# Parnate



## Rintention (Aug 21, 2006)

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Hi All-

My Doctor wants to put me on Parnate. Does anyone take this Med. ? What I found on the Web about Parnate is scary.

Thank-you-

Rachelle

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## arthur56 (Jul 31, 2005)

some docs have a fascination with parnate and the MAOIs but IMO they are far too dangerous, their side effects can kill you or cause a stroke
they should only be consideded after many other antidepressants have been tried and have failed
what ADs have you tried?


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## Caedmon (Dec 14, 2003)

It's definitely killed me. Or, maybe it gave me a stroke. I can't recall. That's what death/strokes will do to you. :b

I once calculated that the odds of a serious medical complication from an MAOI is roughly on par with that of car accidents.

Before Parnate, I would go home after work and talk to *no one*, lay in my bed exhausted, and become further and further destablized and withdrawn.

On Parnate, I am in a clinical graduate program, am a TA, am filmed twice-weekly and watched thru double mirrors during clinic hours, talk routinely with my professors about casual things, have picked up new hobbies, moved three states away to the Pacific NW, get things done, no longer have the same spirals of negative thoughts...
... and I don't hide in my room. 
Your results may vary.

The vast majority of googled MAOI information is lousy and is not evidence-based. Most doctors are also quite ignorant of them. I recently saw a _psychiatrist_, who was still under the mistaken impression that people cannot have pizza or red wine while taking MAOIs. (This was debunked 10 years ago. Go figure.)


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## Weston (Sep 23, 2006)

arthur56 said:


> some docs have a fascination with parnate and the MAOIs but IMO they are far too dangerous, their side effects can kill you or cause a stroke
> they should only be consideded after many other antidepressants have been tried and have failed
> what ADs have you tried?


I agree other antidepressants should be tried first, but unfortunately the success rate isn't that great with SA. I'm sure living with anxiety and having your blood pressure, pulse and who knows whats else yoyo-ing up and down all day isn't very good for your health either. I've been on and off parnate and nardil for many years, and can only say good things about both. As Caedmon indicated it has also let me live a fairly normal but not perfect life. If it cut 10 years off my lifespan, I could live with that.(not that I think it would). Something tells me the stress would have done at least that.


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## PBNC (Mar 4, 2006)

Heck, I'd have loved to have found a doctor who was willing to consider an MAOI right off the bat, without exhausting a battery of SSRIs first. The MAOIs are the most effective drugs for social anxiety, based on most of what I've read/heard, and frankly, as long you use common sense and make sure you understand the drug and its interactiosn, I think dying and/or having a stroke are teeny tiny possibilities, to say the least.


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## jealibeanz (Oct 1, 2005)

According to my psychiatry professor, MAOI's are very very dangerous. Never use them. They have many drug interaction (true). There are huge assortment of SE's. But of course, you can't eat almost anything because of risk of hypertensive crisis. This includes all types of cheese, all wines, any beer, chocolate, sourdough bread, homemade bread, cheese crackers (haha, does this mean Cheez-its will kill you?!), cheesecake, yogurt, it goes on and on in a pathetic manner!


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## Weston (Sep 23, 2006)

jealibeanz said:


> According to my psychiatry professor, MAOI's are very very dangerous. Never use them. They have many drug interaction (true). There are huge assortment of SE's. But of course, you can't eat almost anything because of risk of hypertensive crisis. This includes all types of cheese, all wines, any beer, chocolate, sourdough bread, homemade bread, cheese crackers (haha, does this mean Cheez-its will kill you?!), cheesecake, yogurt, it goes on and on in a pathetic manner!


Sorry to say this, but I think your psychiatry professor is a retarded idiot. His list is ridiculous. I've had wine, cheese and chocolate in the last 24 hours and have only had one mild and one moderate stroke today. I wouldn't even care if it didn't take me 3 hours to type this. Let him believe what he wants.


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## Noca (Jun 24, 2005)

Weston said:


> jealibeanz said:
> 
> 
> > According to my psychiatry professor, MAOI's are very very dangerous. Never use them. They have many drug interaction (true). There are huge assortment of SE's. But of course, you can't eat almost anything because of risk of hypertensive crisis. This includes all types of cheese, all wines, any beer, chocolate, sourdough bread, homemade bread, cheese crackers (haha, does this mean Cheez-its will kill you?!), cheesecake, yogurt, it goes on and on in a pathetic manner!
> ...


 :ditto sounds like an MAOIphobe


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## Caedmon (Dec 14, 2003)

jealibeanz said:


> They have many drug interaction (true).


What do we mean by "drug interaction" in this case? There are synergistic sedative, hypnotic, or excitatory interactions. that is true of almost all psych meds, however.

The "bad" drug interactions are limited to a very few drugs, although they are important to know about. Demerol, dextromethorphan, SRIs, and oral decongestants are the main culprits. Otherwise it is basically not a problem.



> There are huge assortment of SE's.


There are no studies comparing side effects from MAOIs to SSRIs that I am aware of, but they might exist. Studies comparing phenelzine to the TCA amitripytiline found phenelzine to have fewer side effects, but this doesn't tell me much given the high side effect profile of amitriptyline. I would expect a wide range of reactions to MAOIs and probably no higher rates of dropouts vs. other psych meds.



> This includes all types of cheese


Not mozarella, provolone, cream cheese, cottage cheese, american... and likely a few others.



> all wines


wine is okay. All wines.



> any beer


Tap beer only... because of the tap, not the beer. if the tap is unclean and allows tyramine buildup.



> chocolate


Chocolate is okay.



> sourdough bread, homemade bread


This is the first I've heard of this, and I've heard a lot. Alas, I eat these products without effect. :stu



> cheese crackers (haha, does this mean Cheez-its will kill you?!)


