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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Sailboat77 on November 17, 2010, at 15:22:21
I've been thinking of switching to Parnate after being on Nardil for 5 weeks (a gradual increase from 30mg to now 90mg). Part of the problem is that just in the past week, I've had brief pass-outs, 1-2 seconds long, where everything turns a bit fuzzy and I fall over. It doesn't last long or happen when I'm driving but it's still scary. It seems to happen when I get up from a laying down position or get up from sitting. Also, I've had ringing in my ears once in a while and things start to turn muted. I'm not sure if these side effects happen with all MAOI's after 5 weeks. On a side note, atypical antipsychotics, antidepressants, and mood stabalizers have never helped my mood or well-being AT ALL.
*The most important reason I want to switch to Parnate is that I still lack that motivation that allows me to pursue goals, write music or stories, and go out with friends on the weekend. Don't get me wrong, I think the Nardil has helped me but it's given me just a "general" improvement in mood that just isn't enough.
I've always reacted well to stimulants like adderall, but I could never make them work because after 4 hours I would crash and become depressed. I hear Parnate has stimulant-like effects with the added benefit of providing the antidepressant relief of Nardil. I know people may tell me to stick with Nardil for 2-4 more weeks, but I just have a feeling that Parnate might be the better choice. By the way, can you switch to Parnate within the same week of taking Nardil?
Sorry for the long post, but I just feel at a bit of a loss after so many years of trying to find the right medicine that finally provides relief from treatment resistant depression and now that I've had an opportunity to feel better, I just want to get it right.
-Thanks everyone
Posted by Tomatheus on November 17, 2010, at 17:18:39
In reply to Switch from Nardil to Parnate, posted by Sailboat77 on November 17, 2010, at 15:22:21
Sailboat77,
What dose of Nardil are you taking, and how long have you been at your current dose?
I know that this probably isn't going to be what you want to hear, but I would probably give the Nardil more time to see if the fainting spells go away or become less severe. It sounds like the side effect that you're experiencing is orthostatic hypotension, a common side effect of Nardil's that involves dizziness, blurred or dimmed vision, numbness, fainting, and other related phenomena. I never passed out when I was on Nardil, but I did experience dizziness and lightheadedness upon standing during my early days on the medication. For me, the dizziness and lightheadedness went away with time, but I'm not completely sure if these and the other signs of orthostatic hypotension eventually resolve themselves in everybody taking Nardil. I personally think that it would be best to see if the orthostatic hypotension becomes less severe with time and also to see if Nardil becomes more effective with time. If you stop taking Nardil prematurely and Parnate doesn't give you the relief that you're looking for, you might find yourself wanting to try Nardil again and having to go through the first five weeks on the medication all over again. I'd rather give Nardil the time it needs to work so you'll have a better idea of how the medication would affect you long term before moving on to Parnate, but then again, your orthostatic hypotension sounds like it's more severe than mine was, and I can understand not wanting to pass out. That can be dangerous, so I think you have a difficult choice in deciding whether or not to continue Nardil. As I said, I would probably continue with the medication, but if you and/or your doctor feel like it might be too dangerous to keep taking Nardil, I can see why you'd want to stop taking it.
I wish you luck with whatever you decide to do.
Tomatheus
Posted by Tomatheus on November 17, 2010, at 17:21:31
In reply to Re: Switch from Nardil to Parnate, posted by Tomatheus on November 17, 2010, at 17:18:39
Sailboat77,
I just reread your original message, and I realized that I missed the part where you said that you were currently taking 90 mg of Nardil. So, please disregard my question.
Tomatheus
Posted by emmanuel98 on November 17, 2010, at 19:29:33
In reply to Switch from Nardil to Parnate, posted by Sailboat77 on November 17, 2010, at 15:22:21
Postural hypotension happens on parnate as well as nardil. I started taking parnate in the hospital and when they took my vital signs one morning, my BP was 80/50. After I got home, I got dizzy and fell a few times after lying down. The route to the bathroom from my bedroom is right by a flight of stairs, so my husband got a gate to close over the stairs at night in case I fell. That side effect did go away after a few months.
I've never taken Nardil, but I can tell you that parnate is very stimulating. In fact, if I didn't take sleep aids, I will stay up for 48 hours at a time and not feel the least bit tired, just emotionally unstable from lack of sleep.
