like you, my doctor gave me the option of trying Parnate or Nardil. My doc preferred Parnate because of the more appealing side effect profile, and after much deliberation, I agreed, and went with the Parnate. I've been on it for almost 3 months now. Unfortunately, I don't have much to report yet. This is most likely due to the fact that we've been taking it very slow with the dosage increases. Started out on just 10mg/day for a month and have been increasing it 10mg/day about every month. I just increased it again today and am at 40mg/day. So far, I have perceived very little effect from it yet, positive or negative. My doc says it seems, due to my history of resistance to the effects of medication, I'll likely have to hit at least 60mg/day to get any therapeutic effect. I have been less depressed lately, but I believe that has more to do with the fact a I am actively pursuing a remedy for my SA once again and have the tiniest bit of hope that this course of action will reap results, than any anti-depressive effect from the Parnate. But who knows, the Parnate may be subtly be taking effect. However, I am still suffering from low mood, anhedonia/very low motivation, the same level of SA, etc. The only side effect I've noticed so far is the slightest bit of postural hypotension and some mild tinnitus. As far as the diet is concerned, it hasn't been much of a concern so far. I've been pretty careful with it, but have tested some items from the restricted list and have had no adverse effects. I am mostly vegetarian and eat a lot of soy, and have had no problem with it. I've read conflicting reports about soy and MAOI's. Some say avoid it altogether, others say just avoid fermented soy (i.e. tempeh, miso). Like I said, I haven't had a problem with it. Like you, I eat a lot of Cliff bars (almost everyday), so hopefully it wouldn't be a concern for you. Now this could very well be due to the fact the Parnate hasn't taken it's full effect yet, and I'll probably have to be more careful with my diet as my dose increases. Just have to wait and see. Sorry I don't have mush insight to share regarding Parnate, yet. Hope to soon, though. Good luck in whatever you choose, and your questions are always welcome.


I live in Englewood. I am curious what pdoc you are using. If you have the chance, pm. with the name. The one I am currently using is on Cherry Creek Dr. but have seen others in the Denver metro area throughout the yrs. I might recognize the name or possibly have seen him or her.

No, this definatley helps. As far as the soy in cliff bars, that is a concern. As I frequently go on 30-60 mile bike rides and cliff bars are my major source of complex and simple carb combo. when I am actually on the bike and need a heavy bar to quickly down for sustained energy. sometimes after hrs on the bike t, the digestive system is not inclined to eat whole foods, ie- sandwiches, muffins, and I need something more then a bannana, dried fruit or Hammer gels or other simple carbs.And I still have many miles to go.
Once the stored glycogen is used up ( 1 1/2 hrs. in). Nutrition bars are part of my aresenal of energy producing foods. Every rider has thier specific foods, gels etc that work for them. So, for me to give up cliff bars would be a bummer.

Enough rambling, my pdoc is very knowledgeable but is not an expert on MAOI's. though he has scripted them before. I chose Parnate knowing that without the GABA-T effect of Nardil. That I will probably have to continue using poly-pharmacy to a certain extent. Right now, I am also on clonazepam and lamictrogine and plan on staying on them for the time being.

Are you on any other medications in conjunction with the parnate?
Though, I eventually will reduce the klonopin by increments with or without the Ashton Method. Probably using another anoxiolytic med. without the major issues with longterm, daily benzo use.

Now, my pdoc is actually starting me on parnate 10mg tid.. So, I will be starting at 30mg a day after my washout. So, my first day of parnate starts on Christmas day.

The main concerns I have are mostly concerning side effects ( insomnia, tolerability to the med in general, and adjustment to the dietary restrictions.

You mentioned that you do not have any issues with the soy in Cliff bars and many of the borderline foods can be trialed at small doses. Of course everyone can react differently. And I am not going to aged meats, cheeses- brie or miso soup etc.
Are you considering getting a bracelet in case of a medical emergency?
How long of a trial are you willing to give the parnate besides using other types of therapy? Are you willing to try nardil if parnate doesn't work?

I am about 90% committed to giving parnate a trial. Realizing that to obtain any true benefits can take 3-6 months. The meds. that have worked before, have stopped being effective. My SA, GA and atypical depression are getting worse. I am currently in a CBT. and ACT. group. Unfortuatley after months of therapy and money, I am just not getting decent results. I have also used about every class of psycotropic medications that are legal!


----------



## Fed91 (Apr 18, 2012)

My pdoc is actually in Boulder. I can pm you his name if you like. He was a b*tch to get an appointment with, but it was well worth it. He has a considerable amount of experience with MAOI's and seems very knowledgeable and open-minded in general. I feel lucky to have found him.

As far as other meds, I do take klonopin occasionally, but usually just as a sleep aid. I'm pretty careful with my use of it as I had an episode of daily, high-dose benzo use. Well, benzo abuse is more like it. Went through the worst withdrawal imaginable (oh yes, it was hell like I never imagined). Suffice it to say, I learned my lesson about responsible benzo use, so I stay away from daily use for fear of my body becoming physically dependent on them again. Not that I'm against daily use for those who find it therapeutic. I also want to give Parnate a chance to treat my SA as monotherapy before I augment it with anything just so I know the limits/potential of it treating SA on its own.

I've been using klonopin as a sleep aid for awhile. So, it's not something I take to specifically treat insomnia caused by Parnate. It's hard to say if Parnate has affected my sleep as I have had chronic sleep problems for years. I wouldn't say my sleep is any worse since starting. My side effects so far have been minimal to non-existent, but I expect that to change as my dose increases. You may experience more side effects than I have initially just because you're going with 30mg/day right away whereas I started out so low (too low IMO, but my doc likes to start slowly with MAOI's to let the body acclimate to it gradually). 

As far as the diet is concerned, I don't think you have too much to worry about. It's really not that bad. I mean, I don't eat meat anyway, and very little cheese so the restrictions really don't affect me much. I don't know what you're diet is like, but considering your an avid cycler, i would imagine you eat pretty healthy. And, in that case, it makes it much easier, possibly just some small adjustments. I really think you'll be fine eating Cliff bars. As I said, I eat them almost daily and have had no problem whatsoever. cont...


----------



## Fed91 (Apr 18, 2012)

To answer your other questions, yes I am going to get a bracelet. My doc insists that I do. I haven't yet, but I think it is a good idea. You never know what can happen. As far as length of trial, I am going to give it quite awhile, especially since I've been going so slow with it. At first, I was pretty impatient with it, just because I've been dealing with this bullsh*t disorder for so long and just want some f'n relief already. But, I realize this may be my last viable option so I'm going to give it quite awhile. Going to give it at least a year. Just going to keep assessing it as it goes. My doc mentioned augmenting it with Lyrica at some point if the Parnate isn't producing significant results by itself. But, that is far down the line. I still have awhile to go to find my particular therapeutic dosage, if there is one. We are starting to increase the dose more frequently at this point, thankfully. Doc thinks 60mg/day, possibly higher for me.

I am willing to try Nardil if Parnate doesn't do it for me. Whatever works at this point. I don't like some of the additional side effects many report with Nardil. Especially weight gain and fatigue, as keeping in shape seems to be the last activity I can still halfway enjoy right now. But, if it significantly improves my SA, I'll deal with almost any side effect (except spontaneous combustion, never been a big fan of that one :b). 

I've also been in CBT many times, but also without much results. I almost think with SA, one needs a neurobiological change for the better first, and then CBT can become a viable augmentation. I don't know, just speculation. Maybe I haven't put in the proper effort. I also think many therapists don't understand the idiosyncracies of SA, and that we've been 'exposing' ourselves to our fear all our lives. I wish I could find a psychologist that specializes in SA, but have never found one.

Anyway, have a Merry Parnate Christmas and let me know how its working for ya.


----------



## metamorphosis (Dec 18, 2008)

This is an excellent, updated and easy to read review of MAOI interactions or lack thereof, with foods and medications, without the extreme paranoia. It also covers the issue of medical treatment for high BP resulting from tyramine ingestion, from psychotropical.com.
http://psychotropical.com/pdfs/maois_diet_full.pdf

Also a good pdf from the book, which contains useful charts.
*Meal Ideas
and Menus:
Avoiding
High-tyramine
Foods Made Easy
Kathrynne Holden, MS, RD*
http://www.mc.vanderbilt.edu/documents/neurology/files/Tyramine Menu Book 06227101.pdf


----------



## Fed91 (Apr 18, 2012)

I have read the one from psychotropical. I also thought it was excellent. I haven't read the other one yet. I'll have to check it out. Thanks for the info!


----------



## Gwen1234 (Sep 6, 2011)

Fed91,

>>I also think many therapists don't understand the idiosyncracies of SA, and that we've been 'exposing' ourselves to our fear all our lives.

Yes! I totally agree. I try to explain this to my CBT therapist. All these exposure exercises are not useful. I expose my self to frightening, anxiety producing events ALL THE TIME. Has my anxiety gotten any better? Nope.


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> Fed91,
> 
> >>I also think many therapists don't understand the idiosyncracies of SA, and that we've been 'exposing' ourselves to our fear all our lives.
> 
> Yes! I totally agree. I try to explain this to my CBT therapist. All these exposure exercises are not useful. I expose my self to frightening, anxiety producing events ALL THE TIME. Has my anxiety gotten any better? Nope.


I have been without a car for 8 yrs.
So, for me to get around town, I have 3 options- bike, walk, or public transportation. So, I am basically doing "exposure therapy" every day. I can't simply drive from point A to point B. I am forced to deal with more people and am exposed to a lot more social situations because of this. 
And, at least in my case, it has not reduced my SAD to any appreciable degree.


----------



## metamorphosis (Dec 18, 2008)

This is an interesting piece from Dr. Ken Gillman's website.
psychotropical.com
He is a retired psychiatrist with interests in clinical neuropharmacology and psychopharmacology. He has extensively researched and published papers, specifically on the MAOI's. In this text, he weighs the pro's and con's in choosing between phenelzine and tranylcypromine in his opinion.



> *Created on Tuesday, 22 May 2012 17:35
> Last Updated on Friday, 01 June 2012 18:02
> Written by Dr Ken Gillman
> MAOIs - Choices
> ...


----------



## metamorphosis (Dec 18, 2008)

Here is a great paper by Stahl about modern treatment with the MAOI's. The entire document is a good read with the really cool diagrams. Which Stahl is known to incorporate into his books. Pretty much a must read for anyone on an MAOI or maybe starting one!!!

*Monoamine Oxidase Inhibitors:
A Modern Guide to an Unrequited
Class of Antidepressants*
By Stephen M. Stahl, MD, PhD, and Angela Felker, MA

http://www.psy-world.com/1008CNS_Stahl.pdf


----------



## metamorphosis (Dec 18, 2008)

> *Dr. Grossi's Blog
> MAOIs: Drug Interactions Sunday, 03 April 2011Dr. Philip Grossi *
> Each and every week I receive two or three phone, fax, or email communications from pharmacies questioning my concomitant use of an MAOI with another drug. Last week I received a phone call from a former patient whom I treated successfully last year and who moved back to Texas because of a job loss. I had maintained her on tranylcypromine (Parnate) for the last five months while she sought out another psychiatrist in Texas. She reported last week that she had been unable to find another doctor or psychiatrist who was willing to prescribe the medication for her due to the risks involved in using MAOIs. She stopped taking it and noted that the black dog (she liked Churchill's term for depression) was back. The living purgatory she was experiencing when she first met me had returned. Such experiences highlight the misunderstanding and misinformation of a complex subject that is present in the professional community and which is entombed in the Physician's Desk Reference (PDR), textbooks, drug checking computer programs, MAOIs' unfortunate 1960's history, and the Food and Drug Administration (FDA) pronouncements..
> MAOIs are the oldest class of antidepressants. In the early 1950s there were some tuberculosis patients being treated with isoniazid and iproniazid who were noted to brighten, show renewed vigor, and were more stimulated. The drugs' mode of action was discovered to be monoamine oxidase inhibition. A few years later phenelzine (Nardil) and tranylcypromine (Parnate) were introduced. A number of deaths occurred especially in nursing homes around London where a snack of English Stilton Cheese and Chianti wine was given in the afternoon. The FDA received about 500 reports of hypertensive crises which resulted in 30 deaths. Consequently tranylcypromine (Parnate) was withdrawn from the market for about eight months in 1964. After researchers discovered that their use required a diet low in tyramine (an amino acid) diet it was reintroduced into the market.
> ...


*MAOIs in high doses and with stimulants*
http://www.dr-bob.org/tips/split/MAOIs-in-high-doses-and-wi.html


----------



## Gwen1234 (Sep 6, 2011)

I just started Parnate today! Saw a new psychiatrist last night for the first time and we quickly decided that I needed to be aggressive with my treatment. Since stimulants often make me tired we figured that Parnate would not add to my anxiety. 

Anyways, I took 10mg this morning. Will take it for 2 more days than up it to 20 mgs in the morning for the remainder of 2 weeks. Then we will reevaluate the dose. My experience so far: It made me sedated for a few hours. Needed to take a nap. I got a minor headache which was easily cured by ibuprofen. It's 7 p.m. and I don't feel drugged or tired which is good. If I have no trouble sleeping tonight (watching for the famed insomnia) I will try taking the medication at night so I can sleep through the sedation. If I do get insomnia, I will try taking melatonin. No change in mood so far, of course. 

Will report on later days.


----------



## metamorphosis (Dec 18, 2008)

We are practically starting Parnate at the same time. I am on day 2 right now. I believe that you are not taking any other meds? I am currently on Parnate 30mg a day. What is your starting dose?
I also take Lamictal, deplin (basically a more bio-available folate), Klonopin, which I plan on slowly reducing and ambien prn for sleep.

So far, two day in, I am feeling more depressed, as my pdoc took me off of modafinil, at least initially. Modafinil is a gentle stimulant (not amphetamine), that has anti-depressant properties. I plan on going back on it, at least until the Parnate kicks in. As long as my pdoc okays it. 99% sure, as long as I have my normal BP( 120/75), no hypertensive issues or serotonin reactions with foods and meds. I have a blood pressure cuff and some nifedipine, in case of a hypertensive crises. The only other precaution I do not have yet, is a med-alert chain.
I had pretty bad insomnia last night, but I have to look at it realistically. This is day 2. It can be a placebo effect. Though, I have had insomnia on and off for yrs. Also the body has to adjust to the med and the times dosed throughout the day can be played with. Some people say it can take 3-6 months for full results. There are many different strategies not only to potentiate Parnate with 1-2 extra meds. max. But also to help deal with any side effects until the Parnate and it's MAOI inhibition take full effect.

Do you have a good report with your pdoc? Is he/she knowledgeable and open minded? I am lucky to have found a very good one.


----------



## Govinda (May 7, 2012)

I'm about to start a parnate trial. I recently took nardil, but it **** the bed on me. It was working better than anything I've ever tried in my life, but then it started to cause this cyclical depression, intense anxiety, twitching, tachycardia, and other symptoms associated with serotonin overdose. I kept reducing the dose, but could never make it work after 4 or so great months.

I know parnate doesn't work on gaba like nardil, and thus shouldn't help as much with SA, but I'm hoping that I will however get the same boost of self-confidence that I got with nardil, and that this will combine with some sedative treatment to keep me even. That feeling of acceptance and warmth is so key to the fight. * Normally I have this innate shame about the sound of my voice, the look of my face/body, even about the idea of me making noise loud enough for others to hear it. When I took nardil, I lost this shame and was able to participate in life *.