Depends on the type of cheese. processed cheese is okay. You would have to look at the type of cheese on the ingredients list. I would not eat cheez-its, they are not that good for you.



> cheesecake, yogurt


These are okay. Eat up.

The making of a user friendly MAOI diet.
... which is possibly conservative as well, since it is based off of pressor tests which account for 50% of reactions (meaning 50% will be less sensitive, and thus can even eat some of the things on this list).



Weston said:


> I've had wine, cheese and chocolate in the last 24 hours and have only had one mild and one moderate stroke today.


LOL! Don't those cerebrovascular accidents just suck though? :b


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## Weston (Sep 23, 2006)

In all seriousness Rachelle I think your decision should be based on how big an impact social anxiety is having on your life. If it's having a major impact I would not hesitate to try it. Increase the dose slowly. The most likely effect will be hypotension. (Slight dizzyness when you walk flights of steps ect.). Introduce any foods your concerned with slowly just to be safe. Even if you were treatment resistant to other AD's there's a pretty good chance parnate will work.


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## Uglysean (May 30, 2011)

I've just been put on Parnate. This has been my third day after having spent a week abstaining from Effexor :no And a few more weeks being weaned off that stuff. I had severe side effects from that which apparently are not-so-affectionately called "brain shivers" :um an unpleasant phenomena if 've ever had one. All in all it's left me wiht a total wreck and my wife finally wants a divorce. I don't know where I'll be this time tomorrow. It's been unpleasant.


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## Arisa1536 (Dec 8, 2009)

Uglysean said:


> I've just been put on Parnate. This has been my third day after having spent a week abstaining from Effexor :no And a few more weeks being weaned off that stuff. I had severe side effects from that which apparently are not-so-affectionately called "brain shivers" :um an unpleasant phenomena if 've ever had one. All in all it's left me wiht a total wreck and my wife finally wants a divorce. I don't know where I'll be this time tomorrow. It's been unpleasant.


The symptoms you described having nothing to do with Parnate, its effexor withdrawal, it can last a long time for some people it takes months to fully recover the physical side effects but once parnate kicks in ( can take up to ten weeks sometimes less) you should start to feel a lot better 

I would take parnate if i could and i would choose it over nardil for the sheer fact that parnate is better tolerated and does not cause weight gain. MAOI's are said to be the "gold standard" for SA


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## wxolue (Nov 26, 2008)

From what I've heard, for the vast majority of cases, the food restrictions aren't that serious. It's important to be vigilant when you first start, in order to see how your body reacts to tyramine.

Most people don't have to worry about what they eat. Unless you sit there and eat a whole pound of chocolate, or work through a jar of pickled herring, you shouldn't have anything to worry about.

One particular food is extremely high in tyramine: some meat extracts. The most common place to find these are in soups, so make sure you check the ingredients. Miso soup in particular is a big no-no.



Eventually what you have to consider is how debilitating your anxiety is. If you are close to suicide anyway, I can't think of a reason not to try an MAOI. If you really can't operate because of your anxiety, or if your anxiety is keeping you from living the life you want, there's not much to lose from the very low mortality rate of an MAOI. Also consider that stress in general brings a host of medical problems, many of which shorten your life span anyway.


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## CD700 (Apr 22, 2010)

Im up to my second week of parnate

I hope this is going to help me soon.....need to go back to work and im sick of sitting inside hiding away


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## CD700 (Apr 22, 2010)

Oh yeah and I eat what I want, no probs but everyones different so be careful


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## travyglenn (Jun 1, 2012)

Yes, I am dead too after a year of Parnate use! I have my life back. I don't have restless legs anymore, and I feel like a new person, all from the horrible drug Parnate!


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## travyglenn (Jun 1, 2012)

blakeyz said:


> Im up to my second week of parnate
> 
> I hope this is going to help me soon.....need to go back to work and im sick of sitting inside hiding away


You may have to have your doctor up your dose! If you are treatment resistant it takes at least 60mg/day of Parnate to make a difference. I am on 100mg/day.


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## gilmourr (Nov 17, 2011)

travyglenn said:


> You may have to have your doctor up your dose! If you are treatment resistant it takes at least 60mg/day of Parnate to make a difference. I am on 100mg/day.


What if you have orthostatic hypotension and extreme coldness (vasoconstriction because of the alpha 1 receptor agonist feature). I was on it for 21 days at 30 mg but this stuff never went away. Did you just freeze to death for like a few months? I see all of my side effects getting worse titrating up if I was still on it.


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## CD700 (Apr 22, 2010)

travyglenn said:


> You may have to have your doctor up your dose! If you are treatment resistant it takes at least 60mg/day of Parnate to make a difference. I am on 100mg/day.


wow I remember this thread
Yeah I did go up to 60 mg for a while and was on Parnate for about 2 months all up. I gave up on it because it wasn't helping.
I had two days were I thought it was starting to work and for some reason got drunk and never got that felling back.

I found my Parnate script when I was cleaning up the other week and it's still valid for a few more days so I may go back on it.....not really sure
I have really messed up my life mixing alcohol and medication but i think Parnate was OK because i could never really get drunk for some reason


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## CD700 (Apr 22, 2010)

gilmourr said:


> What if you have orthostatic hypotension and extreme coldness (vasoconstriction because of the alpha 1 receptor agonist feature). I was on it for 21 days at 30 mg but this stuff never went away. Did you just freeze to death for like a few months? I see all of my side effects getting worse titrating up if I was still on it.


I remember at 60mg I started to get those side effects
Was so cold my genitals shrunk up like I just had a cold shower lol
I think it got better because I remember trying 70 mg for a while


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## Emile (Feb 3, 2010)

travyglenn said:


> You may have to have your doctor up your dose! If you are treatment resistant it takes at least 60mg/day of Parnate to make a difference. I am on 100mg/day.


