# Parnate vs Nardil for SA / depression



## i_against_i (Nov 29, 2007)

Any info/ personal experiences to share


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## arthur56 (Jul 31, 2005)

both can kill you from side effects and should be an absolute last resort after many other antidepressants have been tried with no help, IMO

some shrinks seem fascinated with them but they are so dangerous, unless you yearn for a flirtation with death :nw


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## Caedmon (Dec 14, 2003)

I take the MAOI Parnate. It works wonderfully. Do a search on my posts and I have written a fair amount about it. 

Also, I am not dead, and I firmly disagree with arthur's statements above, both in tone and in content.


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## dns (Apr 30, 2008)

Parnate has milder side effects. e.g. I have none at all


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## thor_no (Mar 23, 2008)

arthur56 said:


> both can kill you from side effects and should be an absolute last resort after many other antidepressants have been tried with no help, IMO
> 
> some shrinks seem fascinated with them but they are so dangerous, unless you yearn for a flirtation with death :nw


If you are responsible grown up I don't belive they would be dangerous at all. I think it's more likely that you would be killed in a car crash than from a hypertensive crisis on MAOI. If you are struggling with severe anxiety and depression, and other medications don't help, I think it would be better to use MAOI than risking sucide or living a non-social, miserable life in depression.


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## aries (May 2, 2008)

I'm one of few people that has been on both. I first tried parnate because I was convinced I didn't have strong anxiety and that the mild anxiety I had was due to depression (Parnate isn't indicated for anxiety though it's used for it, Nardil is. Plus I was silly and liked the name Parnate.)
Parnate worked fairly well for both anxiety and depression, and had virtually no side effects except drowsiness, though I did notice I felt MUCH more refreshed than I ever used to after 10 hours of sleep. I switched to Nardil after it stopped working as well as I liked. Nardil has treated me well. Less drowsy feeling and less sexual difficulty (it was minimal with parnate but present) but more dizzy. Noticeable orthostatic hypotension. I'd say it's much better for anxiety. Despite some talk about a 2003 reformulation causing issues, I hadn't tried it until 2007 and I'll never know the difference. All I can say is that in its current form it works very well. It's not a miracle and I am still overly shy or hesitant sometimes and I need to work on that. I am more confident in speaking and less inwardly oriented, which I didn't get with Parnate.
Hopefully Nardil's effects don't fade, at least before I can take the most advantage of them... I do think some time I want to try marplan just so I can have something to say about it.

And as for the first reply - MAOIs are far from lethal. The potentially bad effects have been significantly overblown. My resting blood pressure on both parnate and nardil has gone from 120/80 to 130/70, but I've never had any food cause it to go up except genoa salami eaten by accident in an italian grinder. I had what would be about 2.5 slices of it if it were packaged, and though I didn't take my BP, the effects were very minimal. A little headache and I felt anxious about if it was going to do any damage, but it passed without issue. I've been able to eat processed/American cheese, farmer's cheese, and single slices of regular cheddar with zero problems. Any BP changes are in the range of 10-20 points and nothing worth concern. I haven't pushed my dietary restrictions further than that but I've heard stories of people eating cheese pizza without problems and I will probably go ahead and try that next time someone offers me pizza.
Medical interactions? I stopped using recreational drugs after I started wellbutrin and quit my nominal alcohol intake to avoid the seizure risk, and I never used much of anything else except occasionally asprin or ibuprofen... and lots of tums. Once I had a cold and used oxymetazoline nasal spray which is a verboten sympathomimetic, I was too desperate and went against the rules, didn't die or have any wacky effects from it except that I could breathe again.

Everyone's mileage varies but I've found the dietary restrictions FAR more easy to cope with than the SSRI insomnia, agitation and complete sexual dysfunction, or Wellbutrin's decision to simply not work at all, and gave me a constantly inflamed adenoid gland. It wasn't even "activating" like the doctor promised. If I had simple ADHD though, I would swear by it since my attention was helped very much.