*Anyway, will I go through the same process initially that I went through with nardil? * (Nothing but insomnia/sedation for about a week, then hypomania for another, then cycles of crap/heaven before settling occasionally on the target feeling)

I'll try to write about what happens.


----------



## metamorphosis (Dec 18, 2008)

Govinda said:


> I'm about to start a parnate trial. I recently took nardil, but it **** the bed on me. It was working better than anything I've ever tried in my life, but then it started to cause this cyclical depression, intense anxiety, twitching, tachycardia, and other symptoms associated with serotonin overdose. I kept reducing the dose, but could never make it work after 4 or so great months.
> 
> I know parnate doesn't work on gaba like nardil, and thus shouldn't help as much with SA, but I'm hoping that I will however get the same boost of self-confidence that I got with nardil, and that this will combine with some sedative treatment to keep me even. That feeling of acceptance and warmth is so key to the fight. * Normally I have this innate shame about the sound of my voice, the look of my face/body, even about the idea of me making noise loud enough for others to hear it. When I took nardil, I lost this shame and was able to participate in life *.
> 
> ...


Yeah, please do! When do you start the Parnate? What dose are you starting out on and are you taking any other psych meds? It's not a GABA transaminase inhibitor like Nardil. You can always add an anxiolytic with it, if you need to. Which isn't always necessary but there are many options in that case.


----------



## Inshallah (May 11, 2011)

Govinda said:


> I'm about to start a parnate trial. I recently took nardil, but it **** the bed on me. It was working better than anything I've ever tried in my life, but then it started to cause this cyclical depression, intense anxiety, twitching, tachycardia, and other symptoms associated with serotonin overdose. I kept reducing the dose, but could never make it work after 4 or so great months.
> 
> I know parnate doesn't work on gaba like nardil, and thus shouldn't help as much with SA, but I'm hoping that I will however get the same boost of self-confidence that I got with nardil, and that this will combine with some sedative treatment to keep me even. That feeling of acceptance and warmth is so key to the fight. * Normally I have this innate shame about the sound of my voice, the look of my face/body, even about the idea of me making noise loud enough for others to hear it. When I took nardil, I lost this shame and was able to participate in life *.
> 
> ...


Nicely worded


----------



## Gwen1234 (Sep 6, 2011)

Metamorphosis,

I will direct people from the Parnate thread I started to this thread. Posting on 2 threads about the same med is a bit much!

So, I slept like a log last night. No insomnia for me. Slept deeper than I normally do, actually. I decided to take the med again this morning (instead of at night) but this time with food to see if it makes a difference in the sedation. If I'm still sedated, I will take it at night tomorrow. 

I just saw my new psychiatrist for the first time the other night. I liked that he was straight forward and knowledgeable.


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> Metamorphosis,
> 
> I will direct people from the Parnate thread I started to this thread. Posting on 2 threads about the same med is a bit much!
> 
> ...


----------



## Gwen1234 (Sep 6, 2011)

You get a chilled, relaxed feeling? I'm super jealous. I get nothing so far. Then again, I'm just on 10 mg. I will be taking 10 mg for one more day (for a total of 3 days), then I will up the dose to 20 mg a day until I see my doc in a little under 2 weeks. 

I'm not taking melatonin yet. I just have it on hand in case I need it. 

The sedation I was feeling yesterday hasn't happened today. Neither has the headache. So as for day #2, no side effects.


----------



## metamorphosis (Dec 18, 2008)

Thats a plus, as the side effects will certainly come before the positive effects. I hope improvement in mood happens relatively quickly, 4-6 weeks. Though to achieve the optimum therapeutic range takes time and to accurately gauge the full effects can take a few months.


----------



## Govinda (May 7, 2012)

I'm not sure exactly what dose to start on, and I know my doctor isn't either -- he's not that used to using maoi's. I don't mind starting at a sub-therapeutic dose and moving achingly slowly.

I currently take baclofen 40 mg/day (3rd week) as well as propranolol prn. I stopped lyrica a short time ago, because I was feeling like a moron.

What do you think is a good starting dose for someone with Severe SA and only slightly less severe depression?


----------



## Gwen1234 (Sep 6, 2011)

Govinda,

Does you doctor have another doctor that he/she can consult with on the proper starting dosage? As you can see, my doc started me on 10 mg. Metamorphosis' doctor started him on 20 mg. I looked at GlazoSmithKline's website and they recommend starting at 20 mg a day (10 mg twice a day). 

I hear you when you talk about the difficulty about hearing yourself talk. My anxiety has become so bad over the past few months that talking to nearly anyone makes me very uncomfortable. It's painful in fact. I've never been in this place before mentally and it's scary.


----------



## metamorphosis (Dec 18, 2008)

Govinda said:


> I'm not sure exactly what dose to start on, and I know my doctor isn't either -- he's not that used to using maoi's. I don't mind starting at a sub-therapeutic dose and moving achingly slowly.
> 
> I currently take baclofen 40 mg/day (3rd week) as well as propranolol prn. I stopped lyrica a short time ago, because I was feeling like a moron.
> 
> What do you think is a good starting dose for someone with Severe SA and only slightly less severe depression?


 The thre main factors are your pdoc. His/her knowledge on the MAOI's and general practice when starting one. What other medications the patient is on and the patients tolerance to the drug. I believe most start their patients at 20mg (conservative estimate) at least for the Parnate to reach stable MAOI inhibition in the brain. Which is usually 5 days. Then an increase in dose to 30mg. If you are tolerating the med. After that, a 10mg increase until the ideal therapeutic dose. Also, if 20-30mgs causes to many side-effects initially, insomnia, b.p. issues, reactions, or anxiety/agitation. You can always reduce to 10-20mg for a longer period of time. Sometimes 30mg is a sweet spot for some. It can take 60mg. Also, other meds. that you are currently using play an important part.

Some of the links I gave earlier in the thread talks about this.



> Dosage And Administration: Dosage should be adjusted to the requirements of the individual patient. If the patient responds to therapy, the response is usually seen within 48 hours to 3 weeks after starting medication.
> 
> Recommended starting dosage is 20 mg/day (10 mg in the morning and 10 mg in the afternoon).
> 
> ...


http://stahlonline.cambridge.org/pr...utics&name=Tranylcypromine&title=Therapeutics


----------



## Gwen1234 (Sep 6, 2011)

Does anyone know if there is a difference in effectiveness between brand name Parnate and its generic? I am taking the generic.


----------



## metamorphosis (Dec 18, 2008)

I haven't heard anything about generic Parnate being less potent then the name brand . Unlike the infamous reformulation of Nardil. In 2003 Parke-Davis sold the Nardil patent to Pfizer. There was a huge outcry from many Nardil users about it's effectiveness after. many of them being longtime users, 20-30yrs. Also, recently the FDA finally pulled a generic, substandard Wellbutrin from the shelves. This being after yrs of complaints. This has put pressure on the FDA to "get with it" and more closely monitor the generics put out.

http://www.nytimes.com/2012/11/01/b...f-some-generic-drugs.html?pagewanted=all&_r=0

I read one psycho-pharmacologist state that in his personal opinion:
"There is a potential for different effects due to the different binders, colorants and fillers used (Nardil reformulation). They can affect rates of absorption and the site in the gut where most of the drug is absorbed, and that can make a difference to the overall effect of the drug.

You might then assume that generics are inferior and the most reliable response is to the brand name drug, but that isn't the case. I had many patients who only responded to one particular make, and it wasn't the brand name Prozac, it was generic Dr. Reddy's fluoxetine that was often most effective. Some generic manufacturers by either accident or design produce medicines superior to the brand name manufacturers."

I have never heard of any issues with the different Parnate brands.The determination of drug approval is made according to whether it is pharmaceutically equivalent, bio-available, and bioequivalent to that of the brand name. Although everyone has their opinions and some people will always insist on name brand period.

Which is good for me. I believe most generics meet the criteria for potency standards. I can't imagine what the price of the name brand Parnate would be. I use Par, generic formulation. Which is expensive enough. I know of one other generic manufacturer, but the name slips me.


----------



## metamorphosis (Dec 18, 2008)

Day-4 Parnate
Well, first the bad- insomnia has been pretty bad. I am talking around 3 hrs of restless sleep a night. Other side effect is hypersensitivity to the cold.

The good- I can feel it starting to work or what you might call positive side effects. When I take my doses 20mg morning and 10 mg noon. The first few hrs I feel a bit wired, surprise huh!!! But after that, I experience a combination of relaxation and warm feeling comes over me for about 1-2 hrs. I start to feel tired but not to the extreme. It's more of a chilled out feeling. Parnate can increase agitation at least initially. Also, my sex drive is returning after 2 yrs. on Lexapro. All SSRI's can cause frontal lobe apathy. And it can carry over for months or even yrs. for some. So, the return of my sex drive and all those other wonderful SSRI induced side effects are disappearing. Also, Parnate is definitely weight natural for me. Even with some decreased appetite, I expect to shed the extra 20 lbs over time and be at my ideal, fighting weight!!!

This of course is the first day that I should be on a steady state with the MAOI actions taking effect. So the brain is just starting to adjust to full MAO inhibition, obviously.
The insomnia that is the hard part. I can't function on 3hrs of light sleep a night for long. We need our sleep for body and mind health, repair, REM, and all 4 stages of sleep . So, I may employ a TCA with low serotonergic activity- nortriptyline, amitrip., or doxepin ( which is really just an anti-histamine), no clomipramine or imipramine. Possibly Trazadone at 25-50mg, as it is actually an anti-serotonergic drug. It has significant five HT antagonistic properties. And I will be on the sleep dose levels.

Ideally, after figuring out how my brain and tri-monoamines respond to Parnate at a steady state for 2 weeks and sleep doesn't improve. I may want to augment nortriptyline for it's excellent therapeutic and low side effect profile along with Trazadone for sleep. I have to see where I am at first with the Parnate. This will al take time, as I want to follow a responsible and intelligent protocol. Introducing a medication, only if needed after time on a steady state. The only adjunct I am seriously considering now is a sleep med. I see my pdoc on the 10th and we will go from there.

I have been taking my blood pressure 2-3 times a day and am usually around 120's or 130's/80's or 90's. Dr. Gilliam was kind enough to reply to my e-mail to him. He answered many of my questions. He also gave me links to 2 of his pdfs. One of great interest is using the systolic b.p. at rest, immediately when standing and 1 minute after that. It is a great graph and info. using concrete b.p. readings. It explains how to find your therapeutic dose range for people on MAOI's and/or nortriptyline . Following the numbers will show if you are a slow or fast metabolizer of the meds.

http://www.psychotropical.com/


----------



## Govinda (May 7, 2012)

Thanks for the replies and advice. 
There is one other doc at my clinic that has slightly more experience with MAOIs. I'll ask her, but I'm not that optimistic about her tools either.

Sounds like some of you guys have a strategy: sleep meds, combination therapies, etc. What would you recommend for an adjunct to parnate? I'm expecting to need something to help chill me out. Benzos are out (I have a history) and lyrica destroys my memory and concentration. I keep hearing docs and users on this site mention tricyclics, but I tried acouple as monotherapies really briefly and felt no increased relaxation. Is there any reason to believe that they would then work if combined with parnate?

Please, keep the updates coming.


----------



## Gwen1234 (Sep 6, 2011)

I'm on day 4 of Parnate. Upped my dose to 20 mg today, all in the morning. I haven't noticed any difference in my anxiety yet. Haven't had any side effects other than some sedation. Actually, for a couple days it made me sound like I was drunk or super depressed when I talked. Or just drugged. Haven't had trouble sleeping yet. I'm definitely going to lose weight on this drug since I can't eat just anything I want. Last night for New Years everyone was eating Chinese food and I had to settle for scrambled eggs! I'm not a big person to begin with, so there is only so much I can lose before I look not so good.


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> I'm on day 4 of Parnate. Upped my dose to 20 mg today, all in the morning. I haven't noticed any difference in my anxiety yet. Haven't had any side effects other than some sedation. Actually, for a couple days it made me sound like I was drunk or super depressed when I talked. Or just drugged. Haven't had trouble sleeping yet. I'm definitely going to lose weight on this drug since I can't eat just anything I want. Last night for New Years everyone was eating Chinese food and I had to settle for scrambled eggs! I'm not a big person to begin with, so there is only so much I can lose before I look not so good.


That is great that you have no insomnia. Keep in mind that your NT's are now just reaching a steady state of MAOI inhibition. So, your brain chemistry is just beginning to adapt. Most pdocs will say a 3 month trail period is necessary to realize it's full potential at your therapeutic dose, unless your side-effects become to unbearable. Do you have a blood pressure cuff? I find having one invaluable for determining how you are doing on Parnate.
Usual therapeutic dose is 30-60mg by determining not only how you are feeling but also by where your b.p. stabilizes at.


----------



## Gwen1234 (Sep 6, 2011)

I don't have a BP cuff. Was considering getting one. Actually, I might have one stored away somewhere in my house. My dad got me one a while back for some forgotten reason. 

I ordered a medical ID necklace yesterday online that states that I am on Parnate in case I'm ever unconscious and need medical attention. It's a dog tag. Looks kinda cool and should be able to hide it under my shirt (as opposed to a bracelet).


----------



## GotAnxiety (Oct 14, 2011)

Brand name is always better. Get the real deal. Instead of some cheap knock off. 

How much is the price difference btw?


----------



## metamorphosis (Dec 18, 2008)

Govinda said:


> Thanks for the replies and advice.
> There is one other doc at my clinic that has slightly more experience with MAOIs. I'll ask her, but I'm not that optimistic about her tools either.
> 
> Sounds like some of you guys have a strategy: sleep meds, combination therapies, etc. What would you recommend for an adjunct to parnate? I'm expecting to need something to help chill me out. Benzos are out (I have a history) and lyrica destroys my memory and concentration. I keep hearing docs and users on this site mention tricyclics, but I tried acouple as monotherapies really briefly and felt no increased relaxation. Is there any reason to believe that they would then work if combined with parnate?
> ...


For how long have you had anxiety?
How severe is the anxiety?
Will you be using an anxiolytic drug everyday, or as a PRN only when needed?

Okay, so the benzo class is out. That is a good idea. Especially if you have an addictive personality. Also, pregabalin is out. So, gabapentin would probably also be a negative.

In this double-blind study, their conclusions were that Parnate was effective for treating panic disorder and social anxiety disorder, and that 60 mg/day was much more effective than 30 mg/day.

http://www.ncbi.nlm.nih.gov/pubmed/20036427



> *Double-blind comparison of 30 and 60 mg tranylcypromine daily in patients with panic disorder comorbid with social anxiety disorder.*
> Nardi AE, Lopes FL, Valença AM, Freire RC, Nascimento I, Veras AB, Mezzasalma MA, de-Melo-Neto VL, Soares-Filho GL, King AL, Grivet LO, Rassi A, Versiani M.
> Source
> Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, R Visconde de Piraja, 407/702 Rio de Janeiro, Brazil. [email protected]
> ...


http://www.ncbi.nlm.nih.gov/pubmed/20703987



> *
> Monoamine Oxidase Inhibitors: A Modern Guide to an Unrequited Class of Antidepressants*
> Stephen M. Stahl, MD, PhD, and Angela Felker, MA
> MAOIs can be combined with some TCAs (never clomipramine; Table 7) that inhibit NE reuptake if both agents are started simultaneously, at low doses, and if the titration of both agents is done carefully, with blood pressure monitoring, by someone experienced in this rather heroic combination.2,10,18,58 Combining TCAs (though never clomipramine).


