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Dr. Bob is Robert Hsiung, MD,
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Posted by Lamdage22 on March 24, 2022, at 14:54:44
In reply to Re: combining nardil and parnate » rose45, posted by SLS on March 24, 2022, at 12:55:32
Things that could easily kill you are not an exception on the internet. Be careful. Rather talk to your doctor and if you don't think he is good, seek another one.
Posted by rose45 on March 25, 2022, at 7:52:38
In reply to Re: combining nardil and parnate, posted by Lamdage22 on March 24, 2022, at 14:54:44
Thank you both.
SLS you are right, I am desperate and suicidal. I dont even have access to a consultant on the NHS in this country. But maybe this is too dangerous. Lots of people on Reddit are doing it,and Gillman says it is safe, but you guys have experience of it going wrong, so its not worth taking the risk, especially since i would have to do it myself behind the back of the NHS.(UK state medicine). I just dont know how much longer I can carry on like this, with half a brain. You have so much more choice in USA, choosing your doctors etc and you must all have insurance. I have been unable to come off the parnate. Just reducing one pill makes me suicidal. Most people come off their meds much more easily. Anyway thank you both for caring.
Posted by Christ_empowered on March 25, 2022, at 10:21:42
In reply to Re: combining nardil and parnate, posted by rose45 on March 25, 2022, at 7:52:38
hi :-)
changing meds can be -so- difficult. Here in the US, its easy to get on (most...) meds...not so easy to get off of anything. nature of the beast, I suppose? things sound straight up hellish in the UK. So sorry :-(
are benzodiazepines and/or lyrica viable options? when I reduced my Abilify, getting a slight bump in daily gabapentin intake was -quite- helpful. just a thought...
other than that: thoughts and prayers are with you. a number of sites help people deal with psych drug transitions...surviving antidepressants is still around, I think...
try to hang in there. :-)
Posted by Lamdage22 on March 25, 2022, at 12:34:31
In reply to Re: combining nardil and parnate, posted by rose45 on March 25, 2022, at 7:52:38
I heard really bad feedback about the NHS. I know a few english people in my german speaking country. Unipolar depression? Hang in there.
Posted by undopaminergic on March 25, 2022, at 12:56:37
In reply to Re: combining nardil and parnate » rose45, posted by SLS on March 24, 2022, at 12:55:32
>
> I had a severe reaction to an accidental combination of Parnate + Nardil. My doctor was extremely aggressive, and didn't think there would be a problem with making a direct switch without a washout period.
>That doesn't sound aggressive at all. There is no obvious reason to expect problems from going straight from one MAOI to another, because both have the same (primary) effect. Even taking into account the secondary effects of these two drugs, there is no reason to expect a dangerous interaction between Nardil's GABAergic effect and Parnate's amphetaminergic action; if anything, they would tend to cancel each other out.
-undopaminergic
Posted by Lamdage22 on March 26, 2022, at 10:14:02
In reply to Re: combining nardil and parnate, posted by Lamdage22 on March 25, 2022, at 12:34:31
They switched me pretty swiftly, too. But taking both simultaneously? Have you even exhausted all options that doctors feel comfortable with?
Posted by rose45 on March 27, 2022, at 13:05:19
In reply to Re: combining nardil and parnate, posted by Lamdage22 on March 26, 2022, at 10:14:02
unfortunately im under the nhs, and you dont even get to see the consultant, so that idea was a desperate one, as I seem to be unable to come off parnate - everyone else comes on and goes off meds, but why can't I?
Parnate masked my anxiety, but coming off it, even by just 10 mg, brings about the most unbearable mix of physical, mental and psychic pain. I am already ill and cannot work, and all the nhs are suggesting is to go on lithium. The choices are limited if I cannot get myself off the parnate and I was so ill when I first went on maois that my base state is now unbearable, if that makes any sense.
