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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by lewyfly on April 11, 2010, at 5:53:26
I am a cyclist and have been taking taking parnate for 8 weeks. It has shown some improvement on my mood which is great but I "appear" to be feeling weaker on the bike. Does any anybody have any concrete evidence to support this or better stil discalim it?
I would love to hear from any other sports people who take parnate.
Thanks.
Posted by g_g_g_unit on April 11, 2010, at 6:02:24
In reply to Parnate and reduced athletic performance?, posted by lewyfly on April 11, 2010, at 5:53:26
i believe lowered blood pressure will reduce exercise performance. i'm a recreational swimmer and when taking nardil my legs felt like two dead weights
Posted by lewyfly on April 11, 2010, at 6:15:38
In reply to Re: Parnate and reduced athletic performance?, posted by g_g_g_unit on April 11, 2010, at 6:02:24
> i believe lowered blood pressure will reduce exercise performance. i'm a recreational swimmer and when taking nardil my legs felt like two dead weights
Have you done anything to counteract this?, any suggestions?
Posted by g_g_g_unit on April 11, 2010, at 7:37:37
In reply to Re: Parnate and reduced athletic performance?, posted by lewyfly on April 11, 2010, at 6:15:38
> Have you done anything to counteract this?,I stopped taking Nardil (for other reasons though); i was only on it for about 3 months total
> any suggestions?
is your blood pressure lower than usual? i belief the effect is transient .. 8 weeks is still a little early. maybe some more experience MAOI users could chime in
Posted by Phillipa on April 11, 2010, at 10:56:15
In reply to Re: Parnate and reduced athletic performance?, posted by g_g_g_unit on April 11, 2010, at 7:37:37
Not an Maoi user but seems that some take salt tablets to raise blood pressure if low. Phillipa
Posted by bulldog2 on April 11, 2010, at 11:52:53
In reply to Parnate and reduced athletic performance?, posted by lewyfly on April 11, 2010, at 5:53:26
> I am a cyclist and have been taking taking parnate for 8 weeks. It has shown some improvement on my mood which is great but I "appear" to be feeling weaker on the bike. Does any anybody have any concrete evidence to support this or better stil discalim it?
>
> I would love to hear from any other sports people who take parnate.
>
> Thanks.Sometimes will pass..Just walking thru the mall required a massive effort...all your blood is in your legs and your heart has work hard for all exercise
Posted by kirbyw on April 11, 2010, at 13:57:16
In reply to Re: Parnate and reduced athletic performance?, posted by g_g_g_unit on April 11, 2010, at 6:02:24
I have taken Parnate off and on for 25 years and have noticed this since the beginning. However, the last two years have been very difficult. I had bypass surgery two years ago and am supposed to exercise in order to regain my strength. But the combination of Parnate which lowers blood presure with another med, Lopressor, which also lowers blood pressure has made exercise very difficult. the month that I did not take Parnate (trying to switch to Remeron) I was able to do much more exercise, but went into a severe depression. So back to Parnate. Now, I am going to try phasing in Lithium and phasing out Parnate but I am not very optimistic that it will work.
My only other option is to try to go to a higher dose of Clonazapam (am at 2 mg per day) in the hopes that this would control my depression, but higher doses of a benzo create dependency.
I have been very disappointed in the recovery of my physical strength and I know Parnate has been a factor.Also my by-pass surgery was 'optional' as I had not had a heart attack and there were other options but the physician never took into account that a beta blocker would interact with an MAO and put me in a situation where my blood pressure if I take both drops a lot.
But I also have the feeling that Parnate affects energy level in some other subtle way that has not been investigated, that its more than just lower blood pressure. Its just an intuitive feeling.
The other drawback for me of Parnate is that I am 60 and single and it definitely affects my sexual functioning, much more than it did when I was younger. I know this is common, and its another trade off, but its unpleasant.
I view Parnate as a life saver as it was the only anti-depressant that worked for me, but the exercise issue is now a big drawback. And if an intimate relationship is another issue that would improve my depression, then the impact on sex drive and sexual functioning is also an obstacle.
The food interactions have not been a problem for me. Only once have I apparently had a hypertensive crisis, in 25 years.
anyway, hope this helps.
Rick in Costa Rica
Posted by Willful on April 11, 2010, at 14:07:31
In reply to Re: Parnate and reduced athletic performance?, posted by kirbyw on April 11, 2010, at 13:57:16
My pdoc mentioned to me when I started parnate that some people experience muscle weakness especially in the large muscles of the legs, which manifests itself under heavier exercise. He was just letting me know it's a possible side effect.
