Posted by Tomatheus on August 25, 2006, at 21:33:57
In reply to Please Please at least some response...., posted by willyee on August 25, 2006, at 6:15:31
Willyee,
As far as I know, the only time Parnate's formulation was changed was sometime in either 1990 or 1991 -- probably 1991.
The editions of the Physicians' Desk Reference published through 1991 list the following excipients for Parnate:
* acacia
* calcium sulfate
* cellulose
* ethylcellulose
* FD&C Red No. 3
* FD&C Yellow No. 6
* gelatin
* iron oxide
* magnesium stearate
* starch
* sucrose
* trace amounts of other inactive ingredientsSince 1992, the PDR has listed Parnate's excipients as follows:
* cellulose
* citric acid
* croscarmellose sodium
* D&C Red No. 7
* FD&C Blue No. 2
* FD&C Red No. 40
* FD&C Yellow No. 6
* gelatin
* iron oxide
* lactose
* magnesium stearate
* talc
* titanium dioxide
* trace amounts of other inactive ingredientsFrom 1992 to 2000, the section on Parnate in the PDR also included the following statement: "NOTE: Parnate (tranylcypromine sulfate) tablets have been changed from rose-red sugar-coated tablets to rose-red film-coated tablets. The film-coated tablets differ in size from the sugar-coated tablets, but the drug content remains unchanged."
Based on the information that I retrieved from older editions of the PDR, it does not appear that gluten was ever used as an excipient in Parnate tablets. It is theoretically possible that gluten could have been one of the "other inactive ingredients" present in a trace amount up until 2003, but I think that this is unlikely, considering that gluten was never listed as an excipient of Parnate to begin with. So, as far as I can tell, Parnate did not undergo a formulation change in 2003 as Nardil did -- it only happened in the early 1990s.
Whether or not the "new" Parnate that's been manufactured since the early 1990s is equally effective as the "old" version is something that I can only speculate about. The Internet as we know it today obviously didn't exist back in 1992, so if the "new" Parnate is indeed less effective and/or less tolerable than the old formulation, it would have been very difficult for those who noticed a change upon switching formulations to know that other Parnate users were experiencing similar changes. It is conceivable that a doctor with several patients on Parnate could have challenged the efficacy of the new formulation if he/she noticed at least a handful of patients reacting similarly after having switched formulations. However, it is highly unlikely that this would have happened. Even in 1991, it was rare for a psychiatrist to have more than a few patients on MAOIs, and my guess is that most psychiatrists would have just dismissed multiple patient reports of reduced efficacy with the "new" Parnate as a coincidence. So, if Parnate users did indeed notice a change in efficacy or tolerability upon switching formulations, they probably would have attributed the change to their body's ability to respond to the medication instead of to a difference in the drug itself. After all, that's what those who responded badly to the Nardil formulation change were doing before they discovered via the Internet that other Nardil users were having similar problems.
I've read some reports on this board suggesting that Parnate may be somewhat less energizing and activating than it used to be. However, I have yet to read a message specifically stating that a change in Parnate's effectiveness may have occurred during the early 1990s. If Psycho-Babble and other discussion boards devoted to the topic of psychiatric medications had been in existence during the early 1990s, then perhaps we might have seen some reports about the "new" Parnate possibly being less effective than the "old" Parnate. But to my knowledge, no such reports exist. So, if Parnate users did notice changes in the drug's efficacy and/or tolerability upon switching formulations, there's no way that any of us could know about it (unless some current and/or former Parnate users reading this did notice a change back in the early 1990s and are just now suspecting that it might have been caused by the formulation change).
I'm not sure how helpful this post has been. I could probably write more, but I'd basically just be speculating. When it comes down to it, I don't think that there's sufficient evidence to conclude that the "new" Parnate is less effective than the "old" Parnate (I think that the evidence is more convincing when it comes to the Nardil formulation change), but then again, it wouldn't surprise me if it did turn out that the "new" Parnate is somehow inferior. It does strike me as being awfully suspicious that SmithKline Beecher just so happened to have changed Parnate's formulation right before introducing Paxil to the market (the FDA approved Paxil in 1992). It is certainly conceivable that SmithKline Beecher could have changed Parnate to make it less effective in hopes that the Parnate users would switch to the newer, more profitable Paxil, but considering that there is no evidence that I know of to support this possibility, it would basically be nothing more than a conspiracy theory.
Tomatheus
> Latly a lot of my posts have gone unanswered,i know this could be do too the fact i present the same problem over and over,or the recent issue i had,but i ask someone with some pharm knowledge or some idea of this post please ring in,this is a snip from Remedyfind,i dident take the name or anything else even though its there for everyone i just choose not to put someones info out there,anyway here it is,please some form of input....
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> regarding parnates effectivness this was his reply.
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> "worked great until the FDA mandated gluten be taken out of all medications because some people are allergic to. this happened in 03 just like what happened to nardil and now parnate no longer is effective either"
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> Make any sense?
poster:Tomatheus
thread:679906
URL: http://www.dr-bob.org/babble/20060825/msgs/680145.html