Overall opinion - Nardil is better for SA than Parnate but if the side effects are somehow poor for you and Parnate's aren't, then try Parnate, as it can be helpful as well. Both are great for depression and have mild to no side effects that you would expect with SSRIs or TCAs. I wish more doctors were as smart as my psychiatrist, who skipped me to Nardil after SSRIs and Effexor having intolerable side effects and Wellbutrin not working. Serotonin was probably the key for me and is for most people, but for me it is hard to tweak without bad side effects.

edit: it's worth mentioning that I gained around 5 pounds after starting Parnate. That stabilized and I haven't gained anymore, but I do attribute it to the medication since my weight was generally stable before starting either. It *could* have been due to overcompensation for increased hunger after quitting wellbutrin but I doubt it. It's not a big amount and my hunger stabilized after a little while, but I did feel more like eating (not necessarily more hungry just more like I wanted food). Also if you smoke, and have smoked through several months on wellbutrin without needing to quit, MAOIs just might force you to. I can not STAND it anymore, and that was not due to any attempt on my part, I can safely place square blame on the pills.

Also three time a day dosing with Nardil hasn't been a big issue since I did the same with Wellbutrin after XL didn't work as well as generic Bupropion, also that though Parnate took about 3 weeks for a noticeable effect to take hold, Nardil only took around a week. Maybe because I had been on another MAOI as recently as a month before starting it, but I've also heard stories of quick responses with Nardil. I know it wasn't placebo effect... if I were prone to that, and I wish I was, I'd still be on Celexa.
(Okay I know this is a really long post and I'm new but hopefully it was informative)


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## thor_no (Mar 23, 2008)

Aries, I found your information very helpful. Thanks for posting! My doc will try to get me som MAOI's, and reading your post I guess Nardil is the MAOI I should go for first. (If I would get the privelegie to choose)


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## mogadon (Feb 28, 2008)

aries , good informative post,

just wondered how has your weight been on Nardil, is it stable ,have you gained any ?

also what mg dosage are you currently on ?

apparently 1mg/1 kilo is a good dose , according to this, https://www.portsidetechnologies.com/th ... al/TCR.pdf


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## aries (May 2, 2008)

I noticed my hunger up slightly on Nardil but my weight has been stable. I weighed 190 when I started Celexa back in the day, and that caused weight gain - 10 pounds. I dropped about 5 of them and gained another 5 on Parnate and it hasn't changed since then.
My current dosage is 90mg. I will probably drop down to a "maintenance dose" after a while - that's important to consider with an MAOI, usually you drop down to the lowest effective dose after being on something so high. It's 30mg three times a day - two pills since it only comes in 15mg tablets.


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## fraidycat (Oct 29, 2004)

hey aries,
what do you do about the dizziness side effect. Does it subside to a functionable level after a while/ and how long?

and do you notice if if helped w/eye contact as a symptom (if that was a problem with you)?

thanks


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## quat (Sep 27, 2006)

aries said:


> Overall opinion - Nardil is better for SA than Parnate but if the side effects are somehow poor for you and Parnate's aren't, then try Parnate, as it can be helpful as well. Both are great for depression and have mild to no side effects that you would expect with SSRIs or TCAs. I wish more doctors were as smart as my psychiatrist, who skipped me to Nardil after SSRIs and Effexor having intolerable side effects and Wellbutrin not working. Serotonin was probabl


I'm actually the other way around. The hypotension got worse as I went along and I really struggled to get any sleep on it. My body would feel like you feel you have been up for 48 hours straight.


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## quat (Sep 27, 2006)

aries said:


> Overall opinion - Nardil is better for SA than Parnate but if the side effects are somehow poor for you and Parnate's aren't, then try Parnate, as it can be helpful as well. Both are great for depression and have mild to no side effects that you would expect with SSRIs or TCAs. I wish more doctors were as smart as my psychiatrist, who skipped me to Nardil after SSRIs and Effexor having intolerable side effects and Wellbutrin not working. Serotonin was probabl


I'm actually the other way around. The hypotension got worse as I went along and I really struggled to get any sleep on it. My body would feel like you feel you have been up for 48 hours straight.


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## No Limit (Dec 6, 2005)

I've taken both for a long period of time. I'm currently taking Parnate. The side effects are less pronounced with Parnate. The annoying problems I had with Nardil which ultimately led me to stop using it was urinary retention, difficulty moving bowels, and insomnia. I think Parnate is doing a good job for me so far. I haven't encountered any side effects so far. The insomnia is there, but I counter that with Trazadone.