But some people on this list seem to find parnate sedating. Which is weird. If you go to Rxlist, insomnia is the most common side effect.
Posted by Conundrum on November 17, 2010, at 22:49:52
In reply to Re: Switch from Nardil to Parnate, posted by emmanuel98 on November 17, 2010, at 19:29:33
There is a doctor with the sight www.psychotropical.com.
He uses NRI's with parnate that supposedly help with hypotension and decrease the risk of a tyramine crisis.> Postural hypotension happens on parnate as well as nardil. I started taking parnate in the hospital and when they took my vital signs one morning, my BP was 80/50. After I got home, I got dizzy and fell a few times after lying down. The route to the bathroom from my bedroom is right by a flight of stairs, so my husband got a gate to close over the stairs at night in case I fell. That side effect did go away after a few months.
>
> I've never taken Nardil, but I can tell you that parnate is very stimulating. In fact, if I didn't take sleep aids, I will stay up for 48 hours at a time and not feel the least bit tired, just emotionally unstable from lack of sleep.
>
> But some people on this list seem to find parnate sedating. Which is weird. If you go to Rxlist, insomnia is the most common side effect.
Posted by Phillipa on November 18, 2010, at 0:29:47
In reply to Re: Switch from Nardil to Parnate » emmanuel98, posted by Conundrum on November 17, 2010, at 22:49:52
Do you have a blood pressure cuff? Also sit and get up slowly. Do you use salt? Phillipa
Posted by SLS on November 18, 2010, at 7:34:50
In reply to Switch from Nardil to Parnate, posted by Sailboat77 on November 17, 2010, at 15:22:21
Most of the doctors that I have seen have asked me to wait a full 2 weeks between my last dose of one MAOI to the initiation of the next. Some will go with 10 days. There have been reports of stroke occurring in people who have waited less time.
- Scott
Posted by SLS on November 18, 2010, at 7:37:24
In reply to Re: Switch from Nardil to Parnate » Sailboat77, posted by SLS on November 18, 2010, at 7:34:50
> Most of the doctors that I have seen have asked me to wait a full 2 weeks between my last dose of one MAOI to the initiation of the next. Some will go with 10 days. There have been reports of stroke occurring in people who have waited less time.
J Clin Psychiatry. 1998 Jul;59(7):382.
Stroke resulting from a rapid switch from phenelzine to tranylcypromine.Mattes JA.
Comment on:
* J Clin Psychiatry. 1997 Jul;58(7):307-10.
PMID: 9714269 [PubMed - indexed for MEDLINE]
Posted by Sailboat77 on November 18, 2010, at 18:29:07
In reply to Switch from Nardil to Parnate, posted by Sailboat77 on November 17, 2010, at 15:22:21
I saw my doctor today and he suggested I stay on the Nardil for another month (it's been about 1 month already on Nardil). He explained that I need an additional month at 90mg because it sometimes takes that long for an MAOI to take full effect. I'm resistant to most meds, so it may take longer for my brain structure to change.
The side effects such as fainting for a brief few seconds and ringing in my ears are apparently caused by a drop in blood pressure (hypotensive episode) when I stand up too quickly. Apparently, this isn't all too uncommon, although my reaction is more intense than most people.
If after another month at 90mg of Nardil without a significant improvement in mood, then I'll have the option of switching to Parnate. So far I've hit a brick wall and have stopped getting the improvement I did initially when I fist started, so we'll see what happens.
-Thanks for all the input
Posted by henshaw75 on November 18, 2010, at 21:46:12
In reply to Switch from Nardil to Parnate, posted by Sailboat77 on November 17, 2010, at 15:22:21
Your post regarding Nardil is 100% accurate. I've been on it 6 months.
This Nardil (after reformulation) only effects Mood change, not Social Anxiety. If it does, it does a little. If has effected my mood greatly, but moods are not my problem, SA is. If your looking for more of an effect to go out more, write stories etc, try Parnate.
Best of luck
Posted by henshaw75 on November 18, 2010, at 21:50:07
In reply to Re: Switch from Nardil to Parnate, posted by Sailboat77 on November 18, 2010, at 18:29:07
Sorry for the double post. I found 90 mg was too much. 75 mg i really didnt see much side effects.
This is the end of the thread.
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