I'm not sure it's directly related to blood pressure-- but I do think the problem you're experiencing exists. My pdoc didn't at the time offer any solutions, or say it was temporary, but maybe it will be., He simply said not to be concerned that it means anything serious. Often at the beginning, you can experience side effects that fade over time. So this could be one.
Willful
Posted by bulldog2 on April 11, 2010, at 15:26:27
In reply to Re: Parnate and reduced athletic performance?, posted by kirbyw on April 11, 2010, at 13:57:16
> I have taken Parnate off and on for 25 years and have noticed this since the beginning. However, the last two years have been very difficult. I had bypass surgery two years ago and am supposed to exercise in order to regain my strength. But the combination of Parnate which lowers blood presure with another med, Lopressor, which also lowers blood pressure has made exercise very difficult. the month that I did not take Parnate (trying to switch to Remeron) I was able to do much more exercise, but went into a severe depression. So back to Parnate. Now, I am going to try phasing in Lithium and phasing out Parnate but I am not very optimistic that it will work.
> My only other option is to try to go to a higher dose of Clonazapam (am at 2 mg per day) in the hopes that this would control my depression, but higher doses of a benzo create dependency.
> I have been very disappointed in the recovery of my physical strength and I know Parnate has been a factor.
>
> Also my by-pass surgery was 'optional' as I had not had a heart attack and there were other options but the physician never took into account that a beta blocker would interact with an MAO and put me in a situation where my blood pressure if I take both drops a lot.
>
> But I also have the feeling that Parnate affects energy level in some other subtle way that has not been investigated, that its more than just lower blood pressure. Its just an intuitive feeling.
>
> The other drawback for me of Parnate is that I am 60 and single and it definitely affects my sexual functioning, much more than it did when I was younger. I know this is common, and its another trade off, but its unpleasant.
>
> I view Parnate as a life saver as it was the only anti-depressant that worked for me, but the exercise issue is now a big drawback. And if an intimate relationship is another issue that would improve my depression, then the impact on sex drive and sexual functioning is also an obstacle.
>
> The food interactions have not been a problem for me. Only once have I apparently had a hypertensive crisis, in 25 years.
>
> anyway, hope this helps.
> Rick in Costa RicaParnate is supposed to be one of the best for sexual functioning as ads go. How about the emsam patch? Selegiline supposed to be pro sexual.
Posted by emmanuel98 on April 11, 2010, at 20:17:48
In reply to Re: Parnate and reduced athletic performance?, posted by bulldog2 on April 11, 2010, at 15:26:27
I have taken parnate for eight months and have not noticed any weakness or lack of energy when exercising. Not that I'm an exercise buff.
Posted by Phillipa on April 11, 2010, at 21:30:05
In reply to Re: Parnate and reduced athletic performance?, posted by kirbyw on April 11, 2010, at 13:57:16
Rick when took my first ad about 15 years ago anxiety so high my doc gave me along with the benzos 25mg of lopressor to ready my body for paxil l0mg he said and the tiredness from the lopressor was horrible. Slept all the time when first on it. Other thing when I got on the treadmill or ran couldn't raise my heartrate from the lopressor. Finally I dropped it and felt better. So look maybe also at trying another med for the heart. Just a thought. I'm 64 now. So I know how you feel. Love Phillipa
Posted by lewyfly on April 12, 2010, at 2:59:47
In reply to Re: Parnate and reduced athletic performance? » kirbyw, posted by Phillipa on April 11, 2010, at 21:30:05
Thanks for all the comments, not sure how i feel that others have experience the weakness as well. I suppose it could be worse!!
Still keen if some one can point me in the direction of what actually causes the weakness, is it low blood pressure or something else and if so can anything be done to limit the problem.
Thanks a lot guys.
Posted by kirbyw on April 12, 2010, at 11:09:39
In reply to Re: Parnate and reduced athletic performance? » kirbyw, posted by Phillipa on April 11, 2010, at 21:30:05
Thanks Phillipa. There are other beta blockers, but all tend to lower blood pressure. Apparently a beta blocker such as lopressor is essential for people who are post by-pass. Without it, my resting heart rate is too high, like 90 or above.
With it, as you have indicated my heart rate doesn't even go up with exercise, but stays in the range of 70 all day long, but this is norml for beta blockers.
Sincerely,
Richard
Posted by Phillipa on April 12, 2010, at 20:09:14
In reply to Re: Parnate and reduced athletic performance?, posted by kirbyw on April 12, 2010, at 11:09:39
Richard I didn't know that? Kind of embarrassing seeing I used to be an RN. Love Phillipa
Posted by mike0388 on April 13, 2010, at 21:08:31
In reply to Parnate and reduced athletic performance?, posted by lewyfly on April 11, 2010, at 5:53:26
I say give it 2 months and then once your body adjusts to it, then see how much your athleticism has decreased.