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## thor_no (Mar 23, 2008)

Saw my doc today, and he would send an application trying to get me Nardil and Parnate. Don't know which of them he want me to try first, but I guess Nardil , as this was the first drug I brought up.

He didn't seem to know to much about it though, and had to read while I was at his office. He was talking about giving me a MAO-A, but i rejected. Told him that if I should try a new drug, it's certainly better to give me something that is likely to have some efficiency on SA. He also was afraid of the hypotension thing, food/drug interaction that could be fatal, and that it was my own responsibility if i was dying while I on MAOI. I do not have to sign anything, but he wrote in the journal that it was my wish to try the MAOI's and me that brought it up in the first place. He would also contact a specialist that would sign the application. So now I hope to try MAOI's soon.

If/when I get MAOI I will post my experiences.


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## aries (May 2, 2008)

Wow you had to apply for it?
My guy just wrote me a prescription and I took it down to a pharmacy and filed it anonymously (paid cash... as usual...) - they do treat MAOIs as *too* dangerous. I think you have to use them with intent or pretty big negligence if you want to get a hypertensive crisis. There are only a few medications which are truly likely to produce an interaction, and only a few foods (ie, I can eat a slice of cheddar cheese without issue, I've never tried more than one at a time).



fraidycat said:


> hey aries,
> what do you do about the dizziness side effect. Does it subside to a functionable level after a while/ and how long?
> 
> and do you notice if if helped w/eye contact as a symptom (if that was a problem with you)?
> ...


Dizziness... It's complicated, I never got bad orthostatic hypotension, but sometimes I will stiill get dizzy as in, if I shift my vision really fast I feel that weird brief heat in my brain, hard to describe it, but it is quick. Walking and standing aren't hard, driving is fine. I don't remember it being any worse at first since I went up from a low dose.

Eye contact I have never had a big problem with but it certainly helps me be more outgoing. Like, I know what I want to say to people, to be nice, to be friendly and useful, but most of the time (and sometimes still on nardil - I think I need CBT to get the most out of it) I will feel too nervous to be anything but really shy, really quiet and sullen looking, and people think I'm being a jerk, or hiding something, or just that I'm upset. So it is easier all around to say what I mean to say and like, make small talk, smile, to mimick whatever people want to see eachother do to be treated fairly.
Might be worth noticing that last week I had my first psychosis, well into my nardil schedule, but it was under pretty bad stress when my parents kicked me out of the house. See, I got really bad SA and depression when I started college and had to drop out and they resent "wasting" so much money on 3 useful semesters and one where I just failed out completely, though at least I have about 40 credits... but anyway we had an argument and I started hearing (its not as "loud" and I can differentiate between outside voices and this) voices that just amplified my own negative thoughts, people, voices mostly from my family or just my inner monologue, saying I've done a bad job, I'm useless, and turning me into a mean person. So I'll probably have to add an antipsychotic onto nardil but they are safe to do concurrently. BUT just so you know it won't prevent that under really bad unnatural stress you can still break down and be just as bad as anxiety ever got you.


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## Noca (Jun 24, 2005)

arthur56 said:


> both can kill you from side effects and should be an absolute last resort after many other antidepressants have been tried with no help, IMO
> 
> some shrinks seem fascinated with them but they are so dangerous, unless you yearn for a flirtation with death :nw


You know more people die laying in bed than anywhere else. So i guess we should avoid laying in beds too.


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## quat (Sep 27, 2006)

It's rediculous the scaremongering in that post. I'd say Maoi's have caused me the least side effect of any med.


