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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by bearfan on July 13, 2010, at 17:42:27
I've had some kind of sexual dysfunction in virtually all antidepressant treatments i've tried. Over long term, it just made me less interested in it at all. I am thinking about trying a MAOI instead. Is Parnate (a popular choice)free from most sexual side effects (ie sustaining an erection, no orgasm, low libido)? My depression is moderate to mild, but I do have trouble with assertiveness and social anxiety. I've also tried a stimulant with an ssri, but I didn't like the overstimulated feeling often (do maois do that)?
Posted by jade k on July 13, 2010, at 18:22:39
In reply to MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 17:42:27
> I've had some kind of sexual dysfunction in virtually all antidepressant treatments i've tried. Over long term, it just made me less interested in it at all. I am thinking about trying a MAOI instead. Is Parnate (a popular choice)free from most sexual side effects (ie sustaining an erection, no orgasm, low libido)? My depression is moderate to mild, but I do have trouble with assertiveness and social anxiety. I've also tried a stimulant with an ssri, but I didn't like the overstimulated feeling often (do maois do that)?
MAOIs and Sex-Is it possible?
Yes, Parnate and Emsam are good choices (I'm not a guy though). However, MAOI's aren't usually used for mild to moderate depression. Parnate IS a popular choice, but Nardil is usually preferred for social anxiety. Parnate is known for its "speediness". Some people can't tolerate it.
~Jade
Posted by ed_uk2010 on July 13, 2010, at 18:29:42
In reply to MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 17:42:27
>I've had some kind of sexual dysfunction in virtually all antidepressant treatments I've tried...... My depression is moderate to mild, but I do have trouble with assertiveness and social anxiety........
Perhaps it would be better to avoid medication and look into other treatments such as CBT? CBT is known to be effective in many cases of moderate depression and anxiety. MAOIs are not suitable for mild/moderate depression.
Posted by bearfan on July 13, 2010, at 18:32:01
In reply to Re: MAOIs and Sex- Is it possible?, posted by ed_uk2010 on July 13, 2010, at 18:29:42
I have atypical depression. It's mild to moderate only when I'm on meds. Without them I am pretty much house ridden.
Posted by bearfan on July 13, 2010, at 18:33:31
In reply to Re: MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 18:32:01
Also, I was leaning toward Parnate since it tends to cause less weight gain (knowing that Nardil is more calming). If I try a MAOI, and can I go from one MAOI to the next (without washout period).
Posted by jade k on July 13, 2010, at 18:39:22
In reply to Re: MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 18:33:31
> Also, I was leaning toward Parnate since it tends to cause less weight gain
It can cause wieght loss.
>(knowing that Nardil is more calming).
And will likely cause weight gain.
>If I try a MAOI, and can I go from one MAOI to the next (without washout period).
I'm not sure, I think people do it. Was that a question?
~Jade
Posted by Questionmark on July 13, 2010, at 19:34:00
In reply to MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 17:42:27
Parnate not only had no negative sexual side effects for me, it actually increased my drive and pleasure enormously. However, it wasn't very effective for me at all. Actually made my depression worse on many days. Also, i was only on a small dose compared to what many others take (i don't think i went above 20mg if i recall correctly). It's possible that it is more serotonergic at higher doses and would thus have more sexual side effects. Cuz a lot of people do seem to mention having sexual side effects on Parnate.
Nardil is at least as bad if not worse than SSRIs are for sexual dysfunction, however.
Also, a washout period is probably required when switching MAOIs. Esp, in my opinion, from Nardil to Parnate.
> I've had some kind of sexual dysfunction in virtually all antidepressant treatments i've tried. Over long term, it just made me less interested in it at all. I am thinking about trying a MAOI instead. Is Parnate (a popular choice)free from most sexual side effects (ie sustaining an erection, no orgasm, low libido)? My depression is moderate to mild, but I do have trouble with assertiveness and social anxiety. I've also tried a stimulant with an ssri, but I didn't like the overstimulated feeling often (do maois do that)?