A few choices-
- the TCA's: doxepin, nortriptyline, amitriptyline ( avoid the others)
- Buspar (buspirone) might help, but it often takes a few weeks to begin working.
- Hydroxyzine is an old antihistamine. It possesses anxiolytic properties in addition to its antihistamine properties and is also licensed for the treatment of anxiety and tension. It has helped me in the past. Sedation decreases over time
- Tiagabine: binds to recognition sites associated with the GABA uptake carrier.tiagabine blocks GABA uptake into presynaptic neurons, permitting more GABA to be available for receptor binding on the surfaces of post-synaptic cells. It operates as a selective GABA reuptake inhibitor

Last on my list would be a low dose of Zyprexa but I do not like the use of ant-psychotics per se. Though many have found it quite effective.

My main choices would be the pregabalin or gabapentin.

Also, coffee can exacerbate agitation. Exercise, include cardio at least 3-5 times a week for 30 minutes or more is great for anxiety. Getting adequate sunlight daily will really help along with quality sleep.


----------



## metamorphosis (Dec 18, 2008)

GotAnxiety said:


> Brand name is always better. Get the real deal. Instead of some cheap knock off.
> 
> How much is the price difference btw?


If all generic medications were some "cheap knock off", then we would have major health issues across the board and not just on psych. meds.

Prices-
Generic: $148.89 (Par)
Name Brand: $423.59 (GlaxoSmithKline)
Many people do not have insurance and cannot afford to pay the extra $300 dollars. Even with insurance, often the brand name Parnate is not covered.

A great website that finds the best discount coupon for a particular med.-
http://www.goodrx.com/
Thaks to Fed91 for that link!!!


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> I don't have a BP cuff. Was considering getting one. Actually, I might have one stored away somewhere in my house. My dad got me one a while back for some forgotten reason.
> 
> I ordered a medical ID necklace yesterday online that states that I am on Parnate in case I'm ever unconscious and need medical attention. It's a dog tag. Looks kinda cool and should be able to hide it under my shirt (as opposed to a bracelet).


Yeah, I went to the med-alert site and was surprised to see some pendant and chain/necklace choices. I still haven't ordered one yet but I'll take that anytime over a bracelet. What info did you put on there. You can simply put MAOI user. Or how about "don't use Demerol or my family will hunt you down and kill you"
I'm not sure that would fit. I saw one the other day at Walgreens that is actually designed for download onto a computer. You can put all the info. you want on it. Your health issues, psych. disorders and the meds. your on. I think it went for around $26-28.
Also, it is good to have some nifedipine around in case of a serious hypertensive crises. I was Rx'ed 10mg, 6ct. Hopefully, I will not have to use them but it is comforting to know they are on hand.


----------



## metamorphosis (Dec 18, 2008)

Day 6-
Yeah, I know this is just the beginning.

So far my side effects are insomnia. Which is the worst side effect of all!
I've been taking my first dose 20mg in the morning and then take the second around 12-1pm. I still get tired in the afternoon. Many say that the insomnia will decrease. I hope it will or an am going to add a sleep aid after 2-3 weeks. That is if I am only getting 3-4hrs of light sleep.

Another hard issue to deal with is a moderate depression that has set in, with dysphoria and anhedonia. That may be attributed to my brain not only adjusting to the med, but also coming off of two meds.
The other side-effects include sensitive to the cold. Which may not subside but is not that bad for me.

Also, my appetite has decreased. Which is a positive for now, as my time on Lexapro caused weight gain.Well, my appetite has decreased on Parnate. I am making sure that I get plenty of my macro-nutrients (protein, complex carbs, good fats, no or very low trans-fat), I am also eating a lot healthier with a lot of fresh veggies and fruits along with lean meats. I also take a multi-vitamin, B-complex (sublingual), alpha lipoic acid CoQ10, fish oil, melatonin and probiotics, right now.
Also, plenty of water and fresh ginger tea.

Sex drive is finally coming back. Which, as a healthy guy, is how it should be. As my testosterone levels are fine.

I am only on day 6. So, I expect these issues. My pdoc said I should give it at least 3 months, preferably up to 6 months to see how it goes. And I am up for 
it at least for now. I am pretty good at putting up with side effects.

I have high hopes for Parnate, even if I have two add an extra med. or two. Preferably, I would like to use a little meds. as possible. After yrs. of all of the other classes of meds. either not working or pooping out. I am willing and actually have a good feeling to finally try an MAOI.


----------



## Gwen1234 (Sep 6, 2011)

I think I have identified a side effect that I'm experiencing. Tingling in my legs, creepy crawly feelings when I am lying down. It can get pretty intense. I thought it would make it difficult to fall asleep, but I haven't found that to be the case. Still sleeping fine. But it does make me want to get out of bed rather than lay around, which could be a good thing. 

Metamorphosis, you are very knowledgeable about all things MAOI. What vitamins are the most important to take while on them? I've had some bad reactions to vitamins in the past (skin rashes, hair loss, heavy sedation), so I avoid them. But wondering if any would enhance the efficacy of Parnate or replace vitamins that could be being depleted by the med.


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> I think I have identified a side effect that I'm experiencing. Tingling in my legs, creepy crawly feelings when I am lying down. It can get pretty intense. I thought it would make it difficult to fall asleep, but I haven't found that to be the case. Still sleeping fine. But it does make me want to get out of bed rather than lay around, which could be a good thing.
> 
> Metamorphosis, you are very knowledgeable about all things MAOI. What vitamins are the most important to take while on them? I've had some bad reactions to vitamins in the past (skin rashes, hair loss, heavy sedation), so I avoid them. But wondering if any would enhance the efficacy of Parnate or replace vitamins that could be being depleted by the med.


A good B-complex is important. Also, MAOI's. may cause a deficiency in B-6. Many nutritionally oriented doctors believe that most diets do not provide optimal amounts of this vitamin. Some nutritionally-trained physicians advise patients taking these or similar drugs to supplement with vitamin B6, usually at moderate levels such as 50 mg per day. Instead, I take 12.5 mg/day of sublingual P-5-P, the endogenous form of B6. Sublingual forms of co-enzyme B vitamins are the best for absorption, but they take a while to dissolve. So many people just won't take them. A regular B-supplement will do the trick.
Usually the upper limits of supplemental intake is 100mg..

I also take 2 a day multi-vitamin that contains 75mg of B-6. So, I factor that in.

*Excellent link to B-6 including foods rich in B-6, functions, impact of cooking, storing, and processing from my favorite nutritional book: 'The Worlds Healthiest Foods'*
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=108

Here is a good pdf listing many medications and nutrient deficiency caused by them:
http://www.eatwellmd.org/docs/Annual Meeting 2011/Presentations/Yuliya Klopouh_Presentation.pdf

Vitamin for Depression?
A Good Vitamin Supplement Could Be Just What the Doctor Ordered:
http://depression.about.com/cs/diet/a/vitamin.htm


----------



## Gwen1234 (Sep 6, 2011)

Thanks Metamorphosis for the vitamin info!

On my med tag I put my name, an emergency contact number, that I am on Parnate and indicated its an MAOI in case they are clueless, I included my blood type and that I am an organ donor. I got mine from the website www.RoadId.com They give you ideas of what kinds of information you might want to include and why some info is more important than others. And you get to choose what image to include on the front. I put the medical alert symbol on it (of course).


----------



## metamorphosis (Dec 18, 2008)

Wow, you can fit quite a lot on that sucker. The ones I saw on med-alert definitely wouldn't cram all of that info in!


----------



## Govinda (May 7, 2012)

Thanks Metamorphosis.
That's a very hopeful study you attached.
As far as your med recommendations, tiagabine interests me the most. I'll research it some and give it some thought.

I started parnate today at 10 mg. I'm going to start a journal thread today.

I have had (clinical) social anxiety since puberty. I was always quiet, but it wasn't until high school that I started having overt physical symptoms and really felt ashamed for no reason. It has risen and fallen over the years. Two years ago I had a hospital trip that nearly broke me, during which I developed new symptoms and behaviors, such as extreme difficulty with eye-contact. So, I've been clawing my way back since then. Just a couple months ago, on nardil, I was starting to date (a personal first), travel, re-develop friendships, etc. Once nardil failed, I reverted to being a near shut-in. I get choked-up talking to anyone; my eyes water when I look at someone else's; I keep gulping all the time and trying to hide it (makes it worse). Obviously, I'm in a bind. Hope this works.

Anyway, that's a brief glimpse at my anxiety.


----------



## Gwen1234 (Sep 6, 2011)

Govinda,

When the Nardil was working for you, what did it feel like? How did your thoughts and behaviors change? 

And congrats on your first day on Parnate! I'm glad we are taking this trip together.


----------



## metamorphosis (Dec 18, 2008)

On my 7th day, and last night was the first time I actually slept for 6hrs, without a sleep aid. It wasn't the most refreshing sleep, but I'll take it. I attribute it to two things. One my body needing to sleep after a week of 3hrs of very poor sleep. The other part, which I am hoping is the main cause is my body adjusting to the 30mg of Parnate. I am taking the Parnate in two doses. When I first wake up. I take 20mg and try to take my last 10mg by 1-2.

I have talked to my pdoc a few times on the phone. I was asking him about adding a low dose of trazodone or doxepin for sleep. He will usually okay most of my ideas on meds. He knows I do my homework but I think he was right on about not adding any other meds. after only being on the parnate for a week. I see him on the 10th and he wants my body and brain to adjust properly. The drug takes about 5 days just to reach a steady state and then you need time before starting to analyze results. So, we have a baseline level of the med. before adding other meds. That could complicate things, by affecting my b.p. and just muddling where my side effects may be coming from.

If I add any medication, so early with the MAOI. It can just make it more difficult distiguish if any side-effects are from the Parnate or the other meds. At first I was bummed about the decision but hindsight is always 20/20. He basically said that he was against doing anything else, med. wise after only a week. He said it was basically up to me in the final descion. While I can be impatient. I decided to take his advice. 

I have read a lot of anecdotal reports, and a trend is for people to become impatient. Soon, they are adding meds. to quickly. Ramping up the dose of the meds. before they can accurately gauge what the fist med is doing. Especially when dealing with the tricky effects MAOI's are known for. Intially, Parnate should not be titrated up in the first week. Usually the strong biological change in the brain should be allowed to adjust. 2 weeks before adding another 10mg is not that long of a wait.

I am finally feeling some of the more positive effects of the med. The depression, dysphoria and anhedonia has started to lift in the last 2 days. I have more energy this morning and my lethargic state has lifted to a noticeable degree. I still get a slump 3-4hrs after my first dose and my extremities still get cold often. As far as blood pressure is concerned, the numbers point towards a more therapeutic level. My systolic b.p. while sitting is in the 120's. Then I stand and take another systolic read immediately. Yesterday was a first time that the systolic level was actually lower after standing. Which is an indication that the med is starting to reach a decent level. Then I take another systolic reading after one minute. So far, it has gone back to a 120-130's level. This is why orthostatic hypotension is usually a sign that the med. is actually starting to do something.
I haven't had any dizziness yet upon standing, but I expect that to be a side effect. That actually shows a positive response to the med. 

The minor agitation, I believe will dissipate over time. I am also on clonazepam. So that takes the edge off. One of my major plans is to slowly reduce the Klonopin. Eventually, coming off of it completely. I am planning on adding pregabalin, as an anxiolytic. Even though Lyrica can make me very hungry. Based on the fact that the Parnate has suppressed my appetite. The two may achieve a balance there. Lyrica has worked well for me in the past. The only side effect that I could not handle was eating myself out of house and home.

So, I am hopefully reaching some level of stability on the Parnate, at least for today. MAOI's are finicky. So, tomorrow may bring a dump off in my mood but that is a quite common effect. The positive is the fact that I know this and am prepared for it. It really can be a rollercoaster ride for awhile. But I plan on dealing with the side effects without becoming to inpatient. I have a high tolerance when it comes to waiting it out. Throwing in another med. to quickly or ramping up the dose, because I am not feeling the positive effects as soon as I would like; Can often make things worse, IMHO. Then you start wondering which med. is causing what effects. Where as you take one med. and give it time. You are in a better position to judge each meds. specific actions. This is especially true in dealing with poly-pharmacy. When it is not just an SSRI and one other med. to evaluate.


----------



## Gwen1234 (Sep 6, 2011)

6th day on Parnate: The tingling in my legs has seemed to have disappeared. So laying down is not as uncomfortable anymore.

My appetite is completely gone. I could go the entire day without eating and not notice. Yesterday I had a bowl of cereal and one and a half slices of pizza. I forced myself to eat that pizza. Today a bowl of cereal and a salad. Only ate half of what was a small salad. 

As for anxiety and mood, no change. Saw an old friend today and it was exceptionally hard to feel at ease, which was incredibly upsetting. My social anxiety gets worse by the day and I fear the destruction it is doing to my relationships. My only hope is this medication. I wish I was feeling some sort of improvement by now so I had some glimmer of the positive things to come....


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> 6th day on Parnate: The tingling in my legs has seemed to have disappeared. So laying down is not as uncomfortable anymore.
> 
> My appetite is completely gone. I could go the entire day without eating and not notice. Yesterday I had a bowl of cereal and one and a half slices of pizza. I forced myself to eat that pizza. Today a bowl of cereal and a salad. Only ate half of what was a small salad.
> 
> As for anxiety and mood, no change. Saw an old friend today and it was exceptionally hard to feel at ease, which was incredibly upsetting. My social anxiety gets worse by the day and I fear the destruction it is doing to my relationships. My only hope is this medication. I wish I was feeling some sort of improvement by now so I had some glimmer of the positive things to come....


While waiting for the onset of therapeutic response. You could use pregabalin,Lyrica, as an anxiolytic. It isn't in the benzo. class and it actually increases appetite. So, it may balance out appetite suppression that you are having. Plus it works acutely, within an hr or so after taking it.
I am probably going to use it to come off Klonopin. I think it would definitely help you. It isn't physically addictive like the benzos. And even though the less meds., the better. You can use the Lyrica for a few months and see where you stand.

My appetite has decreased also. I just make sure to eat very nutrient dense foods throughout the day. I actually need to lose some weight. So, this is not a problem for me. Just make sure you are getting your macro and micro nutrients.

Also, remember you are only a week or so in. Plus I think your dose is 20mg. I know it is hard but patience is crucial to analyze it's full affects on you


----------



## metamorphosis (Dec 18, 2008)

I'm just past a week on Parnate and I am noticing some side-effects becoming more pronounced.
Sleep last night was pretty bad- 4 hrs

I have been having minor headaches though my b.p. is stable and I am avoiding tyramine rich foods.

I am trying to take my clonazepam later in the day and evening, to possibly help with sleep.

I notice irritability after my early morning dose of Parnate, without the Klonopin . It seems I will either have to take 10mg of Parnate, t.i.d. and probably take the Klonopin, b.i.d. Dosing it in the morning and evening, so it may still help with sleep.

Some of these issues are certainly caused by my own doing. Yesterday, I drank more than my average amount of coffee. I also had my last cup late in the afternoon. Excess coffee not only exacerbates anxiety, but drinking it that late in the day, interfered with my sleep. Which is already compromised. Yeah a bad move.
Also, excess coffee can be attributed to the minor headaches, that I am experiencing.

I also went to a deli last night with my family. Talk about a reality check as far a dietary restrictions (cheese) goes. I knew a deli would be a cheese haven. It really didn't bother me. I just ordered a turkey wrap, avoiding any aged cheese. Actually a much more healthy choice and not a big deal.