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## fraidycat (Oct 29, 2004)

Hey Aries,


> but most of the time (and sometimes still on nardil - I think I need CBT to get the most out of it) I will feel too nervous to be anything but really shy, really quiet and sullen looking,


im slowly coming to this conclusion too. I used to get horrible orthostatic hypotension but after being on it for close to 2 months and im finally now on the dose of 60mg(!), the dizziness's fading. I still get pretty sleepy but im playing around w/foods and pills (caffeine?) that I can take. I know 
exactly what you mean about turning your head too fast. That happens to me right after taking a higher dose.
getting back to CBT, yea ive been practicing a little positive self talk myself. I notice while the side effects of nardil is subsiding and i see a reduction in some SA symptoms, there's still others like eye contact i have trouble with. I have to add cbt in the mix too.

sorry, to hear about the break down and being kicked out of home. (((hug)))....i hope you find a way around it, and as good as nardil is, it's not going to prevent major life crises from affecting you up. =/ thanks for letting us know by the way....what antipsychotic are you thinking of taking. Do you have benzos. They help me feel better in a lot of situations, at least temporarily.

just wondering, at what dose did you felt the best on...and how long did it take you to get to that dose? I'm thinking of going up to 67.5. Not a big jump, but im wondering if I really need to go up to 90 before feeling the full benefits. It took me closed to 2 months to work my way up to 60mg, and still im tinkering with some side effects. *Also as a side effect do you get nervous sometimes, and do you have tips on what to do with that?*


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## mogadon (Feb 28, 2008)

fraidycat and aries , regarding side effects, iv been on nardil for 10 days 45mg dose, are any of you getting or did you get constipation as a side effect when you started,? its really the only side effect thats bothering me, its causing me to feel bloated and im getting mild stomach cramps through most of the day because of it.

i never get constipation normally, as i eat healthy and exercise regular, funny enough i can feel the drug starting to work so im feeling slightly better mentally, but the constipation is putting a dampner on that , im not totally constipated but im passing small hard stools which is not normal for me, i know its not a nice subject to talk about lol

but i just wondered if any of you guys got this side effect, ? and does it subside over time?


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## thor_no (Mar 23, 2008)

aries said:


> Wow you had to apply for it?


Yes, unfortunately we do. Because of the potential hypotensive crisis side effect, the drug is not on the market here. But you can still get it:

If you have failed to respond to at least one ssri, and one snri's, and one TCA in high doses and a psychiatrist applies for the drug for you, you will likely get it.

The problem is that many psychiatrists are afraid of the potential dangerous side effects, but tell their patients that a drug like nardil is not likely to help more than ssri. My pdoc said so, and I asked why he then suggested a ssri #8, when ssri/snri #1-7 did not work? In my opinion it is more likely that a med fail, if 7 meds on the same group level have failed before. Wouldn't it be more rational to try another type of med? He did not answer, but agreed to try get maoi.


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## aries (May 2, 2008)

fraidycat said:


> just wondering, at what dose did you felt the best on...and how long did it take you to get to that dose? I'm thinking of going up to 67.5. Not a big jump, but im wondering if I really need to go up to 90 before feeling the full benefits. It took me closed to 2 months to work my way up to 60mg, and still im tinkering with some side effects. *Also as a side effect do you get nervous sometimes, and do you have tips on what to do with that?*


My psychiatrist brought me up to 90mg within 2 weeks of starting it (started at 45mg) and said don't reduce it for at least 6 months, and it hasn't been 6 months yet.
Nervousness I've never felt as a side effect. So far every time it's failed to be sedating, I've just felt really comfortable on it, as if I were on 20mg of oxycodone.


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## aries (May 2, 2008)

mogadon said:


> fraidycat and aries , regarding side effects, iv been on nardil for 10 days 45mg dose, are any of you getting or did you get constipation as a side effect when you started,? its really the only side effect thats bothering me, its causing me to feel bloated and im getting mild stomach cramps through most of the day because of it.


I got.. ahem.. pooping problems? It's supposed to cause urinary retention but I'm used to that with other meds and have gotten good at letting it all out. It caused bowel retention which isn't exactly like constipation because I could poop but only a little at a time.
It eventually went away, eating prunes helps. Plus they taste good.