Did this help? And if so, how do you take it? Dosages/times a day etc.

I take 80 mg/day in four doses (2+2+2+2), to deal with the hypotension after each dose, but recently I've been upping it to 90, 3+3+3.

I'm at a crossroads. It seems to work a little, but my god it's a high dose, the side effects are becoming intolerable - fatigue, dry mouth and a sort of "dry" feeling to my emotions in general - but it's the only thing that's worked.

Wondering if anyone has had high dose parnate give them a sudden improvement, because I'm getting weary.



blakeyz said:


> wow I remember this thread
> I had two days were I thought it was starting to work and for some reason got drunk and never got that felling back.
> 
> I found my Parnate script when I was cleaning up the other week and it's still valid for a few more days so I may go back on it.....not really sure
> I have really messed up my life mixing alcohol and medication but i think Parnate was OK because i could never really get drunk for some reason


Lol. I love this post. Cut the alcohol and the effects of the parnate come back... but slowly. But they're quite impressive once they do. Also, I definitely know what you mean about fooling around... just be careful with your liver. I have 5+ specific liver protectants to deal with those moments when it just *happens*, but even that is barely enough, specially as the dose increases. Perhaps this is my sole problem.



blakeyz said:


> I remember at 60mg I started to get those side effects
> Was so cold my genitals shrunk up like I just had a cold shower lol
> I think it got better because I remember trying 70 mg for a while


60 is an odd dose. I got more effect from 50; 60 seemed to be the "weird" plateau zone. 80 is a solid dose for me when it works. Logical and in control, pretty horny (yay), and able to deal with social interaction fairly well.

Parnate, or MAOIs in general maybe, are strange beasts. Often you have to hit well past the recommended max. dosage to feel something, and when it hits you think "omfg... OMFG". And then it goes away again.


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## upndownboi (Oct 7, 2010)

Emile said:


> Did this help? And if so, how do you take it? Dosages/times a day etc.
> 
> I take 80 mg/day in four doses (2+2+2+2), to deal with the hypotension after each dose, but recently I've been upping it to 90, 3+3+3.
> 
> ...


what dose were you at, and for how long, before it first started to work? I've been on Parnate for 5 weeks now (1 wk @10, [email protected], [email protected], [email protected], [email protected]) without any noticeable antidepressant effect.

Nardil gave me upper-abodmen tenderness but I'm tempted to give it another try if the parnate trial doesn't work out, at least with Nardil- 75-90mg is the accepted upper therapeutic range and it doesn't suffer from the need to be forever upping the dose grr


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## CD700 (Apr 22, 2010)

upndownboi said:


> what dose were you at, and for how long, before it first started to work? I've been on Parnate for 5 weeks now (1 wk @10, [email protected], [email protected], [email protected], [email protected]) without any noticeable antidepressant effect.
> 
> Nardil gave me upper-abodmen tenderness but I'm tempted to give it another try if the parnate trial doesn't work out, at least with Nardil- 75-90mg is the accepted upper therapeutic range and it doesn't suffer from the need to be forever upping the dose grr


The waiting game sucks
I am going to go back on Parnate soon and I will be giving it 3 months this time before I give up


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## odspot (Sep 1, 2009)

Emile said:


> Did this help? And if so, how do you take it? Dosages/times a day etc.
> 
> I take 80 mg/day in four doses (2+2+2+2), to deal with the hypotension after each dose, but recently I've been upping it to 90, 3+3+3.


How did you get 80/90mg prescribed in Australia? Are you seeing someone who deals with TRD?

My psych. is very good, but doesn't use MAOIs terribly often and won't go higher than the American-ordained 60mg (after I convinced him the 30mg they recommend here probably wouldn't be sufficient).

Also, did you ever get hit by a really horrible sense of overstimulation at a certain dose that later went away? I've been on 50mg for 6 days and feel kinda horrible .. like I'm on an NE overdose or something.


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## CD700 (Apr 22, 2010)

odspot said:


> How did you get 80/90mg prescribed in Australia? Are you seeing someone who deals with TRD?
> 
> My psych. is very good, but doesn't use MAOIs terribly often and won't go higher than the American-ordained 60mg (after I convinced him the 30mg they recommend here probably wouldn't be sufficient).
> 
> Also, did you ever get hit by a really horrible sense of overstimulation at a certain dose that later went away? I've been on 50mg for 6 days and feel kinda horrible .. like I'm on an NE overdose or something.


50mg in 6 days sounds like a real fast titration..
How long did you get the sense of over-stimulation for ? 
I'm going to probably start Parnate again tomorrow but I will be keeping the dose at 30mg for a while this time.


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## odspot (Sep 1, 2009)

blakeyz said:


> 50mg in 6 days sounds like a real fast titration..
> How long did you get the sense of over-stimulation for ?
> I'm going to probably start Parnate again tomorrow but I will be keeping the dose at 30mg for a while this time.


I said I've been on 50mg for 6 days; I didn't say I titrated to 50mg in 6 days -- in fact, it's taken two months. The overstimulation was there at lower doses, like 10/20mg .. then it eased up a bit at 30/40mg (but I think I spent several weeks on each of those doses).

Now it's back at 50mg, and very prominent, but I spoke to a psychiatrist who said that sometimes the MAO-inhibiting effects can lag behind the acute stimulation, and it's possible things will settle down in 5-10 days.


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## CD700 (Apr 22, 2010)

Yeah if it settled after the last dose increases then it would probably do it again
I am really interested to see your outcome


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## CD700 (Apr 22, 2010)

OK just took my first dose about 20 minutes ago
Already starting to feel that weird brain feeling 
I'll keep posting updates for my own future reference and anyone interested 
I'm not going to drink alcohol this time around.....fingers crossed this works....


