Posted by Dave001 on September 21, 2002, at 23:30:37
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by chad_3 on September 21, 2002, at 19:39:03
> Hey Dave -
>
> I tried both Nardil and Parnate at low and high doses. I have (untreated) primary severe generalized Social Anxiety Disorder. I was initially also diagnosied mild sedondary depression, 7 years ago that is.
>
> I think the original dx was almost right on - except I would substitute dysthymia for 2ndary mild depression. I am active and athletic by nature my whole life.
>
> To comment on a few of your queries:
>
> 1) On Dexedrine - I agree with you. I wonder only if is neurotoxic in long term. I respondWell, we've had patients on high doses of amphetamines for over 50 years w/o apparent complications (treatment of narcolepsy). I think most of the studies linking neurotoxicity involved use of substituted amphetamines. And even then, it's the dose that makes the poison...
well to ultra low doses ; ie; 1.5mg lasts all day. However I only tried this a couple times
That is ultra-low. I'm on 30 mg/day which is fairly typical. I have yet to experience any adverse interaction between Dexedrine and the Parnate.
and currently anything more complicated than my low Nardil + Klonopin combo is a bit off for me at this time ... (complicated circumstances political and neurological)...
Benzodiazepines are cognitive inhibitors though; they cause retrograde amnesia in high doses (which is why valium is sometimes given i.v. presurgery) and dose dependly inhibit cognition as a direct effect.
> 2) I slept ok on both. 6 hours clockwork on high Nardil alone and high energy day and night. Parnate I actually took at varied doses with pretty high Klonopin and still was very activated and also agitated and although rejection sensitivity low - I just was not sociable. Everybody I talked to who tried Parnate for primarily SP had similar experience. Maybe in your circumstances you
That's odd; a lot of psychopharmacologists have said the exact opposite: that is, Parnate works better for SP.
would respond better than me - actually it does sound like you would do better than me given your descipription.
>
> 2) I think for SP , Nardil better at higher dose, and Parnate if it works I don't know because I never met anyone - many I talked to with Nardil get better results at higher dose. For depression I think both can work well at low doses oftentimes.
>
> 3) Sleep and weight gain. Nardil weight gain - I hear this is "classic" - but I don't quite know where that comes from. Tricylics, Paxil,Err, the perhaps the literature? Just a guess. ;-)
Remeron - I think those are more likely to cause weight gain personally.
>
> 4) I suggest to try them both. You already started Parnate - cool because is has shorter half life and washout is shorter if you switch off it to try Nardil or something else.The elimination half-life of the drug does not correlate with the pharmacologic effect; the enzyme is irreversibly inhibited so MAO activity only returns to normal as new MAO is synthesized. I'm not quite sure why one would need to wait at all when switching from one MAOI to another; after all, they both do essentially the same thing: inhibit MAO.
Parnate - I will say for me I got a 1-2 day good effect on dose increase fading to axiogenic. I quick buzz. Prozac gives me a lift right on taking too. I think it the amphetamine like effect stated for both of these drugs - which is really temporary IMO on each dosing.
You say, "fading to axiogenic." [sic] What do you mean? You felt an amphetamine-like effect with subsequent anxiety *after* the effect?
> Parnate I kind of liked the middle dose range - saw no advantage to higher - all were tolerable except for not working for me.
Why did you like the middle-range dose if it didn't work for you? :-)
> But good luck with it - sounds like you have better chance with it that someone like me. Try Nardil too if you can - great MAOI is gaining popularity in recent years (expert comments for years Nardil has been underutilized)
>
> It takes years for new drug hype to fade, sometimes there are good new ones, often not...Dave
> Best,
>
> Chad
> http://www.socialfear.com/
>
> Currently I have severe depression, social anxiety disorder, ADD (and probably the rest of the alphabet soup of diagnoses, ad nauseum).
> >
> > I find it rather frustrating that many people describe various medications as stimulating with an "amphetamine-like effect," when I doubtful whether the majority of these people have actually tried amphetamine. I find that dextroamphetamine in therapeutic doses produces a subjective calming effect, with enhanced mental clarity at the same time. It seems to have a high ratio of CNS/peripheral stimulation. By contrast, many of the so-called "stimulating" antidepressants on the market seem to produce much peripheral stimulation, e.g., agitation and anxiety, but do not enhance mental focus.
> >
> > I'm going off on tangents here. I have some specific questions.
> >
> > 1.) If you've had success with Parnate for SP, did you feel any initial agitation from the drug? If so, did it dissipate with continued use?
> >
> > 2.) Nardil and weight gain: I know Nardil is infamous for causing weight gain, but what I would like to know, is whether the weight gain is only secondary to excessive eating, or whether it directly influences metabolism or other factors (e.g., insulin sensitivity) which contribute to the weight gain. If anyone has any references to this I would appreciate it if you could post them.
> >
> > 3.) Although I've searched through the archives (both here and Usenet via Google) and have read much concerning this, I would still be interested to hear from people whom have tried both Nardil *and* Parnate (not necessarily at the same time), and which one you found more effective for various symptoms.
> >
> > 4.) Is there any general consensus whether certain dose ranges are more effective for treating one condition over the other? E.g., are lower doses generally more or less effective for SP, while high doses work better for depression? I know these are generalizations and do not apply to everyone, but I'm interested to know if there are any trends concerning this...
> >
> > 5.) Last one: does the initial insomnia go away after awhile?
> >
> >
> > Thanks, Dave
>
>
poster:Dave001
thread:120640
URL: http://www.dr-bob.org/babble/20020914/msgs/120676.html