Posted by rose45 on March 28, 2022, at 6:47:20
In reply to Re: combining nardil and parnate, posted by Christ_empowered on March 25, 2022, at 10:21:42
Posted by rose45 on March 28, 2022, at 6:52:26
In reply to Re: combining nardil and parnate (nm), posted by rose45 on March 28, 2022, at 6:47:20
thank you all for your good wishes. I dont know what to do.
Posted by SLS on March 28, 2022, at 10:51:55
In reply to Re: combining nardil and parnate, posted by undopaminergic on March 25, 2022, at 12:56:37
There are reasons why I ended up in the hospital.
This is another example of promoting personal theories without sufficient evidence found to substantiate them.
I'm glad you think that my reporting having untoward reactions to combining Parnate and Nardil is without sufficient significance to consider it. What might be an alternate explanation for my reporting a dangerous reaction from combining Parnate and Nardil? Did you take my report into consideration in your musings? I think anyone should have an appreciation for what they don't know.
You simply don't know enough to offer an opinion of any kind regarding the safety of combining Parnate and Nardil. Perhaps you can emphasize that you are guessing, and don't know for sure. Obviously, you argue against my report as if it has no significance in your musings. Think about how your presentations might influence readers to combine drugs that can produce untoward reactions that leave one incoherent and unconscious and in need to immediate hospitalization to administer supportive measures. Penal catheterization is not fun.No doctor of mine ever thought combining MAOIs was safe. Taking two MAOIs at the same time was not the objective. My advice is to allow some period of time seperating the last dose of one MAOI and the first dose of the next. I don't know of any peer-reviewed medical article that asserts otherwise.
I had to go to the hospital in an ambulance after switching from Nardil to Parnate without waiting period.
I am still reticent to declare that we know ALL of the pharmacology of drugs. New dynamics are being discovered for old drugs as technology and creativity yields new observations and theories.
I think empirical observations trump theory.
- Scott
Posted by SLS on March 28, 2022, at 10:53:02
In reply to Re: combining nardil and parnate, posted by rose45 on March 28, 2022, at 6:52:26
> thank you all for your good wishes. I dont know what to do.
http://www.dr-bob.org/babble/20220128/msgs/1119153.html
- Scott
Posted by Lamdage22 on March 28, 2022, at 14:32:05
In reply to Re: combining nardil and parnate » undopaminergic, posted by SLS on March 28, 2022, at 10:51:55
I agree.
> You simply don't know enough to offer an opinion of any kind regarding the safety of combining Parnate and Nardil.
Posted by rose45 on March 29, 2022, at 8:26:09
In reply to Re: combining nardil and parnate » undopaminergic, posted by SLS on March 28, 2022, at 10:51:55
> There are reasons why I ended up in the hospital.
>
> This is another example of promoting personal theories without sufficient evidence found to substantiate them.
>
> I'm glad you think that my reporting having untoward reactions to combining Parnate and Nardil is without sufficient significance to consider it. What might be an alternate explanation for my reporting a dangerous reaction from combining Parnate and Nardil? Did you take my report into consideration in your musings? I think anyone should have an appreciation for what they don't know.
>
> You simply don't know enough to offer an opinion of any kind regarding the safety of combining Parnate and Nardil. Perhaps you can emphasize that you are guessing, and don't know for sure. Obviously, you argue against my report as if it has no significance in your musings. Think about how your presentations might influence readers to combine drugs that can produce untoward reactions that leave one incoherent and unconscious and in need to immediate hospitalization to administer supportive measures. Penal catheterization is not fun.
>
> No doctor of mine ever thought combining MAOIs was safe. Taking two MAOIs at the same time was not the objective. My advice is to allow some period of time seperating the last dose of one MAOI and the first dose of the next. I don't know of any peer-reviewed medical article that asserts otherwise.
>
> I had to go to the hospital in an ambulance after switching from Nardil to Parnate without waiting period.
>
> I am still reticent to declare that we know ALL of the pharmacology of drugs. New dynamics are being discovered for old drugs as technology and creativity yields new observations and theories.