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## fraidycat (Oct 29, 2004)

mogadon,
hehhe..i can't help but to laugh at the *ahem pooping thing. I have it too...hard stool. I find that if i ate a lot of leafy veggies it helps, anything w/fiber should do the trick.
with urinary retention if anyone has that, i notice pressing on my stomach helps get things flowing a bit faster.

aries,
sigh...wow...90 in 2 weeks...i duno..maybe i am a fraidycat. I can't imagine you not getting any side effects on that amount. I get extreme hypotension if i go even a bit higher and horrible sedation which for some reason makes me nervous. It's kind of like i have no control over things and i get extra jumpy. I might give 60 a couple more days then work my way up to 70mg. I get more of that oxycodone/relaxed feeling w/klonopin but i can't really mix the two (nardil and klono) cuz i get extra dizzy. =/ 

But the good thing on nardil is that it really helps with one of symptoms (breathing) which i haven't seen anything else do.


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## aries (May 2, 2008)

I guess I'm lucky. I started right at 45 and got no sexual side effects, to my relief, no agitation, and hardly noticed a thing except a bit of antihistamine effect which wore off after day 1.
Hypotension I don't get... well, a little, but I get good BP on it. I get hypotension laying in bed and that's it, and it doesn't bother me. I got hypertension once from eating sausages, I thought frozen ones would be okay (that I only had to avoid aged/cured/etc) but nope, went to 170/105. I kept taking my BP, I was going to call a hospital if it went over 200/x or if I got that headache, but I didn't thank God! Good thing is you can really feel that as its coming. Your heart rate feels faster or more noticeable, you start to get tingly skin in some areas, you get nervous... at least it's good to have warning signs.


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## urbanspaceman (Sep 18, 2011)

Eight months ago I decided to come off Nardil (main reason I've been living abroad in the far-east and worry about hypertensive crisis plus unavailability there)...After 8 months off Nardil...Trying Mirtazipine (Remeron) - then Mirtazipine with Citalopram and now Seroquel (Quetiapine), I am going through terrible depression and anxiety and am therefore ready to go back on Nardil....Before I do - Is it worth giving Parnate a try? Also has anyone had any experience with Lyrica (Pregabalin).....
Any suggestions appreciated....
Steve - UK


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## CD700 (Apr 22, 2010)

urbanspaceman said:


> Eight months ago I decided to come off Nardil (main reason I've been living abroad in the far-east and worry about hypertensive crisis plus unavailability there)...After 8 months off Nardil...Trying Mirtazipine (Remeron) - then Mirtazipine with Citalopram and now Seroquel (Quetiapine), I am going through terrible depression and anxiety and am therefore ready to go back on Nardil....Before I do - Is it worth giving Parnate a try? Also has anyone had any experience with Lyrica (Pregabalin).....
> Any suggestions appreciated....
> Steve - UK


Did you get any weight gain on Nardil ?
I have been on Parnate before and found it to be a pretty clean drug and can be as helpful as Nardil for some people.
Why are you considering a change you know Nardil worked in the past ?


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## ahmad (Jun 27, 2010)

both can be helpfull, nardil may be more well known for SA by studies and experience, I didnt tried parnate, tried nardil which was very effective for 7 years at high dose with no proplems ,not wrong for any responsible and aware person not respondiong to treatments to try MAOIs, one need to be patient for nardil side effects ,most of them disappear or reduce with time.
as for potency some studies foun parnate to be as effective as the powerfull combination(effexor+remeron).


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## spartan7 (Feb 25, 2011)

*Listen up young chaps, Ive taken Nardil the new nardil no longer works for SA, but still works for depression. The phizer version of nardil does not help with SA i say again. Ive taken up to 75 mg of nardil for 6 months.*


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## Xande (Jul 18, 2011)

spartan7 said:


> *Listen up young chaps, Ive taken Nardil the new nardil no longer works for SA, but still works for depression. The phizer version of nardil does not help with SA i say again. Ive taken up to 75 mg of nardil for 6 months.*


Just wondering, but I'm assuming you've taken the old nardil as well. Who made the old one?


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## spartan7 (Feb 25, 2011)

Xande said:


> Just wondering, but I'm assuming you've taken the old nardil as well. Who made the old one?


I only taken the new one. It only helps for depression not SA, i took it at high doses too. just fyi dont get your hopes up.


