Posted by SLS on March 26, 2001, at 10:03:45
In reply to Parnate after Nardil, posted by SalArmy4me on March 25, 2001, at 13:25:21
> Does it make sense to try Nardil after a washout period of Parnate? Or are they too similar and if one doesn't work, the other won't. {I was on Parnate for a couple months until it pooped-out.
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SalArmy4me,I am to change from Parnate to Nardil soon. They are very different drugs that are not necessarily cross-effective or cross-ineffective. I have tried both and have been partially responsive to both, but I prefer the way I feel on Nardil. There are people who receive absolutely no benefit from one, but go on to obtain a robust response to the other. In fact, I have read of a few people for whom both were totally ineffective who later went on to respond remarkably well to Marplan, another MAOI.
I think most doctors now use a therapeutic range for Parnate of between 40mg and 80mg. So, if you haven't investigated 80mg, you might want to consider it. It is not unusual for medications to need adjustments from time to time, even if we don't understand why.
Another strategy is to use high dosages of Parnate that target a dosage of 120mg and beyond. Parnate seems to do neurochemical stuff at the high dosages than it does at the low dosages, possibly involving serotonin receptors. You should find something regarding this strategy in Dr. Bob's Tips. If not, you can find information regarding its use if you perform literature searches for material written by Jay Amsterdam and Andrew Nierenberg. You can add some things to Parnate and Nardil that are sometimes used to treat difficult cases of depression or chronic bipolar depression.
These include:
- lithium
- anticonvulsant mood-stabilizers
- tricyclics: except Anafranil (clomipramine); desipramine and nortriptyline are usually chosen
- Wellbutrin
- Stimulants: amphetamine, Ritalin, Cylert
- Dopamine agonists: Mirapex, Parlodel, Permax
- Thyroid hormone: Cytomel T3, Synthroid T4
- Neuroleptic antipsychotics: Risperdal, Zyprexa, SeroquelDrugs that you cannot add:
- SSRIs: Prozac, Zoloft, Paxil, Celexa, Luvox
- Serzone
- Effexor
I myself have taken Parnate 150mg + desipramine 300mg + Lamictal 200mg + (amphetamine or Parlodel) + thyroid (often in one gulp). I suffered no additional side effects.There are some doctors who would use your responsitivity to MAOIs to indicate a trial of Effexor. Two rather effective combinations are Effexor + Remeron and Effexor + Wellbutrin. I am interested to combine Effexor with a tricyclic if that time should come.
- Scott
poster:SLS
thread:57486
URL: http://www.dr-bob.org/babble/20010319/msgs/57569.html