On the plus side, my refractory depression seems to be decreasing. Which is always a good feeling. Take me as I am or don't take me at all, without the feeling inferiority or bothering me as much. It is still there but to a lesser degree.
Also, the stimulating properties after the initial dose of Parnate has helped with my depressive/anxiety symptoms. One of the main symptoms of my atypical depression over the last yr or so was an almost constant, lethargic state. Where doing simple daily chores would become a very big deal, ie. cleaning, laundry, dishes, etc. I would get them done but always after days of delay.
I still become tired after a few hrs in between doses. Still, not that big of a deal yet. That can also be chalked up, in part, to lack of sleep.

Also, some of my emotions and general mental state is situational. My girlfriend has just recently moved in. Which everyone knows brings a whole new dynamic to a relationship. Each persons idiosyncrasies become more apparent but she is also really supportive. She understands my mental illness, as it also runs in her family, with her brothers and she is very understanding of my decision to try Parnate. She is really on top of what I cannot eat and what otc's, I cannot take. That means a lot to me.

I plan to start exercising again, around 5 times a week daily. I want to start cycling again and compliment it with strength training.
I know exactly what I should and need to be doing. I have to maintain discipline and get into a daily regimen for increased health both mentally/physically.

Another plus is that I see my pdoc on the 10th to assess the situation!


----------



## Govinda (May 7, 2012)

Gwen1234, I agree with metamorphosis, the first few weeks on maoi's (in my brief experience) are strange and full of rapid change. I want a therapeutic response as well, but that may take a while to come. Pregabalin is a reasonable secondary med. One of the best things about it is that it tends to provide some relief within week 1.

To answer your question, when nardil was working I felt this deep sense of contentment spread through me. It was sometimes physicalized by a warm, tingling feeling in my chest. When it occurred, it seemed like all of the positive affirmations and arguments against my unreasonable fear/shame not only sounded true, they _felt_ true, for the first time in my life. So, for that amount of time, I could easily shrug off any SA worries.


----------



## metamorphosis (Dec 18, 2008)

Govinda said:


> Gwen1234, I agree with metamorphosis, the first few weeks on maoi's (in my brief experience) are strange and full of rapid change. I want a therapeutic response as well, but that may take a while to come. Pregabalin is a reasonable secondary med. One of the best things about it is that it tends to provide some relief within week 1.
> 
> To answer your question, when nardil was working I felt this deep sense of contentment spread through me. It was sometimes physicalized by a warm, tingling feeling in my chest. When it occurred, it seemed like all of the positive affirmations and arguments against my unreasonable fear/shame not only sounded true, they _felt_ true, for the first time in my life. So, for that amount of time, I could easily shrug off any SA worries.


The main reason I read about why people stop taking Nardil is-
-weight gain
-sexual side effects
-low energy/lethargy
-constipation
-water retention

Those are just the ones off the top of my head.
Which side-effects did you experience?
Which one or ones caused you to finally stop taking it?
How long were you on it?
And at what doses?

Even though Nardil has GABAergic effects and is considered the "gold standard" for SA. The side effects seem intolerable or barley tolerable for many!
I would rather use Parnate and maybe an anxiolytic, if needed. I am not into poly-pharmacy. The less meds. that are needed the better. But adding one or two more meds. in the right combination is acceptable for me. If they are needed.


----------



## metamorphosis (Dec 18, 2008)

@Govinda-
So, are you on Lyrica (pregabalin) with the Parnate. I have had a decrease in appetite on Parnate. Not sure if you have? If so, has the Lyrica balanced that out. as one of it's major side-effects is an increase in appetite.


----------



## Gwen1234 (Sep 6, 2011)

Day 8: Last night I went out to hear music with a couple friends. I was so lethargic from the drug that I could barely speak, let alone stand up and dance with them. I felt so drugged and wondered if this was how I am going to feel every day. If so, I won't be able to sustain it. Especially since I have a couple interviews over the next 2 weeks. I can't be a zombie. I only felt it when I was faced with socializing with people. Otherwise the sedation feels mild. Or maybe the sedation just got more intense as the day went on. I don't know. 

Still no change in anxiety.


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> Day 8: Last night I went out to hear music with a couple friends. I was so lethargic from the drug that I could barely speak, let alone stand up and dance with them. I felt so drugged and wondered if this was how I am going to feel every day. If so, I won't be able to sustain it. Especially since I have a couple interviews over the next 2 weeks. I can't be a zombie. I only felt it when I was faced with socializing with people. Otherwise the sedation feels mild. Or maybe the sedation just got more intense as the day went on. I don't know.
> 
> Still no change in anxiety.


What times of the day are you taking i?
How much?
And how long after dose, do you start to feel lethargic?
Also, do you ever have a cup or two of coffee?

Also, talk this over with your pdoc. When I started the Parnate my pdoc basically. Call me at anytime, if you need to and I will get back to you.
Understanding that one of the hardest parts of MAOI's is the initial adaptation by the brain. It can be a rollercoaster ride.


----------



## Gwen1234 (Sep 6, 2011)

I take it first thing when I wake in the morning.
20 mg. 
I start to feel funky pretty soon after taking it. Maybe 15 minutes. This morning I was feeling heavy headed, but last night I was nearly incapacitated, wanting to sleep in my seat. 
I don't drink coffee. 

Yeah, I need to talk to my doc about the sedation. See if it's something that will wear off or if there is something to offset it. As it is, practically anything that gives another person energy puts me to sleep. Hence the not drinking coffee.


----------



## metamorphosis (Dec 18, 2008)

Your brain is still adapting to the steady state of the drug in your system, but I understand your frustration. I woke up today feeling dysphoric and anhedonic. I took my morning dose and it did not help matters. I am in a moderately depressed haze right now, without much motivation. But for me it seems to change daily or even throughout the day. These are common symptoms off early MAOI use and they suck.
Interestingly, last night was the first time since starting Parnate, that I actually slept around 6 hrs. I still think my quality of sleep is compromised. I am not getting enough deep sleep throughout the night, more of the stage 1 and 2.
When do you see your pdoc again or maybe call him/her to talk about sedation? 
Explaining what happened last night and see what he says. Dose can be changed or the times you take it. Certain medications that help with energy levels and are safe may help. When I am feeling crapped out; I tell myself that this is par for the course for most starting the med. So, at least I am not showing atypical symptoms. 

If it becomes to much and unbearable, then I will stop the medication. I am not close to that point and I realize, that if I were to stop to early without giving it a fair trail. Down the road, I might ask what if?


----------



## Gwen1234 (Sep 6, 2011)

That heavy sedation hasn't recurred since Friday night. But still got sleepy around 4pm today. Like I could have taken a super awesome nap if I had the opportunity. 

In other news, I went to a party last night and felt great. I felt like my old, happy, chatty, mostly comfortable self. Unfortunately that was only a short reprieve. Today, back to feeling anxious and unhappy. Great.


----------



## metamorphosis (Dec 18, 2008)

"Up, down, turn around
Please don't let me hit the ground
Tonight I think I'll walk alone
I'll find my soul as I go home"


----------



## metamorphosis (Dec 18, 2008)

This is news to me. After doing some research, melatonin is contraindicated with Parnate. Though some people use 1-3mgs of it on Parnate. I was using 5 mg for the last week or so. I would wake up feeling really crapped out and with a headache. So, I narrowed down the headache issue to l-methylfolate use and melatonin. There was no hypertension involved with the headaches. So, I am stopping the Deplin supplementation along with the melatonin. 

So, MAO metabolises melatonin as in addition to monoamines. This means that melatonin could (theoretically) have a longer half life and possibly greater biological activity when coadministered with an MAOI
Melatonin potentiates the effects of the 5-ht1a receptor. This means that 5-ht1a receptor mediated effects could be increased following melatonin.
For instance, serotonergic side effects could be greatly increased with melatonin. Especially watch out for things like shivering.
While melatonin may work for regular insomnia, it may just not work for Parnate related insomnia.

So, after figuring out this mechanism between Parnate and melatonin. I decided to double check if there was an MAOI warning on my Natrol bottle of melatonin.
Surprise, There is no warning!!!


----------



## metamorphosis (Dec 18, 2008)

Pt.1/3) MAOI pharmacology, dietary issues, and drug reactions:



> ~*Monoamine Oxidase Inhibitors: A Modern Guide to an Unrequited Class of Antidepressants*
> Stephen M. Stahl, MD, PhD, and Angela Felker, MA
> 
> *Role of MAO Subtypes in the Mechanism of Antidepressant Action of MAOIs*
> ...


----------



## metamorphosis (Dec 18, 2008)

Pt.2/3) MAOI pharmacology, dietary issues, and drug reactions:



> ~Monoamine Oxidase Inhibitors: A Modern Guide to an Unrequited Class of Antidepressants
> Stephen M. Stahl, MD, PhD, and Angela Felker, MA
> 
> *Mechanism of Dangerous Drug Interactions with MAOIs: Decongestants and Drugs that Boost Sympathomimetic Amines*
> ...


----------



## metamorphosis (Dec 18, 2008)

Pt.3/3) MAOI pharmacology, dietary issues, and drug reactions:



> ~Monoamine Oxidase Inhibitors: A Modern Guide to an Unrequited Class of Antidepressants
> Stephen M. Stahl, MD, PhD, and Angela Felker, MA
> 
> *Mechanism of Dangerous Drug Interactions with MAOIs: Combining MAOIs with Serotonin Reuptake Blockade*
> ...


----------



## Gwen1234 (Sep 6, 2011)

metamorphosis said:


> "Up, down, turn around
> Please don't let me hit the ground
> Tonight I think I'll walk alone
> I'll find my soul as I go home"


Hah! It's kinda like that....


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> Hah! It's kinda like that....


I have found myself in that space, many times throughout the yrs.


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> Hah! It's kinda like that....


How is everything going?
Are you still on 20 mg or 30mg? 
When do you take the doses? 
Still using it at night?
Good responses?
How are the side effects?

I had a moderate hypertensive crises earlier today. I was concerned enough to take 10mg of nifedipine. 
Strictly speaking, I slipped up! 
I woke up very early in the morning, 5 am. I was half-asleep and I wasn't paying attention to the bottles containing my morning meds. I accidentally took 200mg. mg modafinil. Just for future reference, I wouldn't advise the combo, at least not for me. 11 days in and my first hypertensive crisis with headaches and B.P. climbing after a 1hr. I kept checking my B.P. and realized I needed to do something.
Fortunately, after using the nifedipine sublingually, my B.P. reduced steadily to around 125/82,
It was a stupid mistake. I shouldn't have had the modafinil next to the meds. I am currently taking. 
Needless to say, it has gone into the drawer. Where it belongs.
Not fun!!! :[


----------



## Gwen1234 (Sep 6, 2011)

I'm so sorry about your hypertensive crisis! That's scary. I put away my Vyvanse for the same reason, in case I accidently take that intead of the Parnate. Did you go to the hospital? Or the doctor? Or were you able to manage it on your own? 

Everything's about the same for me. No change yet in anxiety. But I am still on 20 mg, not enough to make a difference. I can't up the dose until I see my doctor this Saturday. I take my dose in the morning (all 20 mg). The only side effect I get now is drowsiness at times during the day. I had to go to bed at 8:30 last night because I was too tired to keep my eyes open. So as you can see, still no insomnia. I sleep better than ever, in fact. Oh, and I don't have an appetite. I haven't weighed myself, but I can see in the mirror that I have lost weight. Today though I do have a bit of an appetite. I have been craving a muffin....blueberry...


----------



## metamorphosis (Dec 18, 2008)

No, it wasn't to the point of hypertensive crises, yet. Once I measured my B.P. a few times, and it was still climbing. I decided it was definitely time to 
take the nifedipine. Once the B.P. started to decline after checking it a few more times in the next 2 hrs. I realized, that I wasn't going to stroke out. This really does show the possible dangers of making a mistake with an MAOI. 
A drug interaction is usually much more concerning and dangerous than a typical food (tyramine) interaction.
It really is crucial to have a B.P. cuff. It will not only save my ***. It is just good for my piece of mind!!!


----------



## metamorphosis (Dec 18, 2008)

Day 12- at 30mg Parnate
I'll do a short update with scores and things
1-10 with 10 being full remission
S.A.- 5
G.A.D.- 6.5
Depression- 7

I am feeling the antidepressant effects, now. The depression has disappeared, at least for the last few days. Hopefully, it will stay like that and even improve.
As far as the anxiety goes, it still doesn't seem to be doing much in that regard. I fully expected that poly-pharmacy might be necessary. I am currently on Klonopin. so, that dampens any severe anxiety.
My G.A.D. has remarkably gone down with this Parnate. I know this for a fact. no longer worrying about things all day, every day. It was not like that before I started the Parnate.
I have lost weight and my appetite has decreased to a pretty healthy level. This is a big plus. Since being on SSRI's, I had added 20lbs and was around 25lbs from my ideal weight. I make sure I eat well, with nutirnt dense foods.

Big issue is sleep. I am getting around 3hrs of light sleep a night. I put in a call to my pdoc, telling him that I need to use something for sleep. I have trazodone, doxepin, and amitriptyline at the house. He should call me back today and at least give the go a head on a low dose of one of them.

I plan on adding Lyrica to the mix. to help with the anxiety and sleep. Also, I plan on using it, as I slowly decrease my Klonopin.
Besides that, when I see him on the 10th, we are going to have to discuss a sleep agent that we are both agree on.
Thats it for now!


----------



## Gwen1234 (Sep 6, 2011)

Metamorphosis,

I'm so glad to hear this med is working for you! I can imagine what a load off it must be to not have depression and far less GAD. I suffer from just SAD, so I'm hoping you have good results in that sphere so I can have hope for my future on Parnate on a higher dose. 

I had my first bad night of sleep last night. I don't know if it had anything to do with the medication or if I was just thinking a lot, along with a cat walking all over me all night, and the snoring next to me.


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> Metamorphosis,
> 
> I'm so glad to hear this med is working for you! I can imagine what a load off it must be to not have depression and far less GAD. I suffer from just SAD, so I'm hoping you have good results in that sphere so I can have hope for my future on Parnate on a higher dose.
> 
> I had my first bad night of sleep last night. I don't know if it had anything to do with the medication or if I was just thinking a lot, along with a cat walking all over me all night, and the snoring next to me.


lol., I always forget to mention this. The Parnate definitely interferes with my sleep, but I have a cat that loves to sleep right next to one of my legs. Even more of an issue, that I can't believe I forgot. My g.f. has restless leg syndrome and snores!!!
Plus, she can fall asleep in about two minutes from hitting the pillow. So, every night I am usually trapped on one side by my cat and on the other with the leg twitching and snoring. I have tried to get her on some supplements like mag. glycinate pwd. and a med. that can help. But she is anti-pills and supplements.
I take my last dose by 1pm, usually. So, I am not medicating extra late

What I need to do; Is to get a California king sized bed and ditch the queen. I am 6'1' and have long legs. I can't even stretch out!!!

My score could be very different tomorrow. As far as your sleep, don't think about the one bad night. That can make it worse. It was probably the combination of the issues you listed above.


----------



## Govinda (May 7, 2012)

*Answers to Questions:*

1) I started nardil at 45 mg and eventually bumped it up to 60 mg.

At 60 I experienced intense myoclonic jerks (for a short time), decreased libido/sensitivity (faded some, but never left), urinary retention, occasional sedation, constipation, and probably a few other sides that I can't remember.

But that's not why I stopped. I would still be on it now if it hadn't quit on me and started causing something akin to serotonin syndrome (same symptoms, less intensity).

2) Yes, I do take Lyrica right now. I usually take 400 mg broken-up into morning and afternoon doses.

My appetite is still really low since starting parnate. I think lyrica more causes water retention and bloating in my face and gut, so decreased food intake doesn't really affect that.