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## therapist1 (May 16, 2012)

arthur56 said:


> both can kill you from side effects and should be an absolute last resort after many other antidepressants have been tried with no help, IMO
> 
> some shrinks seem fascinated with them but they are so dangerous, unless you yearn for a flirtation with death :nw


This guy has ABSOLUTELY NO CLUE on what he's talking about. Anything can kill you. You would seriously have to TRY to kill yourself in order to die from MAOIs.

Last resort? Numerous studies have shown that placebos give 70% of the effect of SSRIs. Meaning they only work because idiots believe they work.

"Yearn for a flirtation with death". Fewer than 50 people have died from MAOIs in the last 60 years. That is less than 1 person per year. And you'll only have a *chance* of having a hypertensive crisis if you eat a ****ing block of cave-aged gouda. Prozac alone has killed WAY more than 50 people in the last 30 years, from suicide and serotonin syndrome. And that is only ONE of TWENTY+ SSRIs.

My friend takes 70mg parnate and 150mg Wellbutrin each day, and has bacon and cheese all the time, and nothing happens. I take 30mg and eat cheddar & bacon all the time and nothing happens. Like I said, you'd either have to try to kill yourself or eat an ungodly amount of cheese to have a chance of getting hurt.


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## therapist1 (May 16, 2012)

There are 2 reasons doctors don't like prescribing MAOIs.

1. They are 50+ years old, so no pharmaceutical companies can get patents on them anymore, meaning they can't make ****tons of money and therefore give doctors a cut of it for prescribing them.

2. Doctors only care about lowering liability/malpractice insurance, so they'd rather prescribe ****ty drugs that don't work (SSRIs) and pay less insurance than prescribe drugs that actually do work and pay more in malpractice insurance, because each year (statistically) at least 1 dumb**** american will eat an entire block of cheese and kill themselves, then their family will sue the doctor. And doctors are scared shirtless of liability drama.

And if you seriously think they're that dangerous, consider this. They have been on the market for LITERALLY 6+ years before the "dangerous dietary interactions" were *accidentally* discovered, when a neuro scientist noticed his wife (who was on MAOIs) got a headache every time she had cheese and wine (two foods rich in tyramine, the amino acid that will cause a "dangerous fatal reaction", which is also exaggerated). If they were so dangerous as people told you, people would have been dying left and right every time they took a bite of cheese, and they would no longer be prescribed. Example of something that is actually dangerous: barbiturates. No one prescribes them anymore bc they are actually dangerous. They've been entirely replaced by benzodiazepines, which aren't dangerous (unless you take a ****ing metric **** ton for months on end, get yourself addicted to them, then quit cold turkey. Which isn't that different from cigarette or alcohol withdrawal).

The medical community just fear mongers these drugs so people are scared ****less of them so they can prescribe them less often, and so people won't eat a bite of cheese so patients won't have the 0.0000001% chance of a *potentially* bad reaction.


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## Inshallah (May 11, 2011)

It's not the food interactions that are very dangerous (because they are indeed overrated), it's the interactions with other drugs used in emergency situations. Anesthetics and painkillers mostly. If they don't know you're on a MAOI, it can have dire consequences. Blood pressure issues for which they see no cause, they'll try to counter with yet another drug that isn't supposed to be taken with a MAOI etc.

But that could easily be prevented if everyone wore a MAOI-bracelet, which apparently, no one does 

Also keep in mind, there aren't many deaths, but there also aren't many prescriptions. I have seen numbers of around 2000 MAOI prescriptions for the entire US.


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## boostinggtir (May 27, 2011)

are you still on Nardil?? getting a better effect?


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## gilmourr (Nov 17, 2011)

Out of a lot of journals that I've read on medline it seems that most huge **** ups with MAOI's are due to accidently mixing a medicine like demerol for pain, or using an SSRI that creates serotonin syndrome.

I think TCA's and even stimulants are safer to mix with MAOI's then SSRI's and MAOI's

Probably why wellbutrin mixes, because doesn't that work greatly on NE and D?


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## robotaffliction (Jul 24, 2009)

spartan7 said:


> I only taken the new one. It only helps for depression not SA, i took it at high doses too. just fyi dont get your hopes up.


they're all the about the same, you probably just got tolerant to the effects. there are no major differences between any of the tablets that are clinically relevant, or it's a placebo effect in your head.


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