![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by MrChips on June 10, 2016, at 9:20:04
I'm considering switching from Tranylcypromine to Phenelzine. I'm wondering if anyone has any advice on this, in particular if anyone had similar problems to me with tranylcypromine and found phenelzine better or worse.
Problems with tranylcypromine:
Has become less effective over time (was never a miracle but it was good for the first few months).
Fine line between helping depression and causing anxiety. 40mg helps but 50mg causes increasingly severe anxiety a couple of weeks after upping the dose. This makes me think it is due to mao inhibition rather than its stimulant properties. Anyway, I can't increase it because of this.
Blood pressure increases after a dose - I take it with propranolol which helps but BP can still randomly go up to 180/100 from taking just 20mg (with a slow pulse, sweating, chest tightness). Usually it does not go so high but this is another reason to discontinue it.
Other side effects: severe brain fog, visual trailing - can't find any reference to this but it's definitely the tranylcypromine or an interaction between it and propranolol or pregabalin.
Did anyone actually have less side effects from Phenelzine (especially brain fog)?Is there some "quality" of mao inhibition - like most ssri's all feel kind of similar (to me), do maoi's share certain features with each other (like brain fog or apathy etc) or are tranylcypromine and phenelzine subjectively very different?
Is it just me or is tranylcypromine really difficult to stop taking? I only need to miss one dose and I get brain zaps and feel really bad. Any advice on switching between maois?
I had success with sertraline+amitriptyline in the past but could not tolerate the amitriptyline for long (palpitations) so I'm also considering venlafaxine or maybe sertraline+nortriptyline. I just need something that is likely to be effective (pretty quickly and with minimal cognitive impairment) for depression and social anxiety.
Thanks...
Posted by Lamdage22 on June 11, 2016, at 6:40:50
In reply to Tranylcypromine to Phenelzine?, posted by MrChips on June 10, 2016, at 9:20:04
i think they are not very different. Mao inhibition is mao inhibition. Parnate has a stimulating metabolite and Nardil a calming metabolite (Gaba-T inhibitor).
hope this is correct
Posted by jonhed on June 11, 2016, at 7:19:21
In reply to Re: Tranylcypromine to Phenelzine?, posted by Lamdage22 on June 11, 2016, at 6:40:50
That is correct!
People say that nardil is superior to parnate when it comes to anxiety,
and the other way around when it comes to anhedonic depression..For me, the stimulant effects of parnate was very anxiety provoking.
I want SO bad to try nardil, but in my country (sweden), we eat that much fermented, aged and tofu-based food that it is nearly impossible to keep the diet..
I know that it's hard for some people to believe me when i say it, but try live in sweden for a year with a tyramine-free diet. It is not easy...
Posted by jonhed on June 11, 2016, at 7:23:32
In reply to Tranylcypromine to Phenelzine?, posted by MrChips on June 10, 2016, at 9:20:04
I'm pretty sure that it's not the mao-inhibition that causes your anxiety, it is the stimulant properties from parnate...
That is my educated guess.Some people can't tolerate that effect, and some people need that effect.
I think you should try a high dose nardil!
Posted by Christ_empowered on June 12, 2016, at 15:25:04
In reply to Tranylcypromine to Phenelzine?, posted by MrChips on June 10, 2016, at 9:20:04
what about effexor+remeron? In some studies, its as effective as parnate w/o as many problems.
Posted by PeterMartin on June 13, 2016, at 1:33:26
In reply to Re: Tranylcypromine to Phenelzine?, posted by jonhed on June 11, 2016, at 7:23:32
I had the same issue with Parnate where my BP would spike pretty high after every dose. I opted to switch to Isocarboxazid (Marplan which is a derivative of Hydrazine like Nardil). I haven't had that problem in the 5yrs I've been on it. So as far as that aspect of Parents I think you'll probably fix that issue with the switch.
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.