*Update:*

Day 7 on the med brought a day of zero sleep and low anxiety/depression. I was able to participate in class today without completely locking-up from anxiety. BUT, I also increased my lyrica intake this morning, 600 mg instead of 400. And, I took a megadose of vitamin b this morning. So, who knows if the parnate is doing anything?

One thing is happening though. My depression spikes seem blunted. Also, since taking baclofen, I've often gotten these moments that seem like hotflashes throughout the day. But since parnate started, I haven't gotten these.

*Complaint:*
My sexual sensitivity has greatly decreased. 
Plus, you know how the average person supposedly phantasizes about sex thousands of times a day, well, that was me about a week ago. Now I can count on one hand all my daily sex phantasies. And usually my thought on sex is: "Why?"

This is disconcerting.


----------



## Govinda (May 7, 2012)

I'm concerned that what happened to me on nardil will happen to me on parnate.
That is, I will feel some amazing effects at about 4 - 6 weeks, then these effects will eventually be swept away, and whatever switch was flipped will be flipped again, causing every dose of nardil to instead trigger generalized panic, photosensitivity, fever, sensitivity to sound, myoclonic jerks, and dark, dark depression. Seriously, eventually I was just lying in bed curled in a ball spasming wildly every time I heard a footfall or the click of a clock. 

I have almost no idea what happened. I would guess that it's something to do with serotonin since it feels remarkably like the feeling I used to get on SSRIs (except x1000) and because the symptoms are exactly those listed for serotonin syndrome. 

Why this suddenly happened beats me. Perhaps the drug began to disproportionately favor serotonin over GABA. 

All I can do with parnate is take it slow and pray.


----------



## Gwen1234 (Sep 6, 2011)

Govinda, are you still on 10 mg? I'm on 20 mg and I'm not experiencing any improvement in anxiety yet. I am glad to hear that you are, at least potentially. 

Your experience with Nardil sounds scary. I hope that you can avoid that on Parnate.


----------



## Gwen1234 (Sep 6, 2011)

Metamorphosis, it sounds like we are dating the same person! Hah! If I don't fall asleep within 5 minutes, forget it. The snoring and the cat take over.


----------



## Gwen1234 (Sep 6, 2011)

Had trouble sleeping again last night. Went to bed at 8:30 (yeah, kinda early) and was still awake by 10 p.m. Took a clonazopam and fell asleep within maybe 15 minutes. I wonder if this is the start of insomnia? What does the parnate insomnia feel like for you guys? I felt tired, but felt my was heart beating a little harder than normal and just wasn't drifting away.


----------



## Govinda (May 7, 2012)

How are you guys doing?

Any improvement in mood? Self-confidence? Anxiety?

What about sexual sides?

I'm still taking 10 mg. Little is happening, but I guess that's expected thus far.


----------



## metamorphosis (Dec 18, 2008)

Govinda said:


> How are you guys doing?
> 
> Any improvement in mood? Self-confidence? Anxiety?
> 
> ...


I'm doing okay. It's hard for me to really gauge anything today. I basically was able to take the day off to catch up on my sleep. The insomnia was really beating me up. And even though I was feeling improvements in GAD and depression. It gets cancelled out, when I am exhausted. So, I slept until 5pm. Basically, all day, but feel better mentally. Even though I will try to get extra sleep tonight. I see my pdoc for 1 1/2 hrs, tomorrow. So, that is a positive. There is a lot to cover with him. Since this is my first meeting with him after starting Parnate.

I have to take the bus across town. Usually I dread this and I am not looking forward to it. It's in interesting how you would might think that a 1 1/2 is a long session with a pdoc. In reality it really is short, especially with so much to cover in one month meetings. I usually make a detailed list of topics I need covered to move it along. So, hopefully I will feel a bit more rejuvenated and inspired about figuring out our next plan of action.

I did talk to him on the phone yesterday and after 3 yrs. of trying unsuccessfully to get my mental illnesses in some sort of decent long term remission. He wants me to give Parnate at least 6 months, and if that does not work. Then we would switch to Nardil. Basically, 1 yr on the MAOI's period. Which I agree with. I want Parnate to be the one. And I have very high expectations.

I will report back after the pdocs visit tomorrow!!!

How are you doing?


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> Had trouble sleeping again last night. Went to bed at 8:30 (yeah, kinda early) and was still awake by 10 p.m. Took a clonazopam and fell asleep within maybe 15 minutes. I wonder if this is the start of insomnia? What does the parnate insomnia feel like for you guys? I felt tired, but felt my was heart beating a little harder than normal and just wasn't drifting away.


For me, the insomnia is the sleep you get barely into your sleep cycle. For me a lot of tossing and turning and then wide awake for hrs. It is very frustrating. I do not want to use a sleep agent, but I think probably have to, at least for the time being. I see my pdoc tomorrow. So that will be one of the main issues. I decided to use today to catch up on my sleep. I still had to use a low dose of doxepin to fall asleep but when I did. I was out and was dreaming constantly. Which shows me, that I have been lacking of REM sleep.
Did you take your B.P. and heart rate, after you felt the h.r. increase?
Still good, if you were able to fall asleep by ten and sleep through the night!


----------



## Gwen1234 (Sep 6, 2011)

Govinda said:


> How are you guys doing?
> 
> Any improvement in mood? Self-confidence? Anxiety?
> 
> ...


I have not had any changes in mood, self-confidence or anxiety. Well, except for Saturday night which I felt pretty fantastic. I was talkative, fairly comfortable, and happy. But that only lasted for a night. I don't expect much of anything to happen at only 20 mg. I see my doctor on Saturday morning. Hopefully we up my dose to at least 30 mg at that time.

I have not had any sexual side effects.


----------



## Gwen1234 (Sep 6, 2011)

metamorphosis said:


> For me, the insomnia is the sleep you get barely into your sleep cycle. For me a lot of tossing and turning and then wide awake for hrs. It is very frustrating. I do not want to use a sleep agent, but I think probably have to, at least for the time being. I see my pdoc tomorrow. So that will be one of the main issues. I decided to use today to catch up on my sleep. I still had to use a low dose of doxepin to fall asleep but when I did. I was out and was dreaming constantly. Which shows me, that I have been lacking of REM sleep.
> Did you take your B.P. and heart rate, after you felt the h.r. increase?
> Still good, if you were able to fall asleep by ten and sleep through the night!


I don't have a way to check my blood pressure, so I don't know if it increased. I woke up that morning with a speedy heart beat too. Figured it was just anxiety. Not experiencing that today.

Oh, and I seem to have my appetite at least halfway back!


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> I don't have a way to check my blood pressure, so I don't know if it increased. I woke up that morning with a speedy heart beat too. Figured it was just anxiety. Not experiencing that today.
> 
> Oh, and I seem to have my appetite at least halfway back!


Yeah, it could have been contributed to a lot of benign things. Like you mentioned, anxiety will do it. If you are excited or ramped up about something situational. Something that is going on in your life. It can be short term, possibly today or the next. I get anxiety, when I have an upcoming appointment the next day. It can be a stressor or trigger for my adrenergic system to overreact and is often the case for those of us that have anxiety disorders. It is a hormonal and NT response that stays within a natural symbiotic realm for most. While, we hit the red quiet easily. 
I think it is probably good that you started at 20mg and that you take it early in the day, IMHO!


----------



## metamorphosis (Dec 18, 2008)

Alprazolam said:


> I took that garbage before and it didn't work


Damn, what garbage is that?
Open up and care to share?
Just wondering where you are going with a very vague post?
Please do get more specific about it.
I would like to hear your views!


----------



## Kaotix (Jan 9, 2013)

Parnate sounds to me like the drug that makes you feel exactly how you are supposed to feel like here's the perfect drug. There are complications though with everyone being different and all that.


----------



## Govinda (May 7, 2012)

Has libido or sexual sensitivity been affected?

Has for me. So, I'm worried about increasing. Even so, I have little choice and I'll go up another 5 mg tomorrow.

Also, what dose do you fellas expect to stop at?


----------



## Gwen1234 (Sep 6, 2011)

I slept last night with no problem! Fell in sleep within seconds. But at least I know the clonazopam will help if I have trouble again. 

Govinda, this "fella"(heh) doesn't have a maximum dose that I plan to stop at. I've read that some people go up to 60 mg before their anxiety gets relief. I will report back after my doc appointment on Saturday. I would like to know what my doctor thinks is a maximum dose.


----------



## metamorphosis (Dec 18, 2008)

Alprazolam said:


> I took that garbage before and it didn't work


How long did you take it for?
Did you stop because you weren't getting any positive response?
Were the side-effects an issue?


----------



## metamorphosis (Dec 18, 2008)

Govinda said:


> Has libido or sexual sensitivity been affected?
> 
> Has for me. So, I'm worried about increasing. Even so, I have little choice and I'll go up another 5 mg tomorrow.
> 
> Also, what dose do you fellas expect to stop at?


I haven't had any sexual side-effects, one way or the other. Alot lot of people mention an increase in sex drive, but there are some that report that it has decreased their sex drive.
Usual therapeutic dose is usually between 30-60mg. A few people go as high as 80mg, but that is in the minority. Others can notice good effects at 20mg.
I plan on staying at my present dose for at least a month or more and see where I'm at. Then increase by 10mg every 3-4 weeks, if I need to.
The dosing seems less tricky than Nardil. Alot of people think that ramping up the dose on Nardil fairly quickly, is the way to go. Then they taper it down but I have heard many different ways to get Nardil "going". How to prevent tolerance issues etc.


----------



## Gwen1234 (Sep 6, 2011)

Alprazolam said:


> month and a half maybe. yes i stopped because it is garbage


What was your highest dose? What dose did you stop at?


----------



## Gwen1234 (Sep 6, 2011)

Went to my doctor this morning. He upped my dose to 30 mg. Said it was up to me when I took the three 10 mg pills during the day/night. I will base it on the level of sedation. I was surprised that he seemed surprised that I wasn't seeing any difference in anxiety at 20 mg. I surely didn't expect any improvement. 

Question: Does anyone know if its OK to eat chocolate, tofu, and soy lecithin on Parnate (not soy sauce, I know to stay away from that)? Everything I read online is confusing. And I miss chocolate kinda.


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> Went to my doctor this morning. He upped my dose to 30 mg. Said it was up to me when I took the three 10 mg pills during the day/night. I will base it on the level of sedation. I was surprised that he seemed surprised that I wasn't seeing any difference in anxiety at 20 mg. I surely didn't expect any improvement.
> 
> Question: Does anyone know if its OK to eat chocolate, tofu, and soy lecithin on Parnate (not soy sauce, I know to stay away from that)? Everything I read online is confusing. And I miss chocolate kinda.


Okay, chocolate in moderation is okay. Try to avoid really dark chocolate and tofu is a no. from all of the research I have done. Soy products are sketchy. Try to google lecithin granules and if you do try it. use a very small amount. I'm going to say no. Soy protein pwds are a no, so unless you can come up with enough evidence. I would be careful!
Someone else may have a more definitive answer!


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> Went to my doctor this morning. He upped my dose to 30 mg. Said it was up to me when I took the three 10 mg pills during the day/night. I will base it on the level of sedation. I was surprised that he seemed surprised that I wasn't seeing any difference in anxiety at 20 mg. I surely didn't expect any improvement.
> 
> Question: Does anyone know if its OK to eat chocolate, tofu, and soy lecithin on Parnate (not soy sauce, I know to stay away from that)? Everything I read online is confusing. And I miss chocolate kinda.


You could take 20mg morning and the last 10mg by 1-2pm. Depending on how your sleep is. Or 10-10-10 spread out. If I take it to late, then I cannot sleep. Insomnia seems to be more of an issue for me, though.


----------



## Gwen1234 (Sep 6, 2011)

I've decided to take all 30 mg in the morning. Doesn't seem to have much of an effect on me side effect wise, except for a fuzzy feeling in my body.


----------



## metamorphosis (Dec 18, 2008)

The nice, warm fuzzy feeling, right!


----------



## Govinda (May 7, 2012)

I had that warm, fuzzy feeling today. 

My friend had to invite some family over and I was deeply nervous about it. But then this mellow contentment and calm spread through me. It didn't feel like the loopy lyrica lift I'm used to. It felt more like nardil did. I'm only at 10 mg and two weeks though. 

If I can reproduce this feeling consistently, I can attack life instead of life attacking me. Let's hope.


----------



## Gwen1234 (Sep 6, 2011)

The warm fuzzy feeling for me is certainly nice, but it doesn't reduce my anxiety at all. I don't feel mellow or content. When am I going to feel better? I know it's only been a couple of weeks, but I'm scared Parnate won't work at all for me.


----------



## Govinda (May 7, 2012)

Yeah, it can be so frustrating waiting for a med to work. It's hard to place your faith in little pills. 

The worst thing is feeling like there's just nothing out there for you. I've felt (and sometimes still feel) like this. 

Not sure how to sooth that fear either. Well, I do know that a combo therapy has greater chances of success and, maybe just as important for my survival, it's easier psychologically. So right now it's lyrica + baclofen + parnate.


----------



## bob1471 (Jan 8, 2013)

*Tried both.. and more!*

30 years ago I was prescribed Parstelin, an MAOI similar to Parnate... almost magical effects, worked like a beaver, got a job etc etc. Unfortunately I caught German Measles in the second week there, and my distinctly unelightened GP stopped them immediately, reacting with horror.

Depression (atypiacl) and chronic anergia soon came back, but foolishly I turned to drink... no GP at my local practice would reistate MAOI's.

Years later, following an attack of pancreatitus and off the booze, depression returned bigtime and I was put on Parnate by an old family friend who is a doctor. Worked well for a while, but after a few months the efficacy wore off, and I started drinking as well... pancreatitus II got me, and although it wasn't too bad, the local hospital nearly killed me!

Parnate and Pethidine DO NOT GO.... despite me showing the Parnate bottle to everyone from porters to consultant....after a few minutes the pain INCREASES.... and how. Went into shock.

Free of drugs and drink, but not gloom and misery, I took some (street) whizz.... and my life began again. One gram/day... probably 0.9g sugar, and 100mg amph., i self medicated with success. Unfortunately, the price of street amphetamine meant much of the money I made working went on that, and eventually I ran into finacial trouble.

No amount of pleading to docs and shrinks helped me, and after a foiled suicide attempt I was referred to the local 'Drug Centre'. They would not help either - but referred me to a private clinic, who after amny tests and some suspicion, prescribed me 100 mg of Dexedrine a day.

I happily and successfully took that for nearly fourteen years, described as a 'model patient' hem hem! During that time I took more than three times my own bodyweightin pure amphetamine sulphate, with no ill effects whatsoever. More later....


----------



## Gwen1234 (Sep 6, 2011)

Govinda said:


> Yeah, it can be so frustrating waiting for a med to work. It's hard to place your faith in little pills.
> 
> The worst thing is feeling like there's just nothing out there for you. I've felt (and sometimes still feel) like this.
> 
> Not sure how to sooth that fear either. Well, I do know that a combo therapy has greater chances of success and, maybe just as important for my survival, it's easier psychologically. So right now it's lyrica + baclofen + parnate.


What does Bacolfen do? Is it good for anxiety? I see it does something with GABA....


----------



## Caedmon (Dec 14, 2003)

I promise one day I will go back and read this informative-looking thread. I just wanted to share that i have taken Parnate for 6 1/2 years.

It WORKS. 

It works when 20+ different medication alchemical potions did not work for me before I tried it.

However, it is best to get to .8 mg/kg for the most effective dose. Trust it as monotherapy. 

