![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Else on April 8, 2002, at 18:09:51
I am currently taking three different meds for SP, atypical depression and ADD and I was wondering if replacing all these meds with Parnate would be a good idea. I know that MAOIs are considered very effective for both SP and atypical depression, and the fact that Parnate is metabolized to methamphetamine presumably indicates that it could replace Ritalin quite nicely as a treatment for ADD. I am sick of sleeping all the time on Remeron and I desperately lack motivation and interest. I know all about the special diet required with MAOIs but I rrarely hear about the more benign (but still annoying) side effects these drugs might produce. Would they be hard to tolerate for someone like me who gets agitated and angry on SSRIs and who suffers from muscle stiffness and insomnia on Wellbutrin and Effexor? I had a very positive experience with Parnate a few years ago but I was also taking massive amounts of Valium and Mogadon at the time so it is hard to say what Parnate would have felt like on its own. If anyone has positive/negative comments to make about the drug I would be very glad to read them as I am seeing my doctor in a couple of days.
Thank You
Posted by JahL on April 8, 2002, at 20:51:01
In reply to Parnate advice anyone? Please!, posted by Else on April 8, 2002, at 18:09:51
>I rarely hear about the more benign (but still annoying) side effects these drugs might produce. Would they be hard to tolerate for someone like me who gets agitated and angry on SSRIs and who suffers from muscle stiffness and insomnia on Wellbutrin and Effexor?
Parnate was a weird one for me. Usually I exceed the rec. max dose for ADs but I couldn't get past 25mg. Anything slightly above that & I would be out like a light, which I didn't expect b/c of the amph. metabolites you mention (just goes to show ymmv). I took 35mg once and couldn't be roused from la-la land for about 20hrs. At a lower dose it felt like an SSRI; irritability, DP etc.
I recently saw one of *the* top treatment resistant/BP guys in the UK. He was of the opinion that low dose Parnate + 3000mg of L-Tryptophan (Optimax) was one of the most effective combos available and it was his first-line recommendation for me. Didn't work out b/c I can't tolerate Optimax; became very irritable/hostile; like swallowing a bucketful of SSRIs.
Effexor was the worst ever for insomnia as well as everything else.
There are more positive stories than mine out there....
J.
Posted by SLS on April 8, 2002, at 20:56:44
In reply to Parnate advice anyone? Please!, posted by Else on April 8, 2002, at 18:09:51
> I am currently taking three different meds for SP, atypical depression and ADD and I was wondering if replacing all these meds with Parnate would be a good idea. I know that MAOIs are considered very effective for both SP and atypical depression, and the fact that Parnate is metabolized to methamphetamine presumably indicates that it could replace Ritalin quite nicely as a treatment for ADD. I am sick of sleeping all the time on Remeron and I desperately lack motivation and interest. I know all about the special diet required with MAOIs but I rrarely hear about the more benign (but still annoying) side effects these drugs might produce. Would they be hard to tolerate for someone like me who gets agitated and angry on SSRIs and who suffers from muscle stiffness and insomnia on Wellbutrin and Effexor? I had a very positive experience with Parnate a few years ago but I was also taking massive amounts of Valium and Mogadon at the time so it is hard to say what Parnate would have felt like on its own. If anyone has positive/negative comments to make about the drug I would be very glad to read them as I am seeing my doctor in a couple of days.
>
> Thank You
Hi Else.I don’t think it is at all certain that Parnate is metabolized into methamphetamine or amphetamine. I hope it isn’t. I tend to believe the literature describing methamphetamine as being neurotoxic – it damages neurons.
My initial uneducated reaction to your question is that Parnate will not act as well to manage ADD as amphetamine or methylphenidate.
Parnate can be combined with Dexedrine, Ritalin, or Cylert. Although I don’t know of anyone specifically who has combined Parnate with Adderall, I don’t see why it could not be. I have taken the following combination: Parnate 120mg + desipramine 200mg + amphetamine 15mg. My head did not explode. You can find a description of this type of treatment in Dr. Bob’s Tips here on this site. I guess you can try the Parnate by itself first, and add back a psychostimulant later if the ADD remains unresolved. However, it would save a lot of time to simply add the Parnate and later attempt to discontinue the stimulant if you are happy with the results.
I think it is worth exploring the use of Nardil (phenelzine) in combination with either methylphenidate or amphetamine. Using Nardil would probably better address the social phobia than would Parnate, and would avoid the risk – although small – of experiencing a hypertensive reaction to such combinations using Parnate.I’m just thinking out loud. I’m sure others will give you some good feedback.
Good luck.
- Scott
Posted by dennison on April 8, 2002, at 22:33:38
In reply to Re: Parnate advice anyone? Please!, posted by SLS on April 8, 2002, at 20:56:44
Hi Agree with SLS parnate has never been shown to be metabolized to methamphetamine . Parnate doesn't undergo cyclopropyl ring opening which would need to occur to form the basic amphetamine backbone. Perhaps you were thinking of l-deprenyl which of course is metabolized to amphetamine. L-deprenyl the selective monoamine oxidase-b specific enzyme blocker is metabolized to approx. equal portions of L-desmethyl-selegiline, L-amphetamine, L-methamphetamine. "Selegiline is simply the brand name of L-deprenyl" --BTW................................................................................................................................................The L-forms of amphetamine and methamphetamine are considerably less potent than the R-forms of course--((( L-levo--- R-dextro , but they do have some amphetamine properties that contribute to L-deprenyl's overall behavioral effects................................................................................................................................................................Ok--Back to parnate - I've taken it for several years , alone and with cylert---It has it's advantages and disadvantages - dietary and drug restrictions - no problem there --the only real problem is the bloodpressure lowerring effect from the parnate- and the sympathetic block, --- for some it's relatively insignificant, for others it's very troublesome. Btw small doses of ritalin and dexedrine as stated by SLS have indeed been used with maoi's, to offset side-effects or boost effectiveness, so that is a valid option, though not all pdoc's are willing to go down that road as pdr has such strong contra-indications of stimulants with maois. Good Luck !!!!!!!!!!!!! :) P.S. BTW one big advantage of parnate was absolutely no cognitive blunting - thinking and concentration were in no way negatively affected, every other anti-depressant I've ever tried interferred with my concentration, some severly so!!!!!!
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.