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## gilmourr (Nov 17, 2011)

blakeyz said:


> OK just took my first dose about 20 minutes ago
> Already starting to feel that weird brain feeling
> I'll keep posting updates for my own future reference and anyone interested
> I'm not going to drink alcohol this time around.....fingers crossed this works....


Why did you stop it again? I thought you had similar issues like me like extreme coldness and hypotension? I don't see how these side effects would stop because Parnate has significant antagonism on Alpha 1 receptors that cause the orthostatic hypotension.

What I never understood is why I felt extremely cold though. Because if parnate has significant alpha 1 receptor antagonism, it should cause the opposite of alpha 1 effects, so vasodilation causing arteries to loosen, greater blood flow and being warmer. That's why I'm thinking there might be merit to the idea that octopamine replaces NE and lack of NE causes the coldness. Anyone else have an idea why I was extremely cold? Wasn't placebo


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## CD700 (Apr 22, 2010)

gilmourr said:


> Why did you stop it again? I thought you had similar issues like me like extreme coldness and hypotension? I don't see how these side effects would stop because Parnate has significant antagonism on Alpha 1 receptors that cause the orthostatic hypotension.
> 
> What I never understood is why I felt extremely cold though. Because if parnate has significant alpha 1 receptor antagonism, it should cause the opposite of alpha 1 effects, so vasodilation causing arteries to loosen, greater blood flow and being warmer. That's why I'm thinking there might be merit to the idea that octopamine replaces NE and lack of NE causes the coldness. Anyone else have an idea why I was extremely cold? Wasn't placebo


I stopped it because it wasn't working. I had two days were i felt it was helping but I got drunk and never got the feeling back. I'm hoping if I don't drink then it will be able to work properly. I know it wasn't a placebo effect because I have tried so many AD's and never felt anything.

Yeah I remember the coldness haha.....Winter just started here 2 so I guess ill be jumping around the house in my sleeping bag.


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## CD700 (Apr 22, 2010)

Day 3
Started 40 mg today, split into morning and noon 
No real side effects but I can tell that the insomnia will probably start tonight.
Already have no appetite as well but I am happy about that 
Went to the gym and had a good session so no sign of Parnate fatigue yet

Would be good to here how other people are going on Parnate if any are still around


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## metamorphosis (Dec 18, 2008)

MAOI's are basically only as dangerous as the person using them unless you have a preexisting medical condition.


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## odspot (Sep 1, 2009)

I'm still taking 50mg. I've adapted to the overstimulation. But it no longer seems to do much for my ADHD like it did at lower doses (30mg), which also caused a lot of anxiety. In fact, it just makes me feel kinda cloudy, which is annoying.

I think I'm meant to go to 60mg (max. dose psych will prescribe) soon. I suggested adding in Memantine to preserve the stimulant effect and help OCD. Not sure if this will work or just make things really messy. He was okay with using Memantine, but thought I should wait 'til I was on 60mg to add it, which seems kinda pointless, 'cos I know you're meant to pre-load Memantine. Since most people use it with stims, I wonder if it'll just make the Parnate too stimulating and worsen the insomnia.

My psych has admitted to not having much experience with MAOIs, though knows some people who use them frequently. I heard it becomes more like amphetamine at higher 80+ doses, so maybe I should ask for him to refer me .. I donno .. I just don't see much point in being on it if it's not gonna help my ADD.


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## odspot (Sep 1, 2009)

Oh yeah, I'm also really cold, though some reports on askapatient say this side-effect goes away ..


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## odspot (Sep 1, 2009)

the overstimulation went away, but now i'm just really fuzzy all the time. same thing happened at 40mg. anyone on Parnate ever experience something similar? does it go away?


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## CD700 (Apr 22, 2010)

This may be a stupid question but how does the over stimulation feel exactly ?
I get uncomfortable and fidget a lot since I have been at 40mg but the first time I tried Parnate I had a similar experience and it goes away after a while. 
I almost consider it a good sign that I am getting this reaction, as at least I know it's doing something. 
Is ADHD a bigger problem for you then Social Anxiety ?


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## gilmourr (Nov 17, 2011)

I had the overstimulation on day 4 just before day 5 and 6 where both of those days were full remission of all depression (just overall incredibly productive and generally happy).

Day 4 I woke up at 6 AM and was just like nuts as ****. Just bouncing off the walls, was like doing push ups and running around, just a ridiculous amount of energy. I then crashed at about 11 AM that day, and it never came back. But it was a bad feeling, I felt skitzo. The 2 days of depression relief were great though.


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## odspot (Sep 1, 2009)

blakeyz said:


> This may be a stupid question but how does the over stimulation feel exactly ?
> I get uncomfortable and fidget a lot since I have been at 40mg but the first time I tried Parnate I had a similar experience and it goes away after a while.
> I almost consider it a good sign that I am getting this reaction, as at least I know it's doing something.
> Is ADHD a bigger problem for you then Social Anxiety ?


when i refer to *over*stimulation, rather than just stimulation, i get things like a blank mind, my focus feels way too narrow to read (my working memory becomes all choppy), i feel like i'm in a hurry all the time, bad muscle tension, robotic emotions ..

anyway, yeah that went away, but now i just feel really foggy which is annoying.

i'd say that yeah, it's probably more important i solve my ADHD than social anxiety, but i also have major depression and really severe OCD.


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## upndownboi (Oct 7, 2010)

is parnate like nardil in that you need to be at a certain dose for, like, 6+ weeks before it works? and all the time at the building up doses doesn't count? I'm just refusing to believe parnate can be as lacklustre as its been so far.