I wish they had it in extended release. Keep in mind the short halflife around 3 hrs.


----------



## Caedmon (Dec 14, 2003)

Govinda said:


> Has libido or sexual sensitivity been affected?
> 
> Has for me. So, I'm worried about increasing. Even so, I have little choice and I'll go up another 5 mg tomorrow.
> 
> Also, what dose do you fellas expect to stop at?


Go up up up, .8 mg/kg was the formula to approximate sufficient MAO inhibition not to mention will promote plenty of dopamine release. My old url reference for this number has disappeared although it matches my personal experience.

Light people may only need 40mg whereas heavier set people may need to go to 70, 80, 100, etc. IMO

Edit: p.s. I take 80Mg/day


----------



## Gwen1234 (Sep 6, 2011)

Caedmon,

At what dose did you start to feel your anxiety subside? I'm at 30 mg and still feel like **** (no side effects though, other than appetite suppression). And how many months am I supposed to wait to see if it works? I've only been taking it 2 and a half weeks, but I'm feeling discouraged.


----------



## boostinggtir (May 27, 2011)

Caedmon said:


> Go up up up, .8 mg/kg was the formula to approximate sufficient MAO inhibition not to mention will promote plenty of dopamine release. My old url reference for this number has disappeared although it matches my personal experience.
> 
> Light people may only need 40mg whereas heavier set people may need to go to 70, 80, 100, etc. IMO
> 
> Edit: p.s. I take 80Mg/day


yes agreed totally. Parnate has a very short half life. 30mg is good of you what to go up an down. All day. Yes shame they don't have. A slow release. I'm going back on nar the gh peptides as the sleep aid. Nardil takes ages to work. I can't stay out of town on parnate. Lol. Or save money woops has been fun


----------



## metamorphosis (Dec 18, 2008)

Nice, everyone chime in to keep a good, informative thread going!!! This is invaluable to all of us using Parnate, specifically, and other MAOI's.


----------



## Gwen1234 (Sep 6, 2011)

Caedmon said:


> Go up up up, .8 mg/kg was the formula to approximate sufficient MAO inhibition not to mention will promote plenty of dopamine release. My old url reference for this number has disappeared although it matches my personal experience.
> 
> Light people may only need 40mg whereas heavier set people may need to go to 70, 80, 100, etc. IMO
> 
> Edit: p.s. I take 80Mg/day


Perhaps this is a dumb question, but i don't understand the .8mg/kg as it relates to Parnate dosing. Can you explain?


----------



## Gwen1234 (Sep 6, 2011)

Ohhh, I just got it. It's .8 mg of Parnate for every kg of a person's weight. Now to run the calculation for my own weight....


----------



## Caedmon (Dec 14, 2003)

Gwen1234 said:


> Perhaps this is a dumb question, but i don't understand the .8mg/kg as it relates to Parnate dosing. Can you explain?


I think you already figurd it out, but to clarify, you take your body weight in kilograms and multiply by .8. It will give a number, usually between 30-90, which may (maybe possibly) correspond to a theoretically good dose. If you are used to pounds then first convert pounds to kg. (X lbs/2.2 = weight in kg). This is just in theory. Tx resistant disorders might go clear up to 120. Very often, side effects such as orthostatic hypotension and fatigue will decrease as dose goes up.

If you get hypomanic and decide to paint the living room at 1:00 a.m., you've gone too far. 

"Waiting period" - if at good dose, should be very short i.e. 3 hrs - 14 days. I feel it within hours. Probably the dopamine release. My personal nonmedical theory is 5 days to trial then increase if needed.

It's very normal for it to screw up your sleep. A midday nap helps. I have learned to accept, I just need a nap somewhere in the day. It seems like it splits the 24 hr wake cycle in two, or something. So wierd. Caffeine helps until after work when I can nap.


----------



## bob1471 (Jan 8, 2013)

*continued...*

(Amphetamine) The (private) prescription cost £25 odd a week, a very reasonable price for one's life. Of course, nothing good lasts forever, and thanks to government interference, the price went up (with only two days warning!) to £160 a week... which was way beyond me. 

In despair I decided to kill myself, and made a serious attempt... 100+ Nurofen Plus, bottle of scotch, plastic bag on head and an IV injection of 30+ Librium capsules, but for good or bad, the needle blocked, and I couldn't shift it! Bag too small as well... suffocation when concious is no way to go!

Passed out, and woke up about eight hours later, v stoned but okay. A most interesting OOBE, but that's another story - suffice to say, death is NOT the end, of that I'm sure.:tiptoe

What really annoys me is that I have been treated as a junkie, rather than someone who is reliant on a drug to cope with depression and have any sort of worthwhile life! Excruciatingly unfair in my opinion. Whatever, I was taken to hospital by the police, and had to do one hell of a lot of talking to avoid being locked up in the loony bin (escorted there by two security guards and a Nurse Diesel type character!). Atrocious.

Whatever, the useless local 'drug and drink clinic' took me on, and prescribed a reducing dose of Dexedrine on the NHS... inevitably I sank back into a deep depression as the dose went down, as I knew I would. 

SSRI's, 5HTRI's and all the other rubbish had no effect, and I became sucidal once more. It's rather like someone with diabetes being told to 'wean themselves off' Insulin... that well known, highly 'addictive' drug on which they are utterly dependent. 

After a search on the net, I managed to nag my GP into prescribing Nardil.... I liked the name, sounds a bit evil. Taking four a day now, and it has really helped, not suicidal, though I miss the 'buzz' of amphetamine, and seem to have been ill an awful lot. Sleep a bit disturbed, allergies, stomach upsets and I have had to use Ventolin again (which I never needed whilst taking Dex.)

I rely on Chest Eze (DoDo's - Ephedrine) to stay awake and keep my chest clear. Blood pressure has been rather low however, and I no longer need medication for it. I still drink, in moderation, and take codeine for various aches and pains - no ill effects.

Interesting anecdote....
".... I ate his liver, with fava (broad) beans, and a bottle of Chianti...." Dr Hannibal Lector, in 'Silence of the Lambs'
Apparently this was not in the script, but an ad-lib by Anthony Hopkins. Many seem to have misunderstood it - have a look at discussions on the web! To anyone familiar with MAOI's however, the inference is obvious. Hopkins is an ex-alcoholic, and seems to have been a troubled man....

I notice that there seems to be a great reluctance to prescribe MAOI's (as many here have mentioned), and much is made of the horrors of interactions with foodstuffs and other drugs. In my somewhat irresposible experience this has never happened, despite eating and drinking many of those forbidden substances. Apart from Pethidine - given to me in hospital - I have had no reactions I know of.

Someone in the trade told me this was due to political interference from pharmacutical companies, who wished to hype and sell new, expensive products like SSRI's back in the 1980's, rather than the far cheaper, out of patent MAOI's. I tend to believe this, having little faith in the honesty of many in that industry, and a deep belief in their greed.

To sum up then, for several months Nardil has cracked my underlying depression. Unfortunately it has not cured my chronic anergia, which is okay I suppose - I am prepared to do ANYTHING to stop being depressed, will take anything and try anything, even taking my own life. I miss the great energy and enthusiasm which Amphetamines gave me, but realise that is only a day to day, short term solution, rather like turning up the radio in the car to drown out the noise of the bearings knocking. I would also say that this solution is okay for me, but most certainly not for most people - I have seen many casualties caused by the stuff, when recreational use turns to dependence. I must be blessed (or cursed?) with the constitution of an ox, both mentally and physically.

This is my first posting to this most interesting group, greetings to you all and I hope I can contribute some useful stuff
Bob xxx


----------



## Gwen1234 (Sep 6, 2011)

Welcome to the forum Bob!

I just emailed my doctor and he gave me the OK to up my dose to 40 mg before I see him in another week and a half. I'm excited to see if this will be an effective dose. And I'm psyched to see that my doctor actually emailed me back...in 5 minutes! Cheaper than an appointment.


----------



## bob1471 (Jan 8, 2013)

Thank you Gwen... and good luck! I find it best to take all four at about 5 or 6 AM (usually wake up now and then), and have a snooze before getting up. To be honest, I don't really notice any 'immediate' effect from Nardil whatever time off day or night I take them... rather like 'topping up' each day. I think this is how they work however, so it is probably just psychological. 

Whatever, they work well on me, and make life at least bearable.


----------



## metamorphosis (Dec 18, 2008)

@bob1471 "I rely on Chest Eze (DoDo's - Ephedrine) to stay awake and keep my chest clear."

Umm, that would be a major no go, while on an MAOI!!!



> Monoamine Oxidase Inhibitors: A Modern Guide to an Unrequited Class of Antidepressants
> Stephen M. Stahl, MD, PhD, and Angela Felker, MA
> 
> There are two general types of potentially dangerous drug interactions with MAOIs for a practitioner to understand: those that can raise blood pressure by sympathomimetic actions (discussed in this section; Tables 5 and 6) and those that can cause a potentially fatal serotonin syndrome by 5-HT reuptake inhibitory actions (discussed in the section below; Table 7).
> ...





> Dawson JK, Earnshaw SM, Graham CS. Dangerous monoamine oxidase inhibitor interactions are still occurring in the 1990s. J Accid Emerg Med 1995 Mar;12(1):49-51.
> Abstract:* The clinical course is described of a 28-year-old woman who was severely ill following ingestion of a Do-Do tablet (which consists of ephedrine, caffeine and theophylline), 24 h after discontinuing phenelzine treatment. *Signs and symptoms were delayed for 8 h after which she developed encephalopathy, neuromuscular irritability, hypotension, sinus tachycardia, rhabdomyolysis and hyperthermia. Her illness was complicated by pneumonia and adult respiratory distress syndrome (ARDS). The management of monoamine oxidase inhibitor (MAOI) toxicity, which can arise from interactions and overdoses, is discussed. It should be remembered that, despite the increase in use of alternative and safer antidepressants, MAOI interactions still occur and unless they are managed appropriately, are potentially fatal. Patients need to be warned that restrictions apply for up to 2 weeks after stopping the medication, and doctors need to be aware that serious interactions can occur in this time period.


----------



## Govinda (May 7, 2012)

End of my second week with parnate and it has helped in a way. I only take 20 mg and it actually doesn't seem to calm me down much. What it does is put me in a slightly better and more accepting mood. My self-esteem goes up a little and I think, "Why does it matter if I get nervous in front of these people?"

Then I often still get red, choked-up, and shaky in social situations. But even that means less to me.

The end effect is that I go into 5 times as many social situations and I am often able to think of them as training for my better future. I sometimes wish that it took away the anxiety, too. But then I remember what happened with nardil: It quit on me and I found that the skills and comfort I developed on the drug were not transferable to my world without it. I think this is because it decreased physical symptoms so well that I never learned to face them. So, maybe it's good that parnate is not actually decreasing my symptoms.


----------



## Govinda (May 7, 2012)

Oh, and I'd like to increase my dose, but I'm worried about a couple things:

1)* Sexual Sides*
I already have much decreased sensitivity and libido. I hear that it's not supposed to do this much, but it's happening to me. With nardil sexual sides eventually decreased (at about 6 weeks). Will this likely happen with parnate?

2) *burn-out, crap-out, ****ting the bed*
Nardil did this to me. I'm going into this actually expecting parnate to do it too. I figure if I stay at a lower dose it's less likely to occur.

3)*Increased anxiety*
Parnate is weird. It's more of an anti-depressant than an anxiolytic and it can occasionally be activating. So, what are the chances that increasing the dose will increase anxiety (even temporarily)?

If someone could speak to these concerns I would really appreciate it.


----------



## billyho (Apr 12, 2010)

Has anyone here probably guys more than girls had any trouble urinating whilst on parnate? I've done 2 trials of parnate a couple years apart and stopped the first time for some other reason, but the second trial i only made it up to 30mg before i had to get a prescription for Bethanechol just to pee
http://en.wikipedia.org/wiki/Bethanechol i was also using the herb Uva Ursi to help start, um going..
i constantly reduced my dose till there was nothing left and the problem went away. I am considering restarting this again and was wondering if any of your guys/gals have been through this particular side effect.
As far as sexual side effects, I had no problem finding the sweet spot where it actually enhances your "abilities", so don't sweat it, you'll find the right does.

Thanks!!


----------



## bob1471 (Jan 8, 2013)

Billyho... I remember no sexual troubles when taking Parnate, though I was a younger man back then, ahem! Unfortunately I haven't had an opportunity to 'test' Nardil in this way yet, not with a partner anyway. It does seem to delay things a bit, to put it politely - maybe that might be useful? Should any ladies wish to join me in a clinical trial, please get in touch... :haha (I'm joking of course....well, half joking)

As for other problems, none remembered with Parnate, but Nardil seems to have coincided with a prolonged attack of the Katmandu Quickstep, which has been quite severe sometimes. I take Loperamide (Imodium) which cures it for a while, but without it I soon relapse. Quite large doses of Codeine don't seem to have much of an effect either.

As for peeing, I noticed at first I had a bit of trouble starting.... bladder full, but no go. This wore off after a short while I'm glad to say, back to normal. I recall no such problems with Parnate or Parstelin.

It may just be coincidence, or a side effect of my digestion rushing the job, but I seem to have been at a rather low ebb healthwise since starting Nardil - a ghastly fungal infection, rashes, itches and colds/flu. All cured now I hope, but not very nice and a bit demoralising. The occasional need to vomit too, which comes over v. suddenly, usually after physically demanding efforts, and with an empty stomach - ugh! This is also under control after taking Domperidone.

With all these problems in mind, I am thinking of switching to Parnate, and giving it another chance. There may have been other reasons it eventually failed to work in the past - that was nearly 30 years ago, and I was drinking heavily.

Does anyone know if it safe to switch straight over, to avoid two weeks of misery? I have to say, I am most impressed with the knowledge and helpfulness of people on this group, thank you all (more later about Ephedrine...). Far more informed than my GP!

Cheers
Bob


----------



## Govinda (May 7, 2012)

If anyone could address the problem of poop out, I'd really appreciate it. When nardl did this it not only stopped working, it started to make things worse: elevating depression, making me hypervigiliant and hypersensitive. I was a mess, and I was absolutely crushed at having tasted the life I wanted for three months then being dropped back into my old world of panic and sadness.

So, at what point does this usually occur?

Is it associated with anything in particular? high dosing? Using other drugs? Plain genetics?

Ways to combat/delay it?


----------



## metamorphosis (Dec 18, 2008)

Good question about the possibility of it's losing effectiveness (poop out). I have no first and account on this. As I have only been on the Parnate for about a month. I am now at 40mg, but I would like to hear some first hand accounts.
It doesn't sound like Caedmon went through that!?!?


----------



## Gwen1234 (Sep 6, 2011)

Govinda, going up in dosage has not caused me to have sexual side effects nor does it cause me extra anxiety. But keep in mind that I seem to be experiencing less side effects than most people. Right now it just effects my appetite, causes occasional dry mouth that doesn't last long, and sometimes makes me tired. 

I've been at 40 mg for two days now. How long should I stay here before trying a higher dose? I haven't had any improvement in anxiety. It's only been three weeks so it might be too soon. But I don't know if I should keep pushing the dose up every week or 2 weeks, or wait for a while at one dose and see if it kicks in. Anyone have thoughts on this?


----------



## Gwen1234 (Sep 6, 2011)

Billyho,

I have not had any problems with urinating while on Parnate. Everything seems to be functioning normally. And I'm up to 40 mg now. Though I have read about other people having this problem on Parnate.


----------



## billyho (Apr 12, 2010)

Thanks for the responses to my questions..

