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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by porkpiehat on October 17, 2017, at 22:16:43
I copied this from Social Anxiety report so I didn't have to retype:
Yesterday I took 30 mgs parnate.
Today I got my marplan. I am used to the lift from parnate that I need to get me through my evening work, so I took 10 mgs parnate and then 10 mgs marplan, and later another 10mg.
I have no idea how marplan binds to and disables the monoamine oxidase, but people have jumped straight from parnate to nardil so I'm guessing I'm ok (plus my doses are so low to begin with). It could bind to the existing MAO that's already disabled or it could target still active ones. In the former it would take a while for marplan to build to therapeutic dose, in the latter it should be quicker.
I almost like the idea of continuing with 10mgs parnate because it has a short-lived amphetamine effect that my body is used to but not enough to create a dopamine or NE crisis because it is built into parnate which is a MAOI. I will ask dr. Gillman but otherwise switch to a 30mg marplan course tomorrow.
After the parnate I had the typical bout of bounce followed by trouble oversharing. this diminished after the marplan, in which case I started thinking about non-work things which haven't exited me in a while...almost to the point of being bored with work and forcing myself into focusing..
I have already noticed the absence of the lion's share of parnate's stimulant effect, in that the compulsive urge to drink and smoke never came tonight. Also I desired to visit a friend in public and instead of feeling nervous and giving people wan smiles and looking away I gave full smiles and wasn't distant.
Still early on. Not sure what is what or if marplan will have any noticable effect in the near future.Fingers crossed. Will continue to use cocktail of trazodone and gabapentin for sleep for now.
Cheers. Chime in with thoughts or use my thread for reference :)
Posted by rjlockhart37 on October 18, 2017, at 2:47:35
In reply to Marplan day one, posted by porkpiehat on October 17, 2017, at 22:16:43
parnate i've seen many times on babble boards, over years it's a strong med, but i've seemed read that it has a sedation were it like wears off or something and you feel bad.....
i've been on prozac for a long time, it helps keep the dark depression away, if i don't take it everything will become just gloom, depression falls after it's left is extreme, don't know why i have such a significant mood depression but it stated around 17, and got worse
marplan seems to just be in general depression, its not stimulating as parnate, nardil is more skyrocket effect, it seems to be a good general med, no extremes of it
Posted by porkpiehat on October 18, 2017, at 20:13:35
In reply to Re: Marplan day one, posted by rjlockhart37 on October 18, 2017, at 2:47:35
Getting to sleep was tough last night. I found myself irritable (cats were too close to me, the dialogue from the tv was stupid and made me angry). I had to take 75 mgs trazodone instead of 50 mg. I remember this from before on parnate and don't remember if it happened when I was increasing or decreasing the dose.
Woke up 2 hours into sleep soaked in sweat. Also had a headache for last several hours of the day.
Today I found focusing kind of difficult, and sort of like I couldn't grab onto my own sense of self, and I couldn't access my sense of humor.
when I took my first 10mgs of marplan, my voice got very tight and strained, which is normally how I feel after I stop an antidepressant. Also, I got the first hint of "eye swooshies" which I tend to get in lieu of "brain zaps" when I stop a serotonergic drug. Felt a little more impatient and full of confrontational ruminations.
I didn't think I wanted to do this but I took 5mgs parnate and it helped with mood, humor, and focus. I finished the day with another 10 mgs marplan.
I chatted quick with Dr. Gilman and he couldn't conceive a problem with my direct swap but didn't get a clear sense of any danger from using a small dose of parnate for stim effect/withdrawls given my low ending dose of parnate and low start up of marplan. I couldn't get a clear sense in web search or using his monogram either.
Part of me already misses the calm brain and focus from full parnate which will probably fade but there's a lack of social avoidance and lack of compulsive behavior that I'm seeing already and that alone might be worth the switch.
If anyone can elucidate a danger in the dovetailing that I'm describing please let me know.
Posted by rjlockhart37 on October 18, 2017, at 21:42:48
In reply to Re: Marplan day two » rjlockhart37, posted by porkpiehat on October 18, 2017, at 20:13:35
i'm definitely not MAOI knowledgeable, but i do know that taking marplan and parnate, that could very well be whats causing this, that's very bad to mix MOAI's that's like mixing Prozac and Paxil, serotonin syndrome big time
talk with your doctor, but I'm really saying taking marplan and parnate together that potentially dangerous, what im thinking is you have to withdrawal from a MAOI, just like a taper period where you go off a SSRI, it takes time for it leaves the system, ask SLS he knows a lot about this topic, maybe it could help....
Posted by rjlockhart37 on October 18, 2017, at 21:52:05
In reply to Re: Marplan day two » rjlockhart37, posted by porkpiehat on October 18, 2017, at 20:13:35
all i know is parnate gives the humor, social interaction because of the increase in dopamine, you enjoy things more, isocarboxazid increases all 3 neurotransmitters, it's as mixing Prozac and Paxil together, but that's all i know, not an expert
side effects i researched: this from wikipedia, hope this gives some quick info
https://en.wikipedia.org/wiki/Isocarboxazid
Posted by porkpiehat on October 23, 2017, at 11:02:40
In reply to Re: Marplan day two, posted by rjlockhart37 on October 18, 2017, at 21:52:05
I'm such a "grass is greener" guy...Kind of regretting the switch to Marplan; why?