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## robotaffliction (Jul 24, 2009)

upndownboi said:


> is parnate like nardil in that you need to be at a certain dose for, like, 6+ weeks before it works? and all the time at the building up doses doesn't count? I'm just refusing to believe parnate can be as lacklustre as its been so far.


when i took parnate my pdoc who was like 80 years old and plenty familiar with prescribing it pretty much said u should feel it in 5-10 days. i felt it around that time, it just made me really irritated and nervous (only at 20mg too), went back to nardil which yes did take 6 weeks to kick in when i took it, and now off meds


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## CD700 (Apr 22, 2010)

upndownboi said:


> is parnate like nardil in that you need to be at a certain dose for, like, 6+ weeks before it works? and all the time at the building up doses doesn't count? I'm just refusing to believe parnate can be as lacklustre as its been so far.


I think it took 7 weeks before I noticed anything last time
But I was getting drunk at least once a week so I think that had an effect

To the other guy on parnate who has been feeling foggy....
MAOI's decrease norephinepherine so maybe that's why ??
They release a certain peptide (forgot the name) wich then lowers NE, even though MAOI's block NE breakdown, they decrease it.


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## upndownboi (Oct 7, 2010)

blakeyz said:


> To the other guy on parnate who has been feeling foggy....
> MAOI's decrease norephinepherine so maybe that's why ??
> They release a certain peptide (forgot the name) wich then lowers NE, even though MAOI's block NE breakdown, they decrease it.


this guy says some interesting things about this



> I always thought the octopamine blocking the activity of norepinephrine/epinephrine at alpha-adrenergic receptors theory was flawed. For one octopamine is a pretty good efficacy partial agonist, it shouldn't block them that much, and secondly, it's a potent norepinephrine releasing agent just like say tyramine, which you'd think would more than offset any direct receptor actions. This N-acetylserotonin discovery makes much more sense. Also, based on these data, I should mention that MAOIs do not actually decrease norepinephrine, but raise it just like serotonin and dopamine as previously expected.


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## boostinggtir (May 27, 2011)

odspot said:


> when i refer to *over*stimulation, rather than just stimulation, i get things like a blank mind, my focus feels way too narrow to read (my working memory becomes all choppy), i feel like i'm in a hurry all the time, bad muscle tension, robotic emotions ..
> 
> anyway, yeah that went away, but now i just feel really foggy which is annoying.
> 
> i'd say that yeah, it's probably more important i solve my ADHD than social anxiety, but i also have major depression and really severe OCD.


Accurate. I can relate to all that.

Over all it has been very helpful to me. An upping the dose on the weekend is nice to be a little more pro social etc... Though I'm thinking nardil plus a stim will be the long term option. I'll try that soonish.


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## odspot (Sep 1, 2009)

Yeah, does the "8 weeks before you notice anything" include the time spent building up to your dose, or is it 8 weeks AT your current dose?

I moved up to 60mg yesterday. So far, it's pretty tolerable. I think the 1mg Klonopin I take at night is helping a lot with the agitation etc. I'd otherwise experience.


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## CD700 (Apr 22, 2010)

I hope it doesn't take me 8 weeks...
So sick of sitting at home 24/7 waiting for a medication to work
I did go out today and watch a movie with my gf and I fell asleep before half way because of Parnate
I need to nap a couple of times a day but it's no problem as I have not much else to do anyway


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## CD700 (Apr 22, 2010)

I have been on 40mg for a week now and the only side effect I get is being drowsy
Has anyone else had this ? I thought it was supposed to cause Insomnia
I take a nap about 40 mins after every dose (4 times a day) and I sleep all through the night...


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## boostinggtir (May 27, 2011)

parnate is all about 50mg plus IMO... (dont hate) try then Deni... Low dose dose nothing for me.


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## odspot (Sep 1, 2009)

blakeyz said:


> I have been on 40mg for a week now and the only side effect I get is being drowsy
> Has anyone else had this ? I thought it was supposed to cause Insomnia
> I take a nap about 40 mins after every dose (4 times a day) and I sleep all through the night...


Yes, 40mg is around where most of the MAO-inhibition starts to occur. I felt very tired and foggy at 40mg. As soon as I pushed up to 50mg, it cleared.

I'm taking 60mg at the moment. Been on this dose a week. Unfortunately, I can only tolerate taking 10mg at a time, so I'm dosing from 9am-7pm and my sleep is pretty poor.

I still get a stimulating effect; probably only mildly depressed at this point, but just feel really blah and emotionless overall. Not sure how much the klonopin I'm taking for sleep is contributing, but I hope it gets better than this.


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## CD700 (Apr 22, 2010)

odspot said:


> Yes, 40mg is around where most of the MAO-inhibition starts to occur. I felt very tired and foggy at 40mg. As soon as I pushed up to 50mg, it cleared.
> 
> I'm taking 60mg at the moment. Been on this dose a week. Unfortunately, I can only tolerate taking 10mg at a time, so I'm dosing from 9am-7pm and my sleep is pretty poor.
> 
> I still get a stimulating effect; probably only mildly depressed at this point, but just feel really blah and emotionless overall. Not sure how much the klonopin I'm taking for sleep is contributing, but I hope it gets better than this.


Yeah It gets a little annoying having to dose so many times a day :yes
I haven't got that stimulating effect you and others have mentioned either.
But today I have noticed my depressive thoughts that usually just completely overwhelm me and cause me to shut off, were not as deep. Could be due to other things like not having alcohol for nearly 3 weeks now......dunno


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## Jondbca (May 1, 2012)

odspot said:


> Yes, 40mg is around where most of the MAO-inhibition starts to occur. I felt very tired and foggy at 40mg. As soon as I pushed up to 50mg, it cleared.
> 
> .


Wow seriously? That's strange you say that because I just went up to 40 and I hadn't had the exhaustion effect until I went to 40, and it was pretty bad. I'll try to bump it to 50 to see what happens.


