Posted by SLS on October 28, 2000, at 11:20:43
In reply to Re: SLS - Was it Something I Said?, posted by Judy on October 28, 2000, at 9:22:17
> Thanks Scott,
>
> Just hoping you might have encountered something about a Nardil patch somewhere along the way.
>
> My reasoning (and it's probably faulty) was that Nardil works wonderfully for me mentally, but physically it is intolerable - outrageous edema, near shut-down of my bladder and bowel functions - I could go on...but if the tyramine reaction doesn't come into play when MAOI are administered transdermally, my hope is that some of the other physical side effects wouldn't either.
>
> As I said, my doctor told me they were definitely doing studies on the Nardil patch at MacLean; and I even called there but was told they don't give out that type of information to mere mortals - so I wait in the limbo of Parnate-induced apathy and anhedonia.
>
> Judy
Hi Judy.I am sort of in the same position you are regarding Parnate and Nardil, only with nowhere near the seriousness of what you experience. I chose Parnate more recently because I am also sensitive to the side effects of Nardil, particularly hypotension and fainting and the inability to urinate with a full bladder. On several occasions, I was scared I would have to go to the hospital for a catheterization. Although this is not too much of a problem when I use Nardil by itself, I have had the need to combine it with tricyclics that potentiate the side effects.
I like the way I feel on Nardil better. Your description of apathy and anhedonia with Panate is familiar.
It's great that you have a doctor who is part of the "loop" to know about the Nardil patch. Is the purpose of the patch to minimize side effects or increase efficacy?
I don't have a clue as to the mechanisms behind Nardil-induced edema. Do you? I imagine it could be related to the hypotension and a lack of vascular tone/volume. Don't know. I guess increasing salt doesn't help you much.
Have you been evaluated for some sort of idiopathic renal insufficiency? Is your bladder condition considered atonic?
Perhaps the drug bethanecol (Urecholine) would be helpful.Also, hypothyroid conditions can contribute to edema
Have you tried Marplan? Marplan is generally thought of as "a weak Nardil". However, I don't know if the term "weaker" is really accurate. I don't think it gets as many people well as does Nardil, but when it works, it can be a miracle. I have read of a few people here who failed to respond to Nardil who went on to experience a robust response to Marplan. Although the two drugs are related chemically (hydrazines), I don't think one can generalize side-effects between the two. It doesn't seem that Marplan is as liable to produce edema as Nardil.
Like I said, I am clueless regarding how Nardil causes edema. Treatment of edema is determined by first identifying the cause as it seems opposite approaches are used depending on the cause. In some cases, I think using a diuretic is exactly the wrong thing to do, as it allows too much salt to exit the blood-stream.
I saw something that recommended dosing Nardil more frequently with smaller amounts to mitigate edema. I guess the Nardil patch would be good for you. Probably me too.
Please post if you learn anything more about it. I wish I could have helped out more.
- Scott
poster:SLS
thread:47438
URL: http://www.dr-bob.org/babble/20001022/msgs/47604.html