-I miss the ability to focus and engage on Parnate
-parnate took care of my atypical symptoms (rejection sensitivity esp.) way better
-I miss my compact 7 hrs of trazodone sleep and waking up ready to go.Again not sure if it's marplan or the parnate levels falling but I'm returning to cognitive problems (can't remember which side my gas tank is on, looking for my car while I'm in it) staying engaged at work, irrational irritability. Negativity.
My sense of humor is largely gone as everything feels like a slight. I get super nervous on the phone feeling I have no right to ask simple questions
I will soon be fat because I am constantly hungry!
I DO NOT MISS...
the compulsive fiendish reaction. I haven't had a glass of bourbon or a cigarette in three days, whereas I was chain smoking and drinking about 2 bourbons EVERY DAY for 6 months on Parnate.
This weird omnipresent feeling of paranoia and impending danger. I seem to be EXTREMELY sensitive to stimulants.
I am dying...DYING...to take 5-10 mgs of parnate for just enough focus and self-possession to get through work. After four days on Marplan I tried this (5mgs Parnate) on Friday morning and felt weird, scared, confused. A tiny bit of klonopin seemed to clear it up. I can't see how such a low dose of either would be a real danger.
I was assuming that doing a hot switch from parnate to Marplan would eliminate the start-up lag as the MAOI levels wouldn't have a chance to dip.
Posted by porkpiehat on October 23, 2017, at 12:34:15
In reply to Re: Marplan day 6, posted by porkpiehat on October 23, 2017, at 11:02:40
Scott can you see a reasonably serious problem with me adding 5-10mgs parnate back after 6 days on Marplan 20-30 mgs? Even combined I'm at less than the target dosage for each.
> I'm such a "grass is greener" guy...Kind of regretting the switch to Marplan; why?
>
> -I miss the ability to focus and engage on Parnate
> -parnate took care of my atypical symptoms (rejection sensitivity esp.) way better
> -I miss my compact 7 hrs of trazodone sleep and waking up ready to go.
>
> Again not sure if it's marplan or the parnate levels falling but I'm returning to cognitive problems (can't remember which side my gas tank is on, looking for my car while I'm in it) staying engaged at work, irrational irritability. Negativity.
>
> My sense of humor is largely gone as everything feels like a slight. I get super nervous on the phone feeling I have no right to ask simple questions
>
> I will soon be fat because I am constantly hungry!
>
> I DO NOT MISS...
>
> the compulsive fiendish reaction. I haven't had a glass of bourbon or a cigarette in three days, whereas I was chain smoking and drinking about 2 bourbons EVERY DAY for 6 months on Parnate.
>
> This weird omnipresent feeling of paranoia and impending danger. I seem to be EXTREMELY sensitive to stimulants.
>
> I am dying...DYING...to take 5-10 mgs of parnate for just enough focus and self-possession to get through work. After four days on Marplan I tried this (5mgs Parnate) on Friday morning and felt weird, scared, confused. A tiny bit of klonopin seemed to clear it up. I can't see how such a low dose of either would be a real danger.
>
> I was assuming that doing a hot switch from parnate to Marplan would eliminate the start-up lag as the MAOI levels wouldn't have a chance to dip.
Posted by SLS on October 23, 2017, at 15:19:00
In reply to Your thoughts SLS??, posted by porkpiehat on October 23, 2017, at 12:34:15
Hi.
> Scott can you see a reasonably serious problem with me adding 5-10mgs parnate back after 6 days on Marplan 20-30 mgs? Even combined I'm at less than the target dosage for each.
Your depression is severe and needs to be treated aggressively. I can fully appreciate the disturbances in cognition that you experience. Cognitive impairment is an index of depression severity.
20 years ago, I was desperate enough to combine Parnate and Effexor without my doctor's consent. He was extremely aggressive, but not reckless. I was reckless. I took a single, tiny dose of Effexor while on 120 mg of Parnate. I experienced an episode of serotonin syndrome of moderate intensity that lasted for several hours. The symptoms included muscle rigidity, and I was incoherent.
I am not given to recommending the combining of MAOIs. That's not to say that it can't be done. However, I have never seen it done safely or successfully. For what you want to accomplish, would going up on the Marplan and adding a psychostimulant make sense?
Can you describe the details of your experience with Nardil?
- Scott
> > I'm such a "grass is greener" guy...Kind of regretting the switch to Marplan; why?
> >
> > -I miss the ability to focus and engage on Parnate
> > -parnate took care of my atypical symptoms (rejection sensitivity esp.) way better
> > -I miss my compact 7 hrs of trazodone sleep and waking up ready to go.
> >
> > Again not sure if it's marplan or the parnate levels falling but I'm returning to cognitive problems (can't remember which side my gas tank is on, looking for my car while I'm in it) staying engaged at work, irrational irritability. Negativity.