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## CD700 (Apr 22, 2010)

Jondbca said:


> Wow seriously? That's strange you say that because I just went up to 40 and I hadn't had the exhaustion effect until I went to 40, and it was pretty bad. I'll try to bump it to 50 to see what happens.


How is your blood pressure since going to 40 ?


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## Jondbca (May 1, 2012)

Pretty low or average I'm not at home now where I have my BP tester thing, but the last time I checked it was about 120 over 70, or something close to that if I recall correctly.


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## CD700 (Apr 22, 2010)

Jondbca said:


> Pretty low or average I'm not at home now where I have my BP tester thing, but the last time I checked it was about 120 over 70, or something close to that if I recall correctly.


Yeah that's what mine is too. 
I think it used to drop though about an hour after dose because my heart rate was going into the 40's and this was partly causing my fatigue I think.


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## upndownboi (Oct 7, 2010)

just some insights I've had about being on Panate for about 3/4 months now, currently on 30mg as this is the max my pdoc is comfortable prescribing, this won't apply to a lot of people but it may for some.

I've come to realise that past trauma is having a fundamental day-to-day effect on me, it means I'm in a frozen state and constantly in a state of hyper-arousal/overwhelm for which I try to use various relaxation techniques (tapping, body awareness, colour therapy, aromatherapy, meditation, hatha yoga), but its a day-to-day battle. For me Parnate's main benefit has been working on the depression but not blunting my feelings so I can work with them more. HOWEVER Parnate is stimulating and hypes me up even more when really what I need is calm and relaxation, this is why I believe Nardil would possible help me more with its absence of stimulation and additional effect on GABA, perhaps augmented with lyrica/gabapentin I don't know. I believe this would help reduce the hyper-arousal to a level where I could get even more out of therapy in terms of addressing the underlying trauma and re-processing it, so I will be bringing this up with my pdoc and asking him to consider switching me 

So, I know its kind of obvious when you think about it, but its taken living it for me to really understand that- if you believe that trauma is playing a part in your illness (unexplained hyper-arousal, inability to learn and synthesize new info etc) then Parnate is probably a no-no as it can exacerbate things  Nardil on the other hand is probably the way to go, the only thing I am slightly concerned about is Nardil putting me too much into the comfort zone to do the work I need to do or inducing too much apathy, but I have been assured the later isn't an issue compared to SSRIs and with sensible dose management the former can also be avoided.

ps. IME Parnate at 90mg+ seemed to have the paradoxical effect of helping me relax and calm down more and I believe a dose in the 90-120mg range might have been ideal for me, however this isn't an option under my current pdoc (asking for a referral to the esteemed psychopharmacologist Prof. Nutt is something I'm considering as, frustratingly, effective treatment for my issues seem to fall well outside his comfort zone).


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## CD700 (Apr 22, 2010)

His actually called Prof. Nutt ? lol!

That sucks your current pdoc won't go above 30mg as there is evidence that 60mg is twice as effective then 30mg for social phobia.
http://www.ncbi.nlm.nih.gov/pubmed/20036427

Sometimes you need to be a bit sneaky because of all the bureaucracy involved.
I'm not sure about how the system works in the UK but I found a few tricks to be able to take 70mg of Parnate when I was supposed to be on 40mg. I didn't like being dishonest but it's what I had to do.


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## upndownboi (Oct 7, 2010)

blakeyz said:


> His actually called Prof. Nutt ? lol!
> 
> That sucks your current pdoc won't go above 30mg as there is evidence that 60mg is twice as effective then 30mg for social phobia.
> http://www.ncbi.nlm.nih.gov/pubmed/20036427
> ...


lol yeah  the irony being he's one of the few not suffering from the collective madness of the psychiatric profession that makes it such a fckin gauntlet, hoping if i see him i won't have to trick-me-do quite so much as I have been lol


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## CD700 (Apr 22, 2010)

Parnate 60mg, Day 68 

Woah! Massive brain stimulation out of nowhere today. It's hard to explain the feeling. I had to lie down for a couple of hours. It's like the stimulation was battling the depressive parts of my brain or something.


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## upndownboi (Oct 7, 2010)

blakeyz said:


> Parnate 60mg, Day 68
> 
> Woah! Massive brain stimulation out of nowhere today. It's hard to explain the feeling. I had to lie down for a couple of hours. It's like the stimulation was battling the depressive parts of my brain or something.


thats awesome to hear  I bet its given your morale a shot in the arm too. I felt a similar thing on prozac during the time it was obliterating my depression, I think its a good sign.


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## Jondbca (May 1, 2012)

blakeyz said:


> Parnate 60mg, Day 68
> 
> Woah! Massive brain stimulation out of nowhere today. It's hard to explain the feeling. I had to lie down for a couple of hours. It's like the stimulation was battling the depressive parts of my brain or something.


How did you take it 60 mg all at once? Or broken down? You were on 40 mg. before right?

I know I'd rather have the brain stimulation than the drowsiness I've been getting on 40 recently though..


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## CD700 (Apr 22, 2010)

Jondbca said:


> How did you take it 60 mg all at once? Or broken down? You were on 40 mg. before right?
> 
> I know I'd rather have the brain stimulation than the drowsiness I've been getting on 40 recently though..


Started 50mg July 18th and 60mg August 6th.
I take it 20 mg split into three times a day. 9am, 1pm, 5pm

The drowsiness does go away eventually.

Splitting dose, caffeine pills, or even going back down to 30mg for a while may help your fatigue. I know going up dose to fast was making mine worse.


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## Ash10105 (Aug 21, 2012)

*It works*

Thought i'd share my experience.

I've tried almost every medication without success.

Finally parnate actually works. Here's my story week by week

Week 1 - Euphoric feeling. Felt quite high and ontop of the world. Slightly dizzy. I ate soy sauce as I read food interactions were overrated (They are not). The soy sauce gave me quite a strong headache. Anxiety was still quite high. Extreme insomnia (I no longer needed to sleep). I'm super full of energy and bound off walls!

