Posted by Scott L. Schofield on March 30, 2000, at 10:32:17
In reply to Re: Parnate and cardiac toxicity? Scott!, posted by Anna P. on March 28, 2000, at 11:25:12
Hi Anna.
> > > Can anyone please explain to me that issue? I would like to consider Parnate as my last resort, but I've experienced alreadty the heart pain on Moclobemide, and stimulants. I know, it wasn't anxiety symptoms. My EKG was fine , but the cardiologist has said all these meds are stimulating for the heart. I take already different medicines for 5 years. what are my chances for Parnate? I was always helped by the stimulating medications. Parnate could help, as I'm bipolar II, and nothing helps so far.
> > Parnate (tranylcypromine) is a good choice for depression in bipolar disorder.
> > Is the "heart pain" you experience the same as heart-palpitations? With heart-palpitations, you can feel your heart beat, but it should not be painful. If your doctor thinks that the "heart pain" is a normal side effect, I would not worry too much. I have heart palpitations sometimes when I start a new drug. Usually, it goes away.
> > Parnate is not supposed to be cardiotoxic. It does not hurt the heart. It can increase heart rate. For some people, it can raise blood pressure. This is not common. However, it can be dangerous. It usually happens at the beginning. Sometimes it gets better, sometimes not. It is a good idea to check your blood pressure when you start treatment. Usually, Parnate lowers blood pressure. It can make you dizzy when you first stand up, but then it goes away. Usually, the dizziness gets better with time, but doesn't always go away completely.> I don't know what type of a bipolar I have, it must be atypical, as I don't experience mania or hypomania.
How old are you? (Be honest) :-)
You may not be bipolar type-I. Bipolar type-I must have mania. You are depressed only. If you are young, maybe you have bipolar type-I or bipolar type-II, but the mania will happen later. Infrequently, someone can have bipolar depression only. You might not have bipolar disorder.
Does lithium help? Does Depakote help? Does Lamictal help? Lamictal sometimes works very well for bipolar depression.
Do you have dysthymia or double-depression?
It sounds like you have unipolar depression. You might have the atypical-type. You have taken many antidepressants without mood-stabilizers, correct? None produced mania when you started them or stopped them.
Are you tired all of the time?
Do you sleep too much?
Do you move or speak very slow?
Do you eat too much?
Are you too skinny?
Are you nervous around other people?
Do you wake up early in the morning?
When is the depression worse - morning or evening?
> My problem is that any medication I try, works couple weeks, then stops.What drugs?
Have you tried a tricyclic drug? - imipramine, desipramine, amitriptyline, nortriptyline?
My problem is almost the same. I take a drug for two weeks. Then it starts to work. It works for only three days, and doesn't work any more. I can increase the dosage, and it still does not work. Parnate and Nardil (both MAO-inhibitors) work better for me than other drugs.
> I've experienced strong heart pain with Moclobemide, which I took for six months maximum dozes, and then in combinations with Revia, Cytomel and stimulants. It didn't happen at the beginning of thre therapy, though.
Did the heart-pain start when you were taking moclobemide by itself? What dosage? Did it get better or go away?Was Cytomel the worst for making the heart-pain? Do you lose hair?
> It was happening, when I was breathing, but later on I was waking up hot on my face, with REALLY intense heart beat.
This sounds bad. Your sympathetic nervous system (adrenalin, norepinephrine) was working too much.
> But I'm willing to try Parnate. All I know, I never can go on stimulants again.
Parnate works better than moclobemide (usually). It sometimes acts like a mild stimulant, though. You have to try it to find out. 40 - 80 mg. Sometimes adding lithium helps for unipolar depression using dosages of 300 - 600 mg.
Maybe Nardil is better. It does not have as much stimulant effect as Parnate. There is really no way to predict which will work. Trial and error. :-( Sometimes Parnate is better for bipolar depression or very anergic depression. Sometimes Nardil is better for atypical unipolar depression and for anxiety or social phobia.
> What about the augmentation of Parnate besides Lithium, Depakote, Lamictal
> Cytomel, stimulants, and Wellbutrin?Have you tried Wellbutrin by itself? Combining Parnate and Wellbutrin is generally safe and sometimes works when nothing else does.
* Very important. Because you may have too much sympathetic nervous system activity, you should be careful of high blood pressure when you first start Parnate. This does not happen often. It probably will not happen to you. But you must take your blood pressure to be sure.
It sounds like there are many things for you to try.
- Scott
poster:Scott L. Schofield
thread:26241
URL: http://www.dr-bob.org/babble/20000321/msgs/28492.html