Posted by pedr on April 17, 2010, at 10:07:21
In reply to Re: Parnate and reduced athletic performance?, posted by lewyfly on April 12, 2010, at 2:59:47
> Thanks for all the comments, not sure how i feel that others have experience the weakness as well. I suppose it could be worse!!
>
> Still keen if some one can point me in the direction of what actually causes the weakness, is it low blood pressure or something else and if so can anything be done to limit the problem.
>
>
> Thanks a lot guys.Hi,
this is a real problem with me too. I'm on Nardil 90mg which is also an MAOI. I've posted on this topic and many Nardil users have the same problem - looks like it's an MAOI thing. As for what the cause is and how to address it, I'm sorry but I don't know.I've been on Nardil for many months now and unfortunately still feel like my limbs are made of lead when I play soccer, cycle or run. It's like they're running at less than 10% power, right from the off. It's horrible :( It's like wading through tar.
I posted on the subject (you will prob find if you search on PB) when I had the additional symptoms of seeing bright white lights and getting really dizzy, even after just jogging up a flight of stairs. The consensus there was low blood pressure. I started taking 1/2 tablespoon of salt each morning, with 3-4 pints of water and that helped a lot. It doesn't help with the leaden-feeling though unfortunately.
Like you say, being less depressed far outweighs having these side-effects but it is pretty sh1tty. If you do find out what it is and a way to combat it, please do post it.
Best,
Pete
Posted by lewyfly on April 18, 2010, at 19:02:16
In reply to Re: Parnate and reduced athletic performance? » lewyfly, posted by pedr on April 17, 2010, at 10:07:21
> > Thanks for all the comments, not sure how i feel that others have experience the weakness as well. I suppose it could be worse!!
> >
> > Still keen if some one can point me in the direction of what actually causes the weakness, is it low blood pressure or something else and if so can anything be done to limit the problem.
> >
> >
> > Thanks a lot guys.
>
> Hi,
> this is a real problem with me too. I'm on Nardil 90mg which is also an MAOI. I've posted on this topic and many Nardil users have the same problem - looks like it's an MAOI thing. As for what the cause is and how to address it, I'm sorry but I don't know.
>
> I've been on Nardil for many months now and unfortunately still feel like my limbs are made of lead when I play soccer, cycle or run. It's like they're running at less than 10% power, right from the off. It's horrible :( It's like wading through tar.
>
> I posted on the subject (you will prob find if you search on PB) when I had the additional symptoms of seeing bright white lights and getting really dizzy, even after just jogging up a flight of stairs. The consensus there was low blood pressure. I started taking 1/2 tablespoon of salt each morning, with 3-4 pints of water and that helped a lot. It doesn't help with the leaden-feeling though unfortunately.
>
> Like you say, being less depressed far outweighs having these side-effects but it is pretty sh1tty. If you do find out what it is and a way to combat it, please do post it.
>
> Best,
> PeteHey Pete,
Thanks for the reply.
I am really no further ahead with the weakness problem, i would love to see some concrete facts!I rode in an mountain bike race on the weekend, the first hour i felt lke I had no legs but then i seemed to start to go a bit better, it was like my legs had woken up!!
Oh well, my friens keep reminding me at least I am out there giving it a go!, medication or no medication.
Goodluck and lets keep at it.
Cheers.
Posted by pedr on April 18, 2010, at 22:23:47
In reply to Re: Parnate and reduced athletic performance?, posted by lewyfly on April 18, 2010, at 19:02:16
> Hey Pete,
>
> Thanks for the reply.
> I am really no further ahead with the weakness problem, i would love to see some concrete facts!
>
> I rode in an mountain bike race on the weekend, the first hour i felt lke I had no legs but then i seemed to start to go a bit better, it was like my legs had woken up!!
>
> Oh well, my friens keep reminding me at least I am out there giving it a go!, medication or no medication.
>
> Goodluck and lets keep at it.
>
>
> Cheers.That's EXACTLY how it happens to me about 50% of the time. I'll feel leaden and powerless for the first half or hour or so and then in the space of 5 mins BOOM I get to 100% power. I then feel light on my feet, powerful, athletic and have high endurance.
I've even tried to have a pick-up game before I play a league game to try to take advantage of this phenomenon but that's not always easy to find time for. Nor does it always work especially since my IBS normally has a significant say in my well being.
