Posted by King Vultan on October 22, 2004, at 14:55:37
In reply to Re: I've gained 8 lbs from Zoloft and CAN'T Lose it!!! » King Vultan, posted by yznhymer on October 22, 2004, at 13:26:37
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> Is a trial of parnate worth the effort on my part? To be honest, I'm past the point of being willing to try things blindly... I'd like to know that there is some basis to believe it might be a) effective and b)tolerable in terms of side effects, especially re anorgasmia.
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> By the way, any thoughts on why Nardil was so robust but the SSRI's, Wellbutrin, TCAs were relatively ineffective? My knowledge about the chemistry is rudimentary, if that. I guess I'm wondering if the Nardil was hitting a neurotransmitter (dopamine?) that the others don't and if this would be helpful info in choosing my next trial?
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> Thanks in advance,
> Mark
Parnate has a low incidence of sexual side effects, probably fairly similar to that of Wellbutrin. It is very powerful and doesn't have a lot of side effects other than it seems to be notorious for causing insomnia. Nardil is also quite powerful but seems to have a ton of side effects. The efficacy of Nardil and Parnate mainly comes about because they work on all three neurotransmitter systems that are primarily thought to be involved with mood, serotonin, norepinephrine, and dopamine, simultaneously. This in contrast to most antidepressants, which generally only work on one or two of these systems. In addition to that, Nardil also works on the GABA system, which is involved in anxiety. This is the same system that benzodiazepines like Klonopin and Xanax also work on, so Nardil may be especially useful for individuals with relatively high levels of anxiety.The weight gain problems with Nardil seem to be related to it being a hydrazine derivative, which may affect metabolism and/or how glucose is utilized. The sexual side effects are from its powerful actions on serotonin and resemble SSRIs somewhat in that respect. There appear to be less libido problems with Nardil than with SSRIs, probably because of its simultaneous actions on the dopamine system, but orgasm problems are notorious and brutal. Nardil can also cause significant problems related to lowering of blood pressure and heart rate.
Parnate lacks most of these side effects because it is an amphetamine derivative (it does not work on GABA as Nardil does) and has a stimulant effect that seems to counteract the sexual and cardiovascular problems. Weight gain does not seem to be much of an issue for the same reason, as it is not a hydrazine derivative like Nardil to begin with, it has no histamine blockade as the tricyclics do, and its stimulant effect may help keep appetite at bay. I find my appetite to be normal on Parnate, or perhaps slightly enhanced (compared to taking nothing, when depression may be reducing my appetite), but I do not believe it is slowing down my metabolism as some of the other drugs I have tried do. By far the biggest problem I have had on Parnate is insomnia, which was also a problem for me on Nardil. Dealing with it remains a challenge at this point, but with the right sleep med or combination thereof, I should be able to conquer it.
Todd
poster:King Vultan
thread:405595
URL: http://www.dr-bob.org/babble/20041018/msgs/405990.html