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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by huggave on April 28, 2002, at 14:25:37
Hi everyone,
My pdoc mentioned the MAOI Parnate as an alternative to SRRI if now Prosac high dose (~80mg?) not will work.
Anyone with experience from Parnate? Any sexual dysfunction with it?
I have read that it is better than Nardil when it comes to SD.Thanks!
Posted by JonW on April 28, 2002, at 20:44:57
In reply to Parnate and sexual dysfynction...?, posted by huggave on April 28, 2002, at 14:25:37
Hi huggave,
What other drugs have you been on? It seems a bit illogical to jump to an MAOI if all you have been on is prozac. Maybe serzone, welbutrin, remeron, or definitely moclobemide before parnate! You might even try lamictal before an MAOI. However, if your symptoms and drug history make it a logical choice then Parnate is supposed to be better than nardil for side-effects so I'd give it a go. You could also try augmenting the prozac with say wellbutrin which might also help with the sexual dysfunction. As far as SD is concerned, viagra seems to work for a lot of people.
Hang in there,
Jon
Posted by huggave on April 29, 2002, at 0:16:53
In reply to Parnate and sexual dysfynction...?, posted by huggave on April 28, 2002, at 14:25:37
Hi Jon,
Thanks for your reply! Sorry to be a little short in my previous AD-history. I have been on Paxil (30mg/d), Remeron (120mg/d), Edronax (reboxetine 16 mg/d),Effexor XR (600mg/d),pramipexole (2,1mg/d),each of them in combination with my standard dose lithium, but with no success. Only one thing has ever touched the apathy/anhedonia/fatigue of my illness; Remeron(60mg)+Effexor(375mg)+ lithium. That was a cocktail that I tried a few weeks on my own a year ago and it really made me feel normal! I would like to try it again if my pdoc agree, but I think she consider the Parnate as an earlier alternative.
Regards,
Huggave
Posted by cirrus6000 on June 4, 2002, at 17:05:58
In reply to Re: Parnate and sexual dysfynction...? » huggave, posted by JonW on April 28, 2002, at 20:44:57
is moclobemide even legal in the usa, has it been approved by FDA?
Posted by JonW on June 4, 2002, at 17:23:58
In reply to Re: Parnate and sexual dysfynction...? » JonW, posted by cirrus6000 on June 4, 2002, at 17:05:58
> is moclobemide even legal in the usa, has it been approved by FDA?
Hi cirrus6000,
It is legal to be prescribed moclobemide and order it from another country that has it, but it has not been FDA approved.
Jon
Posted by cirrus6000 on June 4, 2002, at 17:25:52
In reply to Parnate and sexual dysfynction...?, posted by huggave on April 28, 2002, at 14:25:37
how many have been on parnate and have had any sexual dysfunction. As opposed to nardil and have had any sexual dysfunction? b/c i was on nardil while i could get it up and all i had ejaculatory difficulties will i have the same effects on parnate? please correspond.
Posted by cirrus6000 on June 4, 2002, at 17:28:33
In reply to Re: Parnate and sexual dysfynction...?, posted by cirrus6000 on June 4, 2002, at 17:25:52
how many have been on parnate and have had any sexual dysfunction. As opposed to nardil and have had any sexual dysfunction? b/c i was on nardil while i could get it up and all i had ejaculatory difficulties will i have the same effects on parnate? please correspond.
Posted by JonW on June 4, 2002, at 18:52:42
In reply to Re: Parnate and sexual dysfynction vs Nardil , posted by cirrus6000 on June 4, 2002, at 17:28:33
> how many have been on parnate and have had any sexual dysfunction. As opposed to nardil and have had any sexual dysfunction? b/c i was on nardil while i could get it up and all i had ejaculatory difficulties will i have the same effects on parnate? please correspond.
Hi cirrus6000,
I had *complete* sexual dysfunction on every SSRI and Parnate (and I mean complete!), and I was so convinced that I was going to get dysfunction on Nardil... however, I didn't! My point is that you really have to try it and see because you never know! Another strategy might be adding an atypical anti-psychotic like zyprexa to the mix. My worst every SD was on zoloft, but when I added zyprexa the SD wasn't much of a problem. I know other people have had success with this type of a combination so that's something else you could try. Prozac + Zyprexa is supposed to be special for treatment resistent depression.
Good Luck,
Jon
Posted by Seamus2 on June 4, 2002, at 19:47:55
In reply to Re: Parnate and sexual dysfynction vs Nardil , posted by cirrus6000 on June 4, 2002, at 17:28:33
Nardil induced complete anorgasmia w/ no impotence; Parnate had no effect whatsoever.
Posted by cirrus6000 on June 11, 2002, at 20:31:54
In reply to Re: Parnate and sexual dysfynction...? » cirrus6000, posted by JonW on June 4, 2002, at 17:23:58
> > is moclobemide even legal in the usa, has it been approved by FDA?
>
> Hi cirrus6000,
>
> It is legal to be prescribed moclobemide and order it from another country that has it, but it has not been FDA approved.
>
> Jondo you need a prescription for it to be legal i know you can go to the black market for presciption drugs i have a felony on my record and would prefer to be extra cautious
Posted by JonW on June 11, 2002, at 22:25:31
In reply to Re: Parnate and sexual dysfynction...? » JonW, posted by cirrus6000 on June 11, 2002, at 20:31:54
I don't think Dr. Bob allows this type of discussion, but let me break the rules for just a second and say that it's safe to assume that you need a prescription. I wouldn't take a chance if I were you -- even if there may be some gray area. Besides, it only benefits you to be working with an experienced psydoc.