Gwen, when i was on parnate, I went up 10mg a week till 30 and then held there till i couldn't tolerate it. I think you should give 40mgs at _least_ a week, maybe 2. The other consideration is how much parnate do you have and if you run out before your next pdoc appointment.. Will your doc be willing to call in a refill before your next appt?

Govinda, from what i've read there isn't much parnate poop out, but i haven't researched it in awhile. One strategy i do remember reading was decreasing the dose for a few days or so and then ramping it back up to where you were or a little higher to fight the poop out.


----------



## bob1471 (Jan 8, 2013)

I must say, I am amazed at the knowledge and helpfulness of people on this group - a refreshing change from the medical community in the UK! I have always thought that those who have not personally suffered from or experienced mental ilnesses themselves (particularly depression) are ill qualified to treat them.

Some personal experiences of Nardil: It certainly has helped me greatly to cope with my atypical depression, for which I am very grateful. It does seem to have had some side effects however, many of which have been mentioned on this thread with reguard to both Nardil and Parnate.

Since taking Nardil I have had persistent attacks of the Katmandu Quickstep, quite severe at times. Large doses of Codeine don't seem to help, but Loperamide (Imodium) has - I am now dependent on it I suppose. 

I have also suffered from inexplicable attacks of vomiting, usually after physical exertion - most unpleasant, as it usually occurs on an empty stomach and hits me hard and fast, rather embarrassing when in the street. Usually I manage to control attacks of impending sickness with control and dignity, being a highly experienced drinker.

For a short while I was troubled by urinary retention, full bladder but unable to 'start' for quite a while. This seems to have vanished now, after several months on Nardil. 

In the same area, I find that I am almost impotent, which is not all that important being single at the moment. Let us just say that things seem very 'delayed', which might possibly be rather useful, I don't know? If any ladies wish to join me in a clinical study of this phenomena, please get in touch. Strictly in the cause of science of course, ahem!

Joking aside, my general health has not been very good since atarting on Nardil. This may be due to the debilitating effects of the problems mentioned above, but recent blood tests showed that I am a bit anaemic, and my immune system seems to be at a low ebb. It also seems to have itched me up, with inexplicable skin rashes, a persitent cough and what seems to be an everlasting cold. While taking Dexedrine, I had no need for my Ventolin inhaler (I am asthmatic), and hardly suffered from hayfever and other allergies. Not so with Nardil.

One other thing I noticed a couple of times was my reaction to bright sunlight. Everything looked brilliant and dazzling, though it wasn't really unpleasant or uncomfortable. I assumed my pupils were dilated for some reason, but they weren't. 

I am prepared to put up with all these things, as anything is better than being depressed, but I do seem to recall that when I was taking Parnate and Parstelin, I had no noticeable side effects at all. As a consequence, I am thinking about switching to Parnate - and have a couple of questions...

Will I have to suffer the two week 'withdrawal', or can I switch from Nardil to Parnate straight away?

Secondly, are either of these drugs compatible with Viagra? Someone gave me a bottle of them (tut tut!), and I am curious to try them. I may be somewhat impotent and 'slow off the mark', but the interest and urge is still there. 

Thanks for your help and advice everyone.

Cheers
Bob


----------



## Caedmon (Dec 14, 2003)

Govinda said:


> If anyone could address the problem of poop out, I'd really appreciate it. When nardl did this it not only stopped working, it started to make things worse: elevating depression, making me hypervigiliant and hypersensitive. I was a mess, and I was absolutely crushed at having tasted the life I wanted for three months then being dropped back into my old world of panic and sadness.
> 
> So, at what point does this usually occur?
> 
> ...


I have had this happen actually on Parnate and had to withdraw then restart. This was after 4 years of taking it though. It was horrible and I was so glad to go back on it. Took Klonopin in the intermission which helped. I am concerned with poop out too and might preventatively take a medication "holiday" this summer when I am least likely to be depressed.

I think it might be genetic? This seems to be a risk with all antidepressants as the neurons try to achieve their genetically-directed, crappy homeostasis.


----------



## Gwen1234 (Sep 6, 2011)

I just had a worrisome thought (surprise surprise). Someone PLEASE clarify this for me if you can. That "warm and fuzzy" feeling that Parnate gives you after you take a dose, is THAT the therapeutic benefit of the drug? Meaning, is Parnate only meant to change the physical sensations of anxiety and not the mental issues, like negative thoughts? Is that all I'm ever going to get out of this drug? Because that is FAR from what I need this for....I hope my question made sense.


----------



## metamorphosis (Dec 18, 2008)

Gwen1234 said:


> I just had a worrisome thought (surprise surprise). Someone PLEASE clarify this for me if you can. That "warm and fuzzy" feeling that Parnate gives you after you take a dose, is THAT the therapeutic benefit of the drug? Meaning, is Parnate only meant to change the physical sensations of anxiety and not the mental issues, like negative thoughts? Is that all I'm ever going to get out of this drug? Because that is FAR from what I need this for....I hope my question made sense.


No, not at all. The initial feeling you are describing has to do with the immediate DA release. The therapeutic properties, that include atypical depression, refractory depression (hyper-sensitivity to rejection) and the anxiolytic effects are obviously a direct result of the actions Parnate has on the triple monoamines. But it isn't a direct result of that acute feeling, overall.


----------



## Gwen1234 (Sep 6, 2011)

Thanks Metamorphosis. Still waiting on the anxiolytic effects. No change yet. Feeling discouraged.


----------



## billyho (Apr 12, 2010)

metamorphosis said:


> No, not at all. The initial feeling you are describing has to do with the immediate DA release. The therapeutic properties, that include atypical depression, refractory depression (hyper-sensitivity to rejection) and the anxiolytic effects are obviously a direct result of the actions Parnate has on the triple monoamines. But it isn't a direct result of that acute feeling, overall.


+1
When it did work for me, the warm fuzzy feeling was slowly replaced by the therapeutic effects.


----------



## Gwen1234 (Sep 6, 2011)

mynameisthis said:


> i got headaches so bad i wanted to be sick


I'm sorry. That sounds unbearable. I got a headache on the first day, but I took ibuprofen and it went away. Sounds like headache medicines weren't helpful in your case?


----------



## metamorphosis (Dec 18, 2008)

mynameisthis said:


> i got headaches so bad i wanted to be sick


Initially, that was a big issue for me and it wasn't because of my bp.. Which, I took every time I had a headache. It was always around 120/80. So, it wasn't a hypertensive issue. I had one every morning but it did go away after a few weeks. I am not one to get headaches. Now, I can understand how those who get chronic headaches and it effects them in such a terrible way. I couldn't imagine dealing with that!!!


----------



## Govinda (May 7, 2012)

*Good News:*

Parnate has absolutely started working for me. It seems to dampen my anxiety by way of increasing my general sense of well-being. By that I mean that it doesn't feel like it has any overt somatic effects -- HR, breathing, flushing -- at least none as strong as benzos. But, throughout the day, even when something stressful is coming up, I'm filled with this mellow feeling that things are fine. I don't feel glowing; I'm not jumping up and down for joy; and I'm not about to take-on public speaking. No hypomania. But, the daily social moments that were impossible crises about a month ago look like minor obstacles in a life that might work.

I've been taking 20 mg on most days for a few weeks.  The feelings of well-being popped up a day after a temporary increase to 25. I've dropped back to 20 mg since and the feeling has only faded slightly.

*A couple other things I noted*: The day I really started feeling ok I also got my first bout of hypotension. I also had some difficulty moving bowels -- nothing terrible. This follows a similar pattern to my nardil trial, in which positive sensations came after hypotension first popped up. With nardil, the hypotension decreased after about a month on the same dose, but the benefits started becoming intermittent around the same time. I would get a week or so of good times followed by a week of hypersensitive hell. Usually, increased GI trouble -- constipation, gas, etc. -- would herald the switch-over. A few months later the benefits disappeared completely and that change was also associated with GI problems.

There are definite patterns here. The problem is that I *really, really do not want my parnate foray to be like my nardil trial.* When nardil quit on me and I lost that new life I had, I felt suicidally awful.

So, I have to figure out a way to stretch out the effects. My first step will be to use it more sparingly and to decrease the dose from time to time.


----------



## Govinda (May 7, 2012)

Whew!... I'm sitting at the computer and the bluriness and ringing in my ears is starting to fade. I had just taken a nap and then I tried to rise in a way that I thought was slow and careful. I guess it wasn't, because I started to get severe hypotension almost immediately. 

Actually, it's kind of weird. It's not exactly immediate -- I stand and feel fine, then after 5-20 steps I get it. And when it happens I have between 0 and 2 seconds to respond before I bash my head on the floor. Guess that's the blood starting to pump, but not really getting the job done.

This is a particularly bad bout. I keep trying to stand up, then ... no, no, sit back down again, gather yourself ... then again, still no. I've tried to stand and walk about 5 times. It was never quite this bad with nardil. But I also wasn't on baclofen, which is a muscle relaxant and so effect blood flow, especially venous return. 

Also, must note that a flood of euphoria came when things started getting blurry. Could just be effect of lack of blood flow/oxygen. Yeah, probably that.

Ok, attempt #6 ...


----------



## Emile (Feb 3, 2010)

Big post:

I had a strange remedy to this "poop-out" syndrome that I discovered about twoo weeks ago - I'd stopped taking it period because I didn't like the way it made me feel as a person (TMI). I lasted about a week and a half before the depression became too much and I knew I was just sinking again. But my personality did feel more normal.

Then I restarted at the same dose as before (80mg) because I couldn't be bothered titrating up. Well I had a huge response for about a week. In fact I thought I was on the way to recovery but it seems to have collapsed again.

I think there could be two reasons for this phenomenon - particular to both MAOIs.

*A).* One is B6 interaction. As you probably know irreversible MAOIs react with B6 and deactivate both their own function and B6 itself. I'll try and get some hard data to back this up cause it seems pretty hard to find. I'm taking a prescription b6/P5P concoction that hasn't solved the problem so I don't even know if it's that big an issue. BUT I will say when I had some pyridoxal-5-phosphate, supplementing with that when I was down seemed to help a lot. Not pyridoxine. Pyridoxine is bollocks.

*B).* MAOIs interact with NE - they deplete it and replace it with octopamine, a much weaker sympathomimetic. Jury is still out on why this occurs but it could be both a reason that dietary problems totally disappear (for me, anyway) after a bit of treatment, and why MAOIs just seem to die after a few months.

From here:



> Gradual accumulation of octopamine in adrenergic neurons, for instance, may be the result of MAO inhibition and resultant alternate hydroxylation of tyramine to octopamine. It has been suggested that octopamine may replace NE from intra-axonal storage granules. Octopamine released upon sympathetic stimulation may act as a 'false neurotransmitter' with minimal activity at a- or b-adrenergic receptors. The result is a functional block of sympathetic neurotransmission


I dunno if there's anything we can do about that. That link is good though, and offers some detailed stuff.

edit: forum needs spoiler tags >.<

edit edit:

Something else (relevant bolded):



> An immediate consequence of MAO inhibition is an elevation in the intracellular concentration of catecholamines, including 5-HT and other biogenic amines (tyramine, tryptophan, octopamine and PEA). Within a period of hours following amine accumulation, a decrease of neuronal firing can be demonstrated in serotonergic and noradrenergic neurons ... *Increases in intracellular amine levels result, via feedback inhibition, in a reduction in amine synthesis. Amines accumulating in the cytoplasm begin to enter amine storage vesicles. From there, they may either displace endogenous amines or be released as co-transmitters or partial transmitters.*


I'm too wasted to figure this out right now, but it seems the fact MAOIs prevent breakdown of _all_ monoamines might be a reason they're such a pain in the ***, and stop working, because too many non-neurotransmitters accumulate where they shouldn't.

Iono really, I'm grasping at straws. TCP is keeping me above the water but that's it. I wish doctor's could tell us about this so we didn't have to research it ourselves. But then again they're pretty hopeless when it comes to most of the other antidepressants, so...


----------



## gilmourr (Nov 17, 2011)

Emile said:


> Big post:
> 
> I had a strange remedy to this "poop-out" syndrome that I discovered about twoo weeks ago - I'd stopped taking it period because I didn't like the way it made me feel as a person (TMI). I lasted about a week and a half before the depression became too much and I knew I was just sinking again. But my personality did feel more normal.
> 
> ...


I'm not quite sure about the "octopamine" theory because on Nardil and Parnate I get norepinephrine side effects. When i was on cymbalta I had cold intolerance, shivering at times, a lot of energy and insomnia. I don't think anyone can argue that cymbalta isn't a potent NRI.

On Nardil and Parnate I've had the same effects if not worse at high doses. On parnate I was almost hypothermic. There might be a different mechanism, I'm just not so sure I believe that parnate and Nardil are not a potent NRI.


----------



## Gwen1234 (Sep 6, 2011)

Govinda,
I'm so excited for you! That's fabulous that the med is starting to work. And at such a small dose!


----------



## Gwen1234 (Sep 6, 2011)

So I might be experiencing a side effect of constipation??? Tried taking a cheapo laxative for the first time last night and it didn't work. Any reccomendations? Gee, this is a fun posting....


----------



## Gwen1234 (Sep 6, 2011)

So how is everyone doing? Any improvements? Me, no. But just came from my doc and we are upping my dose to 50 mg this week and then 60 mg the following.


----------



## Govinda (May 7, 2012)

Sorry to hear that Gwen. I hope your benefits arrive soon. 

As for me, I'm not sure what's up. Today I had a training class. We sat in a circle and were repeatedly called on and asked to participate in activities with one another. I didn't feel the sheer panic that I used to have, so I guess that's something. But I didn't feel that deep self-assurance that I felt on nardil and on this drug last week.

One thing that makes it hard to figure out what's doing what is the fact that I am currently quitting baclofen. It usually just made me feel uncomfortably flushed and nervous, with brief periods of euphoria. Anyway, quitting baclofen is supposed to be hell -- a lot like benzos -- but I don't feel much of anything. Maybe slight shaking in the hands and slightly increased nerves. Interestingly, when I first started parnate all the uncomfortable sides of baclofen stopped -- as if parnate somehow blocked them. So, perhaps parnate is counteracting the effects of bac withdrawal. Who knows.

I'm taking 20 mg parnate most days and 30 mg on socially tough days like today. It hasn't been a horrific failure or a glorious success. I think I might go up. It's tough though, cause I don't want to be greedy and burn the med out early (I expect burnout is inevitable for me) but I'm on the cusp of some opportunities. I've been recovering at my parents' house for a year and a half and now I'm picking out an apartment. I also really want to try my hand at dating. I had started dating for the first time in my life on nardil and I felt like a fuller person. Maybe I could find someone to ease my nerves too. But I feel like I need just a little more out of the med to start. 

So, I think I'm going to increase to 35 or 40 mg. I hope this doesn't murder my member.


----------



## bob1471 (Jan 8, 2013)

Metamorphosis, I never thanked you for your well-informed, highly detailed warning about Ephidrine... consider it done! My (natural) BP seems pitifully low, and the result is that I seem to crave things that stimulate it - to avoid falling over, and give me a buzz of excitement. Reckless amybe, but to be honest, I'd rather be dead than dead tired and depressed.

Cheers

Bob


----------



## Gwen1234 (Sep 6, 2011)

Metamorphosis,

How are you doing?????