During week 1 I took 10 mg parnate for 3 days then 20mg.

Week 2 - SA is extremely down. 70% of SA is gone. Note I still feel quite tense and a bit too on edge however, the anxiety no longer controls me. I am far more social and comfortable talking to girls and superior figures. The euphoric feeling has decreased. I feel a little dizzy and still have insomnia however, it is not as bad. I'm still a bit to full of energy. Parnate seems to have a stimulating effect.

During week 2 I took 40mg parnate.

Week 3 SA is still down about 70% which is great! Still pretty tense but I'm pretty happy with this medication. I've noticed a fair increase in derealisation and I'm a little dizzy at times. That being said the side effects are totally bareable compared with other medications. My appeitite has decreased slightly and I believe I will lose a little weight. My energy levels are slowly starting to normalise however, I am still very energetic and throw myself around. I have also noticed

And you know the best part!! NO SEXUAL SIDE EFFECTS. In fact I'm a 24 year old guy and my sex drive has been the best it's ever been! Okay so there has been a few sexual notes:
Takes me longer to orgasm
Sexual arousal feels quite different
My erections are stronger
I feel less of an interest in masturbating yet more of an interest in having sex

Okay so bottom line is parnate is working. The side effect including insomnia are totally bareable. I might need to increase my dose to 60 mg to totally remove my SA disorder.

Re: Food interactions: It's quite easy to avoid the no go list. Really there isn't too much. That being said do take the food interactions seriously as the headache hurts if you eat something wrong . I've occasionally noticed a slight headache which I attribute to eating something with a little bit of the naughty thing your not meant to eat.

My concerns: 
Some people say it poops out and stops working. I hope this will not be the case with me
I'm still very tense despite anxiety being drastically reduced
The insomnia is a little annoying
I feel a little dizzy/high/depersonalised

BUT OMFG IT WORKS. NOTHING ELSE HAS WORKED FOR ME.... Gogo Parnate ze lifesaver.

I take 40mg all in the morning as this way = less insomnia.


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## Jondbca (May 1, 2012)

That's awesome Ash10105, keep us posted as time goes by! Also, let us know if you've noticed any weight changes, I thought mine was going down - but it's been going up as well as bloating time has gone by... Not sure if it's the Parnate or some other factor.


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## ihateanxiety1 (Feb 8, 2012)

I'm back on parnate. If anyone has anyone questions PM me. It's the only medication that reduces my anxiety that I can tolerate. It needs to be taken at almost exactly 2PM every day as otherwise it will mess with your sleep cycle. It also makes climax very difficult. It's great for anxiety thou. At 30mg 60% less anxiety. At 40mg 70% less anxiety. Higher dosages cause heart palpitations for me.


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## ihateanxiety1 (Feb 8, 2012)

*No poop out*

Just a quicky. Still on parnate. No poop out effects. The anti-anxiety effect is still very much the same.

Still causing trouble finishing in sex. Still causes some insomnia and an increased heart rate.

All in all still trucking along. Much better than nothing.


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## miminka (May 10, 2009)

gonna talk to my doctor sometime this week about going on this drug for my treatment-resistant depression. from all the research i've done it seems like a positive thing. i'm not sure i'm ready or even able to be entirely without medication, especially because my insurance doesn't cover the long-term therapy that i need if i were going to be med-free. 

nothing else has worked to take away my depression and anxiety. ssris have all been miserable, and i've tried at least six. even benzos aren't ideal because i don't feel right, i can't focus, i just feel drowsy and listless. i'm a university student so i obviously can't have that. even taking mdma: you'd think for once i'd feel euphoric, really happy, confident, content, optimistic.. that lasts for such a short amount of time and then i crash back to my normal state, my mood going up and down like a yoyo, it's pretty unpleasant. 

so.. we'll see how this one goes. i don't know how familiar my doc is with MAOIs because since i was 13 she tried one ssri after the other with no success, and obviously never considered MAOIs. also, they apparently are much more effective in treating atypical depression and borderline personality disorder.


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## miminka (May 10, 2009)

Ash10105 said:


> *BUT OMFG IT WORKS. NOTHING ELSE HAS WORKED FOR ME.... Gogo Parnate ze lifesaver.*


really hope this is the case for me. got my script for 20mgs this aft


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## Weston (Sep 23, 2006)

miminka said:


> really hope this is the case for me. got my script for 20mgs this aft


 20 MG is really low dosage. Parnate has a stimulant effect and 20 MG may help. Nardil doesn't have the same stimulant effect and low dose almost never works. They both kick in differently. Parnate sometimes works quickly, I think because of the fact it acts as a stimulant and Nardil is usually like a light switch turning on suddenly after a few weeks of increasing the dosage gradualyy.


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## ihateanxiety1 (Feb 8, 2012)

*Still on it *

I'm still on parnate. Has anyone else found that it's the only drug that actually does anything at all for anxiety. The rest for me were just garbage.

It's not a miracle pill. I highly recommend finding a good therapist at the same time and working on any sources of anxiety whether conscious or subconscious.

Parnate is good, it works but it's not a miracle pill. Definitely do not take after 2PM! You won't sleep... Lol. Careful taking doses > 30mg. They caused minor heart issues for me.

Also please take the food restrictions seriously. If you don't you get nasty headaches, increased anxiety and palpitations and increased BP. A little cheese prolly won't kill you but try to avoid esp the very aged cheeses. Wine/liquor hasn't been an issue for me.

On a side not parnate totally cured my IBS... That's a plus .


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## Caedmon (Dec 14, 2003)

Back when I first started Parnate, I had unusual feelings of a strong heart beat at 40 mg. EKG cleared me of any real trouble. The feeling subsided within a month or so.