Good Luck,
Jon
Posted by cirrus6000 on June 11, 2002, at 23:32:30
In reply to Re: Parnate and sexual dysfynction...? » huggave, posted by JonW on April 28, 2002, at 20:44:57
thank you for the imput, could you recomend a site to order from? and also would you recommend Parnate for SAD and depression? The two do usually go hand in hand. I've tried all the SSRI's they didn't do anything for me exept make me limp. I know you're definitely pro-moclobromide but could you possibly recomend me something FDA approved?
Posted by JonW on June 12, 2002, at 1:06:11
In reply to Re: Parnate and sexual dysfynction...? » JonW, posted by cirrus6000 on June 11, 2002, at 23:32:30
Hi cirrus6000,
Nothing personal, but I want to respect Dr. Bob's rules so I can't answer your first question.
Parnate may be effective for you for SAD and depression. Everyone's different. There are plenty of reasons to believe Nardil is more effective in general (for SAD, at least), but that's not to say Parnate won't be the magic bullet for you. Have you tried Neurontin? Have you tried Serzone? Although there is less convincing data, have you tried Wellbutrin? Maybe a combination? Why not consider trying to treat the sexual dysfunction with something like Viagra?
Jon
Posted by cirrus6000 on June 12, 2002, at 11:10:44
In reply to Re: Parnate and sexual dysfynction...? » cirrus6000, posted by JonW on June 12, 2002, at 1:06:11
yes i've tried serzone and am currently on neurontin, tried Nardil which left me with ejaculatory difficulties. i heard that parnate was better for social anxiety. check out this website: www.anxietynetwork.com/parnate.html
and www.socialanxietyinstitute.org/parnate.html
Posted by Dr. Bob on June 12, 2002, at 12:21:04
In reply to Re: Parnate and sexual dysfynction...? » JonW, posted by cirrus6000 on June 11, 2002, at 23:32:30
> thank you for the imput, could you recomend a site to order from?
Please don't use this site to exchange information on how to import into the US prescription medication without a prescription:
http://www.dr-bob.org/babble/faq.html#illegal
Thanks,
Bob
PS: Follow-ups regarding posting policies, or complaints about posts, should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by JonW on June 12, 2002, at 14:18:59
In reply to Re: Parnate and sexual dysfynction...? » JonW, posted by cirrus6000 on June 12, 2002, at 11:10:44
Hi cirrus6000,
I'm aware of the idea that Parnate is more effective for social phobia, but I don't think there is any data that confirms this opinion. I believe there are one or two open studies that show Parnate effective and it certainly follows that if Nardil works other MAOIs should as well, but how does that compare to the multiple controlled studies of Nardil? I also understand Dr. Liebowitz (who is no dummy when it comes to SP) to share this opinion. The clinical impression of several of my psydocs and the impression you get here at psycho-babble certainly supports the implication that Nardil is the "gold standard" -- be it with many side-effects and restrictions, of course. Maybe the anxiety institute prefers Parnate because it gives you more energy and inspiration to try some of the behavioral therapy, who knows? Parnate is effective, but I don't think there is any reason to dethrone Nardil as the "gold standard". I've pasted a recent abstract from the begining of this year below about the current treatment of SP:
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11801236&dopt=Abstract)
--------------------------------------------------
Pharmacotherapy of social anxiety disorder.Blanco C, Antia SX, Liebowitz MR.
Department of Psychiatry, Columbia College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA.
Over the last few years, a number of medications have demonstrated their efficacy in the acute treatment of social anxiety disorder. At present, selective serotonin reuptake inhibitors probably constitute the first line treatment, based on their safety, tolerability, and efficacy in the treatment of social anxiety disorder and common comorbid conditions. Data from single trials suggest that clonazepam, bromazepam, and gabapentin may have efficacy similar to the serotonin reuptake inhibitors, but further studies are needed to confirm these findings. The monoamine oxidase inhibitor phenelzine appears to be at least as efficacious as these other agents, but should be reserved for cases that fail to respond to these safer medications. Among the reversible inhibitors of monoamine oxidase A, brofaromine may also be an effective drug, while moclobemide appears to be less potent.Future research directions should include delineating ways to achieve remission (as opposed to response); developing strategies for augmenting partial responders and treating nonresponders to first line approaches; studying the long-term response to medication and prevention of relapse when medication is discontinued; clarifying ways to integrate psychosocial and pharmacological treatment approaches; developing predictors of which patients do best with which treatments; and the treatment of social anxiety disorder in children and adolescents.
Publication Types:
Review
Review, TutorialPMID: 11801236 [PubMed - indexed for MEDLINE]
--------------------------------------------------Jon
Posted by cirrus6000 on June 12, 2002, at 20:58:58
In reply to Re: Parnate and sexual dysfynction...? » cirrus6000, posted by JonW on June 12, 2002, at 1:06:11
yes i've tried the serzone, neurontin, clonazapam coctail, the serzone didn't do any thing for me as far as SAD. so then i decided to go for the "gold" standard, Nardil which left me with ejaculatory difficulties, will Parnate do the same thing? what should i do? i'm still taking the clonazapam and neurontin.
Posted by gypsea on August 20, 2002, at 11:14:11
In reply to Re: medication without a prescription » cirrus6000, posted by Dr. Bob on June 12, 2002, at 12:21:04
Hi folks,
I'd love to find out what any of you may have learned about viagra with nardil as a fix for anorgasmia. I've been on 45 mgs of Nardil for about 11 years and still experience anorgasmia for long periods of time. It comes and goes, along with urinary difficulty. Nardil is still working great for me, but the anorgasmia is a real bitch! Please respond!
This is the end of the thread.
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