----------



## Govinda (May 7, 2012)

update:
35 mg parnate/day + 10 mg baclofen + 600 lyrica + propranolol prn. 1 month or so on this stuff and it's effects have been fairly consistent. I think it felt a bit stronger in the beginning -- that feeling of okayness -- but it hasn't completely faded and I'm still able to get through most social situations. I've found that it takes a couple of hours to really kick in and so I wake up a couple hours early, take the meds, and by the time I get ready and get to work I'm usually ok. Hypotension still occurs. Sometimes I get very dizzy, but it's usually when I'm really tired. Unfortunately it makes me really tired in the evening most nights. Insomnia has not been a problem; actually a bit of the reverse. I still feel sort of asexual, which I don't like, but maybe that will fade. 

I'd still like to gain some ground so that I can really attack life, especially dating, but if nothing extra happens I can probably live with this for a while. I would recommend trying this combo to anyone who wants to attack both SA and depression -- you must be ready to sacrifice a teeny bit of brainpower though. 

I'll continue to work for meds that work better or have fewer sides though.

How is everyone else doing? Dosage/time on med? Level of SA?


----------



## metamorphosis (Dec 18, 2008)

Stayed steady on 40mg dose but problems with fluctuations in BP for no reason are causing my pdoc and myself to discontinue for some weeks. Heart comes over anxiety in more ways than one!


----------



## Caedmon (Dec 14, 2003)

Govinda said:


> I'd still like to gain some ground so that I can really attack life, especially dating, but if nothing extra happens I can probably live with this for a while. I would recommend trying this combo to anyone who wants to attack both SA and depression -- you must be ready to sacrifice a teeny bit of brainpower though.
> 
> I'll continue to work for meds that work better or have fewer sides though.
> 
> How is everyone else doing? Dosage/time on med? Level of SA?


I started to write to this and then realized i should start a new topic, so I'll just say good luck! I really hope the meds help out.

Caffeine helps my parnate-induced hypotension btw, and plenty of hydration and salty foods (yum), and over time it is less noticeable. Medically necessary potato chips.


----------



## bob1471 (Jan 8, 2013)

*Parnate day three..*

Parnate - third day.

I stopped taking Nardil over a week ago, and the result was a quick trip into living hell. Exhausted, blackly depressed, tearful... and 'actively' suicidal, sharpening knives and testing them on my arm (a bad habit.... slowly plucking up the courage for a coup de grace, and somehow being satisfied by the blood and pain). All this I had expected, but was unpleasantly surprised by the horrific intensity of my 'natural state', and its negativity.

I had been to see the doc, and after looking through my records he agreed that the debilitating side-effects of Nardil were likely responsible for my poor health, i.e. skin problems, constant diahorrhea, hypotension, physical weakness, sudden projectile vomiting for no apparent reason.... it was becoming 'not worth it', or so it seemed till I stopped taking the stuff. 

After this he prescribed one of the 'new' ones, which I'd never heard of - 
After checking this site and others however, I decided that this was not going to be effective enough, and before touching it, went back to see him asking for Parnate (which had at least worked before and was a lot stronger. "No longer listed, sorry..."

A bit of research encouraged me to go back again and check out Adderall ("not available in the UK"), Modafinil ("Hmmmm... sorry, a psychiatrist might prescribe, but I can't...") and last hope Tranylcypromine.... i.e., Parnate (shakes head "Hmmmm... very dangerous stuff, I'm not sure...?")

I was in tears as the (predictable) conversation went on....
"Look, I really don't care if it kills me doc, anything is better than this - including death, I have no fear of it..." 
"Suicidal?"
"Yes - very"
"Thought of a method?"
I listed about ten, including the length of my hanging drop according to Mr Pierrepoints table (five foot two, plus another foot for luck), ending up with 'good old carbon monoxide'.... yes I did have plenty of rope, yes I could get heroin if required (my prefernce) and yes I had a car....

And so I left with my precious Parnate prescription, something I'm not proud of, but when desperate....
Although it was only a week after saying goodbye to Nardil, I really didn't care any more - when I say I will do ANYTHING to escape the horror of depression, I mean it - and took one that evening. Then another a few hours later.

One of the ghastliest things about my Nardin 'withdrawal has been a set of dreams, incredibly vivid, not all bad, but incredibly intense. That I don't mind, but for the first time ever I found myself somehow 'unparalysed', falling out of bed and screaming for things in my sleep, only relieved by being violently awakened by someone who was extremely alarmed by it all. Had a far more peaceful night...

Yesterday I took three, and as I write today I have taken two. It is hard to be objective when you are the subject, but I'll try. My mood has certainly picked up, activity increased, and I feel something 'impending' if that ios the right word? Strangely emotional, but no hint of anxiety or panic (in fact, none of that throughout this whole grisly experience.

So, how do I feel? Bowels are back to normal, appetite reduced (no bad thing at 100 kilos!), a certain stiffness in legs and slight pain in knees, hips and ankles, but I had that before. Still itchy, but even that isn't as bad. The Nardil is probably still in my system, and I expect no miracles. 

Mentally is more difficult to describe. On the plus side I feel a curious sense of anticipation, a bit like the very first stages of going up on LSD or MDMA, but with no apprehension or anxiety. Suicidal feelings strangely switched on and off, but already seem to have vanished. What is most odd is a very emotional sense of the past, memories of dear friends dead and alive, an almost E like desire for company, affection, love and human contact, and the faint stirrings of desire, though more for cuddles than sex. As if these things (long forgotten) were somehow waiting in the wings somewhere, but there is a lot of work to be done. Also a sense of leaving it a bit too late (I'm 54 and have long since lost my looks, front teeth and much confidence, groan!), and having nothing much to offer...

Standing back, I see this as positive and a hopeful sign, having had no hope (or even thoughts) of pleasure, excitement and having another partner in this life again. It is a little painful even so, and I get a bit tearful at wonderful memories and lost relationships - even though a couple are not altogether lost even now. 

Will I ever know the exquisite highs of being in love and having fun again? I am already starting to see the possibility that it could happen, though it will take some time and a great deal of work.... a good feeling even so?

Altogether, well worth the risk, though I would certainly NOT recommend such irresponsible recklessness to anyone else, this is not intended to be a recommendation, merely a personal account. I should add that almost everyone on this group seems to have great respect for their health, unlike me who has and still does take little care and risks it without hesitation in order to feel better and crush depression. As I said, I have no fear of death, and to be honest a wish for it somehow, even when not depressed.

All considered, I highly reccomend this stuff - it worked for me before and seems to be working now. Be not afraid of all the grim warnings, if you are sensible with it, the rewards well outweigh the dangers IMHO. Good luck to you all, and congratulations to all those for who it seems to be working!

Will keep you posted (should I survive!)


----------



## Govinda (May 7, 2012)

Interesting acount Bob.

I identify with a few of your statements. I got that extreme yearning for physical affection and the sentimental glow of romance. I think this might simply be the effect of a quick shot of dopamine. I liked it, though there was an undercurrent of melancholy to this yearning.

Also, like you, I feel the pull of not being -- even when I'm happy. At first I thought it was because I thought that good times would never last, but I realized that wasn't the case. I'm simply drawn to this idea. Maybe I can overcome this magnetism, maybe not. 

Unfortunately, parnate is not providing me much relief at this point. Every time I increase in dose I feel great, but then it fades fairly fast. Let's hope I'm not screwed.

Good luck, and keep us updated.


----------



## bob1471 (Jan 8, 2013)

*parnate update - day five (or is it six?)*

So far so good.... have had a trace of hypotension, but got rid of it with coffee and ephidrine (tut tut!). It has lifted me out of the pits of despair, with no ill effects at all. Went up to 30mg, and have been feeling much better - not a thought of suicide, skin much better and nowels back to normal. No prolectile vomiting either, which is nice to know. I figure I must have been allergic to Nardil?

What you say about the 'sentimental' feelings I appreciate. I think it is a positive part of 'coming back to life' again, after hovering in another place far from it? Hard to describe, but a few tastes of real joy have reminded e of the past, and what may well lie ahead - I hope so.

For instance, it is snowy here at the moment, and the birds are very hungry. I took some out of date bread to the local churchyard, and spread it on some of the tombs - instantly surrounded by a great flock of seagulls, which felt like angels flying over my head - truly beautiful! And I am WALKING instead of trudging, with a new found energy I had forgotten. This is truly marvellous, I can't tell you!

Good luck with Parnate my friend, I think it may be the key for me... we shall see?

Cheers
Bob


----------



## bob1471 (Jan 8, 2013)

Ahem... that should have read 'bowels'....


----------



## bob1471 (Jan 8, 2013)

Another good day.... but a bit of a problem last night. Had bee crouching down playing with the cat, and got up a bit quickly... crash! Almost no warning, poleaxed. Got up again, supporting myself on the wall.... "there, no problem!" I said to flatmate.... whumph! Came round at once, but rather alarming. Have been v careful since, getting up in stages, and not attempting to race away....

Must be Hypotension? Whatever, against all orders (in the packet), I took a couple of do do's... tut tut! Have been fine today, but rather alarming. Luckily I only broke a light.... had my head hit the edge of the glass coffee table, it could have been William Holden time!:dead


Going to see the quack Monday, this should alarm him!

I'm not sure how best to deal with this. All the dire warnings about hypertensive crisis interest me.... but seeing my BP must be pitifully low, perhaps a smidgin of liver and broad bean pie with cheese topping washed down with Chianti might raise it to manageable levels?

Or perhaps a small dose of amphetamine (yummy!):clap

I realise tinkering like this is dangerous, so don't anyone else be tempted to try it until I've personally tested it!:afr

Cheers
Bob (up to 40mg and doing okay...)


----------



## crossfadex (May 17, 2008)

Just bumping this thread for any updates.

I'm interested in possibly switching my Nardil for Parnate.


----------



## vanvog (Jan 30, 2013)

I've been on Parnate for 7 weeks now, my current dose is 80 mg/day. It still gives me a buzz and I need a nap after it kicks in an hour or so after I take it. I take 80 mg in one single dose because divided doses (as suggested) are even worse, making me sleepy and not functional all day. Taking it at night doesn't work either because I wake up after a few hours of sleep. Parnate can be very sedating for some people, I guess I'm one of them. This is my only complaint, so far the excess fatigue and cold sensitivity are the only s/e. 

As for my SA it is gone 70%, I feel like a different person. I'm no longer suicidal. My OCD is much better. Anhedonia is not getting better though. As for depression, not being suicidal is something but I don't feel like my depression is getting significantly better yet. 

I think I'm gonna stay on it for a while because I feel better. Having to have a naptime everyday is not such a huge price to pay. Unfortunately the augmenting options are very limited with Parnate.


----------



## metamorphosis (Dec 18, 2008)

Is there anyone left to post on this thread? Or is it just going to die off? I may be back on Parnate after I talk to my pdoc tomorrow. The other meds I have been using, are just not working anymore, and my unipolar depression is starting to rear it's ugly head. That is a huge warning sign for me. I find it a bit disconcerting that the thread has seemingly been abandoned. Making me wonder if any of the posters are still on Parnate or if there are any others who would like to post.


----------



## metamorphosis (Dec 18, 2008)

Well, it looks like this thread has been retired. I am wondering what happened to everyone who was posting on here. Hopefully doing well and are in remission. I will be starting Parnate again following a flush out period. Every med. I have used since then. I have been treatment resistant to. So, I'll be back on Parnate in about a month at the most. This time I am going to start at a lower dose and use asenapine, Saphris at a low dose for sleep. I am excited about giving it a good run. I will probably use a low dose benzo or another anxiolytic with it. But it is going to be one step at a time. We are looking at giving it a 3-6 month trial period. Hopefully, with the steps I take this time; Things will go smoother and now just waiting to clear all meds. out of system and start using Saphris tonight to see how it help with sleep in general!
BTW if Parnate users want to help bring this thread back. Then please post, I have to reread a lot of the research I have done on the MAOIs, a lot of the info is on here.
Also anyone on an MAOI chime in
I know we have Parnate users out there! ;D


----------



## metamorphosis (Dec 18, 2008)

:cig


----------



## yourfavestoner (Jan 14, 2010)

I'm trying Parnate as soon as I'm done with this ****ing Zoloft trial. I'll be posting regular updates once I get my hands on it.


----------



## odspot (Sep 1, 2009)

vanvog said:


> I've been on Parnate for 7 weeks now, my current dose is 80 mg/day. It still gives me a buzz and I need a nap after it kicks in an hour or so after I take it. I take 80 mg in one single dose because divided doses (as suggested) are even worse, making me sleepy and not functional all day. Taking it at night doesn't work either because I wake up after a few hours of sleep. Parnate can be very sedating for some people, I guess I'm one of them. This is my only complaint, so far the excess fatigue and cold sensitivity are the only s/e.
> 
> As for my SA it is gone 70%, I feel like a different person. I'm no longer suicidal. My OCD is much better. Anhedonia is not getting better though. As for depression, not being suicidal is something but I don't feel like my depression is getting significantly better yet.
> 
> I think I'm gonna stay on it for a while because I feel better. Having to have a naptime everyday is not such a huge price to pay. Unfortunately the augmenting options are very limited with Parnate.


Was 80mg better than lower doses for your OCD? I went up to 60mg last year, which had no effect on anxiety; my psychiatrist at the time refused to go higher, but I've just met with a specialist who uses high-doses of MAOIs regularly. I also found doses up to 60mg a little agitating and overstimulating; again, does that improve on 80mg?

It's a pity it isn't helping your anhedonia .. that's one of my core symptoms, which I was hoping the Parnate would ameliorate.


----------



## miminka (May 10, 2009)

so far so good all things considered. about two months on parnate and i have to say to anyone considering MAOIs DO NOT simply brush off all the dietary restrictions. i understand everyone is different and they react to different things. though i know that it is almost unanimously advised to avoid tofu and soya sauce altogether.

i've been playing it safe with regards to dietary restrictions. haven't feel the need or desire to experiment much. though overripe fruits, i've learned from two horrible occasions, should not be messed with. the first time, i ate a half of an overripe avocado and immediately felt the tell-tale stiffness in neck, headache, weakness. i suppose i had a hypotensive crisis on these occasions. my blood pressure lowered and i felt extremely faint. the second occasion was worse. i had some strawberries that i thought were fine, they were a little on the overripe side but i wasn't worried. about two hours after i ate them i became so weak that i couldn't move or talk and i felt, again, stiffness in neck, headache. i became hypothermic. my bp was going crazy. luckily i didn't need medical attention on both occasions but i've learned my lesson.


----------



## Iwillovercomeanxiety1 (Aug 23, 2010)

If Nardil ends up not working well enough for me, should I give Parnate a try? Can it work better for anxiety than Nardil? I heard it can be more stimulating and also help decrease sweating, which are two problems I have.


----------



## bluenotebooks (May 25, 2009)

I just switched back to Parnate after after being on Nardil for a while. The nardil side effects, especially the sexual dysfunction, became too much of an issue.


----------



## bluenotebooks (May 25, 2009)

Iwillovercomeanxiety1 said:


> If Nardil ends up not working well enough for me, should I give Parnate a try? Can it work better for anxiety than Nardil? I heard it can be more stimulating and also help decrease sweating, which are two problems I have.


I think Nardil was better for anxiety for me but Parnate totally kicks my depressions ***. I prefer Parnate. Fewer side effects.


----------



## Iwillovercomeanxiety1 (Aug 23, 2010)

bluenotebooks said:


> I think Nardil was better for anxiety for me but Parnate totally kicks my depressions ***. I prefer Parnate. Fewer side effects.


How is Parnate for your anxiety? How often do people find Parnate to be more beneficial for their anxiety than Nardil? Is it very rare? Because I wouldn't want to switch to a med that is very unlikely to be better for my anxiety than Nardil has been for it


----------