You could try that though - before a race or something, do an hour-long warm up?
Pete
Posted by pedr on May 10, 2010, at 23:28:24
In reply to Re: Parnate and reduced athletic performance?, posted by lewyfly on April 18, 2010, at 19:02:16
Ready for some good news? No? Tough :)
I played 2 intense games last week and prepared for them by:
1/ delaying my nearest Nardil dose until after the game (or dropping it - prob not recommended)
2/ taking Provigil 200mg 5 hours beforehand.After some initial lead-limb feelings, I quickly went up to 90+% normal muscle power! I did not get that slow-motion feeling, that deep ache and horrible feeling of weakness. I'll try the same approach this week if I can get a game and report back. Trying not to get too excited in case it was soome other factor.
Cheers,
Pete
Posted by lewyfly on May 11, 2010, at 3:07:57
In reply to Re: Parnate and reduced athletic performance? » lewyfly, posted by pedr on May 10, 2010, at 23:28:24
Hi Pete, That is great news, hope it works for you next time as well. Let us know on the post. I have made some changes too, in consult with my doc we have decided against pursuing with parnate. I was starting to get very angry and iritable as the does increased.
Going to clean out and try something different, hopefully get back on the bike again.
Let us know how you go.
Cheers.
Posted by Jill Laplace on May 16, 2010, at 9:36:27
In reply to Re: Parnate and reduced athletic performance? » lewyfly, posted by pedr on May 10, 2010, at 23:28:24
I also had this problem on 12 mg of selegiline (EMSAM patch). When running/playing soccer/weight lifting I would encounter that leaden muscle feeling. I would also have to breathe very hard to maintain a level of activity that normally came easily. My strength was reduced by at least half and my endurance much more than that. Low blood pressure seems to me to be the likely culprit.
The selegiline lost its effect after 2-2.5 months so I discontinued it. Now I am thinking about trying isocarboxazid (Marplan) and so I was thinking about solutions to this side effect once again.
Drinking water and increasing salt intake is a good start, but didn't do enough in my case.
I was looking into fludrocortisone, which seems to be the most mentioned approach in the literature. Corticosteroids are known to have effects on mood so if you try this be sure to monitor your mood. See the psychopharmacology textbook link below for a discussion of dosage.
Another approach also mentioned in that textbook is eating small amounts of cheese. It doesn't need to be said that this is playing with fire, but it may work if the fludrocortisone fails. Personally, I accidentally consumed a small amount of soy containing vegan-mayonnaise a week after I had discontinued phenelzine (Nardil) and got a mild headache as a result. When I tried doing some push-ups, my strength seemed to be closer to normal.
If you are going to try this idea, discuss it with your health care professionals. Over the long term, I could imagine some theoretical concerns about repeated stress induced by rapid changes in blood pressure, but I don't know enough about the cardiovascular system to speculate with any confidence.
In imagining myself trying the strategy, I thought I would get a blood pressure cuff, try ingesting a small amount of cheese, and then monitor my blood pressure for the next few hours. I would do these measurements several times before exercising because presumably the exercise would further increase the blood pressure and you don't want the blood pressure to be too high. Tyramine content is variable so I would try to use a cheese or other tyramine containing product that is manufactured in a pretty standard way, something like those Sargento's cheese slices that come presliced in a plastic package (Kraft American cheese slices presumably wouldn't work since they are safe to eat with an MAOI). Even so there are still going to be variations in tyramine content so one would have to experiment with and use this strategy very cautiously.
I looked into buying pure tyramine and using it in measured quantities. You can purchase it from manufacturers like Gold BioTechnology, but it is pricey ($69 for 50 grams). The bigger problem though is that tyramine produces a mild reaction with 6 mg (mg = milligram), a moderate one with 10-25 mg, and a severe one with 25+ mg. You would want to use a scale sensitive to at least 1 mg and preferably one sensitive in the microgram range. These kinds of scales are quite pricey, well over $1,000. The price plus the risks of catastrophe if you err by a small amount makes this approach seem pretty impractical.
I'd love to hear the outcome if anyone tries the fludrocortisone or the small amount of cheese strategies. Please be very careful if you experiment with using the cheese or other tyramine containing substance.
Posted by Deneb on May 27, 2010, at 21:18:16
In reply to Re: Parnate and reduced athletic performance?, posted by Jill Laplace on May 16, 2010, at 9:36:27
Hello Jill Laplace!
Welcome to Psycho-Babble! I hope you work closely with you doctor and find a solution to the low blood pressure problem. Stay safe!
Deneb
This is the end of the thread.
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