Posted by angels78 on July 13, 2010, at 20:18:05
In reply to MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 17:42:27
I had to decrease my dose from 75 to 60, just to get an erection. Now my libido is going out of control. ;)
Posted by Phillipa on July 13, 2010, at 21:06:15
In reply to Re: MAOIs and Sex- Is it possible? » bearfan, posted by angels78 on July 13, 2010, at 20:18:05
Wash out period neccesary to best of my knowledge. Phillipa
Posted by emmanuel98 on July 13, 2010, at 22:04:39
In reply to MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 17:42:27
I had no loss of libido from parnate, but then I had no loss of libido from any SSRI either.
Posted by emmanuel98 on July 13, 2010, at 22:07:07
In reply to Re: MAOIs and Sex- Is it possible? » bearfan, posted by Questionmark on July 13, 2010, at 19:34:00
You do need to washout for two weeks between MAOI's. But so what? If your current medication is't working, what's the problem with a couple of weeks med-free?
Posted by bearfan on July 13, 2010, at 22:12:18
In reply to Re: MAOIs and Sex- Is it possible?, posted by emmanuel98 on July 13, 2010, at 22:07:07
How long a washout from paxil to parnate 5 days ?
Posted by jade k on July 13, 2010, at 22:18:38
In reply to Re: MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 22:12:18
> How long a washout from paxil to parnate 5 days ?
I believe thats 2 weeks also. Its important to follow what pdoc says with the washout periods.
~Jade
Posted by ed_uk2010 on July 13, 2010, at 23:48:39
In reply to Re: MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 18:32:01
>I have atypical depression. It's mild to moderate only when I'm on meds. Without them I am pretty much house ridden.
Ah, OK. In that case, it makes sense to try an MAOI.
Did you ask about paroxetine? You need to have been completely off paroxetine for a minimum of one week (although some recommend two weeks) before starting an MAOI. The 'rule' varies with the SSRI eg. you have to have been off fluoxetine for at least five weeks before starting an MAOI.
A washout period of two weeks is recommended when switching from Nardil to Parnate or vice versa.
Posted by jedi on July 14, 2010, at 0:42:13
In reply to MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 17:42:27
> I've had some kind of sexual dysfunction in virtually all antidepressant treatments i've tried. Over long term, it just made me less interested in it at all. I am thinking about trying a MAOI instead. Is Parnate (a popular choice)free from most sexual side effects (ie sustaining an erection, no orgasm, low libido)? My depression is moderate to mild, but I do have trouble with assertiveness and social anxiety. I've also tried a stimulant with an ssri, but I didn't like the overstimulated feeling often (do maois do that)?
Hi Bearfan,
I am a large male and am currently on 60mg of Nardil daily. When I get above this level then orgasm is very difficult for me. Libido is not the problem, but for me - at dosages above 60mg, then ejaculation is delayed or absent.Parnate will have less sexual side effects, but if you do not like the stimulated feeling, then it might not be for you. IMHO, Nardil is still the gold standard for treatment resistant, atypical depression with social anxiety. The lower the dosage the less are the sexual side effects. So take the lowest dose that will relieve your symptoms.
Good Luck,
Jedi
Posted by bearfan on July 14, 2010, at 2:20:41
In reply to MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 17:42:27
what is the stimulated feeling you are talking about with Parnate like? A coffee buzz or more like a prozac? Also what does it 'feel' like to be on a MAOI? Can you now give public presentations without problems?
Posted by jedi on July 14, 2010, at 12:02:58
In reply to Re: MAOIs and Sex- Is it possible?, posted by bearfan on July 14, 2010, at 2:20:41
> what is the stimulated feeling you are talking about with Parnate like? A coffee buzz or more like a prozac? Also what does it 'feel' like to be on a MAOI? Can you now give public presentations without problems?