> >
> > My sense of humor is largely gone as everything feels like a slight. I get super nervous on the phone feeling I have no right to ask simple questions
> >
> > I will soon be fat because I am constantly hungry!
> >
> > I DO NOT MISS...
> >
> > the compulsive fiendish reaction. I haven't had a glass of bourbon or a cigarette in three days, whereas I was chain smoking and drinking about 2 bourbons EVERY DAY for 6 months on Parnate.
> >
> > This weird omnipresent feeling of paranoia and impending danger. I seem to be EXTREMELY sensitive to stimulants.
> >
> > I am dying...DYING...to take 5-10 mgs of parnate for just enough focus and self-possession to get through work. After four days on Marplan I tried this (5mgs Parnate) on Friday morning and felt weird, scared, confused. A tiny bit of klonopin seemed to clear it up. I can't see how such a low dose of either would be a real danger.
> >
> > I was assuming that doing a hot switch from parnate to Marplan would eliminate the start-up lag as the MAOI levels wouldn't have a chance to dip.
>
>
Posted by PeterMartin on October 24, 2017, at 13:55:23
In reply to Re: Your thoughts SLS?? » porkpiehat, posted by SLS on October 23, 2017, at 15:19:00
If you look back I posted recently about a failed switch from Marplan (been on it successfully for 7yrs) to Parnate (2nd time trying it and again it started to cause huge box spikes after each dose after week 2).
I took a 3 day washout and restarted Maplan on the 2nd of October(30 up to 50 a few days later)
I had a really rough 10 days or so but on the 18th I noted in my journal "mood = great/Marplan". Been doing well since. Early morning wakes usually come 3weeks or so in based on my past experiences. I'm starting to get that now 1am to. Bed, up 6ish.
Im probably not as treatment resistant as some but maybe this will give you some hope. Not sure about adding Parnate but the more you do (for the immediate effect) the longer I'll take to drop it complete imhk (potential withdrawal).
Posted by porkpiehat on November 2, 2017, at 13:58:54
In reply to Re: Your thoughts SLS?? » porkpiehat, posted by SLS on October 23, 2017, at 15:19:00
> Hi.
>
> > Scott can you see a reasonably serious problem with me adding 5-10mgs parnate back after 6 days on Marplan 20-30 mgs? Even combined I'm at less than the target dosage for each.
>
> Your depression is severe and needs to be treated aggressively. I can fully appreciate the disturbances in cognition that you experience. Cognitive impairment is an index of depression severity.
>
> 20 years ago, I was desperate enough to combine Parnate and Effexor without my doctor's consent. He was extremely aggressive, but not reckless. I was reckless. I took a single, tiny dose of Effexor while on 120 mg of Parnate. I experienced an episode of serotonin syndrome of moderate intensity that lasted for several hours. The symptoms included muscle rigidity, and I was incoherent.
>
> I am not given to recommending the combining of MAOIs. That's not to say that it can't be done. However, I have never seen it done safely or successfully. For what you want to accomplish, would going up on the Marplan and adding a psychostimulant make sense?
>
> Can you describe the details of your experience with Nardil?
>
>
> - Scott
>
>
Hi Scott:I was not on Nardil ever, rather 6mos Parnate and now Marplan. I've avoided the temptation to pop even half a pill of parnate. I did take 5mg ritalin earlier in the week. It helped concentration but did make me nervous and freezing cold...Prazosin helped a little but it's not a feeling I want to have often.
I wouldn't say my depression is severe or really treatment resistant, but rather atypical in that I can't tolerate a lot of other treatments despite their efficacy.
I'm wary of the stimulants. My experience with adding them to SSRIs and just the stim effect of parnate both had similar effects of paranoia and meanness and serious lack of empathy. Eww. But I recognize this and I can stop if I try again.
I'm thinking nortriptyline or clonidine might help with the anxiety/focus problems if they continue.
Posted by porkpiehat on November 8, 2017, at 15:19:11
In reply to Re: Your thoughts SLS??, posted by PeterMartin on October 24, 2017, at 13:55:23
PeterMartin:
I'm wondering if this sounds familiar to you: Lately when I take my marplan dose, I get a weird "anti-anti depressant" effect whereby I get tight voice, cognitive problems, and anxiety/loss of confidence. Once the whole dose is taken, I almost feel "drunk" in terms of difficulty expressing myself to others and filtering things. Tired and apathetic eventually, and then right before bed it seems to all clear up.
these effects I mentioned remind me of what I feel like when I stop taking AD's. (tight throat, etc).
Seeing as my doctors have no experience with it, I'm having trouble knowing if I should increase or what might be responsible.
Today I tried to take all 40mgs at once in the morning, hoping whatever side effects would fade soon. I got tired and apathetic, kinda mean. It's how I remembered Parnate when I would take it during the daytime (after the initial happy buzz wore off)
Does this ring familiar to you? I wasn't expecting to have more anxiety on Marplan than on Parnate.
I hope you are able to read this. I don't know of anyone else with Marplan experience. Thanks
This is the end of the thread.
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