Those round red pills are like skittles of peace. I love my Parnate.


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## barry1685 (May 25, 2011)

Why can't one switch MAOIS on a quarterly basis is they have high tolerance to medications. (I.E. Nardil for 3-4 months, then parnate for 3-4 months, and switch back to nardil) I heard of one person doing this because they built tolerance all the time.


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## watertouch (Nov 4, 2013)

barry1685 said:


> Why can't one switch MAOIS on a quarterly basis is they have high tolerance to medications. (I.E. Nardil for 3-4 months, then parnate for 3-4 months, and switch back to nardil) I heard of one person doing this because they built tolerance all the time.


One probably could, the inhibition of MAO is there for 2weeks, but the effect from the drug is not, they have verry short half lifes. I have never consider this so there might be some interaction.


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## Caedmon (Dec 14, 2003)

At the same time, some people have reported that they stop and restart an antidepressant, and it doesn't work as well the second time around.


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## watertouch (Nov 4, 2013)

Caedmon said:


> At the same time, some people have reported that they stop and restart an antidepressant, and it doesn't work as well the second time around.


*Im mostly rambeling so no need to read!!!!*

Tell me about it..(tried Prozac like 5times) This is my 4th time on Parnate, 1st time got energized, sleeping problems and such, sleept about 3.5hours a day, Doc and i desided it was to little, so stopped and gonna try Amphetamine, It required a licens from the healtdepartment, and it wasnt approved... Had to change Dr. after that (he started working at another place)

Tried some other meds after that Sensaval+modafinil i think... Then back on Parnate worked great the first cans i had (had some left), then i must got a faulty batch because that effect went away as i changed. Added the AAP Solian to increase DA. 
Got real brainfog sometime here, Also did a "Neuropsychiatricevaluation" (long word), good general knowledge but score abit lower on short term memory and abstract thinking and such. Wais-iv test

Took another break after a year, was going to Black Sabbath with the guys n knew there would be alot of beer n crap. Decided to not go back until after christmas, (food interactions) and i wanted to see how i felt without medicine. Switched clinic since i laughed the headcheaf of 11clinics of that chain in the face 4times and corrected him infront of others,revenge was to not refill my BZ. 
Cold turkey after years of use, pfft not likely, egomaniac fool.

And by some act of a higher power, while sitting in the waiting room at the new clinic my old Dr. walked out there and even recognized me.
Switched to him naturally, and we started a "stimulant trial", boom car crashed in my home. 
Started Parnate again to battle anxiety and suicidal thoughts. Naturally it wasn't any stimulating comming from Vyvanse, but no problem sleeping or afternoon fatiuge... But suicidal thoughts are gone, obsessive thinking and reflecting on how other may have "perceived" me in social situations are almost nill.

Altough my main problem is Fatiuge, but Parnate doesn't worsen it.

Abit long, but sometimes it's nice to went things, and with Parnate i don't care how its perceived...


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## Caedmon (Dec 14, 2003)

barry1685 said:


> Why can't one switch MAOIS on a quarterly basis is they have high tolerance to medications. (I.E. Nardil for 3-4 months, then parnate for 3-4 months, and switch back to nardil) I heard of one person doing this because they built tolerance all the time.


Sounds unusual at such a fast rate. Some antidepressants take three months to fully work anyway. There are many options for dose optimization and then augmentation before switching. If it stops working within 3 months it was because was bouncing off the dopamine release. Or hypomanic. Or at any rate required a mood stabilizer on board to prevent recurrence. That would be my angle anyway.


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## zeusko87 (Sep 30, 2014)

miminka said:


> really hope this is the case for me. got my script for 20mgs this aft


hi miminka

are you from bosnia and herzegovina? is parnate avaliable there because i am from croatia and here it is not avaliable anymore.


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## watertouch (Nov 4, 2013)

zeusko87 said:


> hi miminka
> 
> are you from bosnia and herzegovina? is parnate avaliable there because i am from croatia and here it is not avaliable anymore.


In Sweden one has to specially import it. Requires a licens though from our healtdepartment. Don't know how it's over there at your country.
We also have the equall care in EU, so one could seek treatment in another country, if ones country cannot supply that care.


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## miminka (May 10, 2009)

zeusko87 said:


> hi miminka
> 
> are you from bosnia and herzegovina? is parnate avaliable there because i am from croatia and here it is not avaliable anymore.


i was originally but now i'm living in montreal (canada). yeah, there's no way to get parnate over there, but it's still on the market here. there were a few times my pharmacy had to import it from other retailers because it's so rare, but it can be filled.


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## watertouch (Nov 4, 2013)

miminka said:


> i was originally but now i'm living in montreal (canada). yeah, there's no way to get parnate over there, but it's still on the market here. there were a few times my pharmacy had to import it from other retailers because it's so rare, but it can be filled.


My Parnate made by GSK is actually imported from Canada, but as always almost everthing is made in India.


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## Iwillovercomeanxiety1 (Aug 23, 2010)

I'm considering going from Nardil to Parnate. I saw that Parnate has a side effect of possible hair loss. I'd rather not lose any more hair, as I'm already on Propecia and have lost some hair. Is hair loss something I should be concerned about if I were to be on Parnate? How likely is it that it will cause hair loss? Or how often does it?


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## DonD (7 mo ago)

For anyone finding this thread. Parnate is not scary. It can be a lifesaver for people who are treatment resistant.
Checkout Dr. Ken Gillmans website for lots of up to day information. A lot of the dietary restrictions are out of date.
Dr. Ken Gillman 

What's scary is every antidepressant that's dished out is an ssri.


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## LittleEarthquakes (Jan 13, 2013)

Don't believe the scary stuff. MAOI's are to be respected but they are safe.


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