Hi,
For me the Parnate buzz is way more than coffee, but then I have tolerance to caffeine. I would say it is like a small dose of stimulant like methylphenidate. Parnate caused pretty severe insomnia for me. The Nardil insomnia I can counteract with 50mg of diphenhydramine(Benadryl). I am really sensitive to the histamine blockers. It takes a stronger sleep aid for Parnate, such as trazodone or low dose Seroquel.I can give presentations in my area of expertise, but this is usually small groups. I have not spoke in front of a large crowd for years. Many people will use a beta blocker to counteract the physical symptoms of this kind of anxiety.
My palms used to sweat all the time. When I would shake someone's hand I would have to wipe my palm first. With Nardil, I have not had this problem for years. I will also start spontaneous conversations with strangers. Just make a joke or whatever. Before Nardil, it really took a concentrated effort and caused severe anxiety to do this.
Be Well,
Jedi
Posted by bearfan on July 14, 2010, at 12:09:21
In reply to Re: MAOIs and Sex- Is it possible? » bearfan, posted by jedi on July 14, 2010, at 12:02:58
As far as Parnate vs Nardil, I've heard Parnate is a bit more tolerable, and has less weight gain than Nardil. Although Nardil may be less likely to induce a hypertensive crysis. Are they about the same, or do you have a preference one way or the other? My anxiety is a primary concern with depression a close 2nd, would one be better than the other, or would both work nearly the same. Also what is your experience with other MAOIs (open for any poster), like Marplan, Emsam and the Reversible one Moclobemide?
Thanks
Posted by jade k on July 14, 2010, at 12:45:56
In reply to Re: MAOIs and Sex- Is it possible?, posted by bearfan on July 14, 2010, at 12:09:21
> As far as Parnate vs Nardil, I've heard Parnate is a bit more tolerable, and has less weight gain than Nardil. Although Nardil may be less likely to induce a hypertensive crysis. Are they about the same, or do you have a preference one way or the other? My anxiety is a primary concern with depression a close 2nd, would one be better than the other, or would both work nearly the same. Also what is your experience with other MAOIs (open for any poster), like Marplan, Emsam and the Reversible one Moclobemide?
>
> ThanksHi bearfan,
I liked Jedi's description of Parnate in terms of its "speediness" Much like a stim. I haven't tried Nardil, but I would be much more comfortable giving presentations, etc. on Parnate than off. But I was fine before depression as well. Emsam was very much like Parnate to me but I was only on it for a month or two. When I started increasing dose, I switched to Parnate as food restricts were going to come into play anyway. With anxiety as your primary disorder, though, you have a good argument for Nardil. Its a tough call.
Good Luck!
~Jade
Posted by MoonageDaydream on July 15, 2010, at 12:53:04
In reply to MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 17:42:27
The only thing I've noticed in the sex dept while taking a typical (40 mg) dose of Parnate is that it sometimes takes me a bit longer, but it hasn't caused the numb feeling and complete anorgasmia that some SSRIs caused. My libido is virtually the same, maybe 15-20% reduced, but its such a small reduction I can't even conclude that Parnate is the cause. In other words, the sexual side effects have been very mild and tolerable compared to SSRIs, which all caused intolerable side effects except at lower doses.
I'd definitely give MAOIs a try. Personally I think its worth trying EMSAM before Parnate, though. They are fairly similar drugs, but with EMSAM you don't have to follow the MAOI diet (at least at lower doses), which is a HUGE benefit in my opinion. Both have stimulant-like effects that are too strong for some people, but its still worth a try. My personal reaction was that Emsam was less stimulating than even a small dose of Ritalin/Amphetamine, and Parnate has actually been sedating, so keep in mind that everyone reacts differently to drugs.
Posted by benzo85 on July 16, 2010, at 18:40:46
In reply to MAOIs and Sex- Is it possible?, posted by bearfan on July 13, 2010, at 17:42:27
On Nardil my libido is about the same. At 75mg I get anorgasmia, but give it 3months and then I can orgasm again at that dosage. Sex is better on Nardil, really, it gives more control on when you want to go.
This is the end of the thread.
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