>
> I think empirical observations trump theory.
>
>
> - ScottThanks for the warning Scott. Im sure you are not the only one who has had a bad experience.
Interesting that Ken Gillman who is an expert on MAOIs seems to think that it is safe to cross-switch.
But he has given me wrong advice in the past too - so it just goes to show how tricky it is to navigate through all the opinions and information.
And your experience is not theory, it is real and proof that cross-switching these meds is not safe and reliable, even though some people may get away with it.
Posted by SLS on March 29, 2022, at 9:28:11
In reply to Re: combining nardil and parnate, posted by rose45 on March 29, 2022, at 8:26:09
> > There are reasons why I ended up in the hospital.
> >
> > This is another example of promoting personal theories without sufficient evidence found to substantiate them.
> >
> > I'm glad you think that my reporting having untoward reactions to combining Parnate and Nardil is without sufficient significance to consider it. What might be an alternate explanation for my reporting a dangerous reaction from combining Parnate and Nardil? Did you take my report into consideration in your musings? I think anyone should have an appreciation for what they don't know.
> >
> > You simply don't know enough to offer an opinion of any kind regarding the safety of combining Parnate and Nardil. Perhaps you can emphasize that you are guessing, and don't know for sure. Obviously, you argue against my report as if it has no significance in your musings. Think about how your presentations might influence readers to combine drugs that can produce untoward reactions that leave one incoherent and unconscious and in need to immediate hospitalization to administer supportive measures. Penal catheterization is not fun.
> >
> > No doctor of mine ever thought combining MAOIs was safe. Taking two MAOIs at the same time was not the objective. My advice is to allow some period of time seperating the last dose of one MAOI and the first dose of the next. I don't know of any peer-reviewed medical article that asserts otherwise.
> >
> > I had to go to the hospital in an ambulance after switching from Nardil to Parnate without waiting period.
> >
> > I am still reticent to declare that we know ALL of the pharmacology of drugs. New dynamics are being discovered for old drugs as technology and creativity yields new observations and theories.
> >
> > I think empirical observations trump theory.
> >
> >
> > - Scott
>
> Thanks for the warning Scott. Im sure you are not the only one who has had a bad experience.
> Interesting that Ken Gillman who is an expert on MAOIs seems to think that it is safe to cross-switch.
> But he has given me wrong advice in the past too - so it just goes to show how tricky it is to navigate through all the opinions and information.
> And your experience is not theory, it is real and proof that cross-switching these meds is not safe and reliable, even though some people may get away with it..
That's a very safe way of looking at it.
I switched from Parnate to Nardil.
Guesses:
1. Switching from Nardil to Parnate *might* be safer, but not safe enough.
2. Nardil *might* be more serotonergic than Parnate, based upon my experience with clorgyline, which is specific for inhibiting MAO-A. It does not inhibit MAO-B at all. It was considered by the NIH in 1992 when they gave it to me to be the most powerful antidepressant in the world. To me, Nardil felt more like clorgyline than it did like Parnate. For me, Nardil makes me feel much "brighter" than Parnate and less "speedy".
3. Nardil is better for anxiety disorders. However, I don't know the extent to which it improves depression that is accompanied by anxiety without there actually being an anxiety disorder present.
4. I would be very interested to know how Gillman came to his conclusion. Did he offer evidence for his rationale?
I don't know enough about your history to make any recommendations other than to say that if you tried Parnate already - and especially if it helped you at all - Nardil is different enough from Parnate to be worth trying.
* Colonoscopy in a few hours. Yuck.
- Scott
Posted by rose45 on March 29, 2022, at 9:30:12
In reply to Re: combining nardil and parnate » rose45, posted by SLS on March 28, 2022, at 10:53:02
> > thank you all for your good wishes. I dont know what to do.
>
> http://www.dr-bob.org/babble/20220128/msgs/1119153.html
>
>
> - ScottKen Gillman suggests noritryptiline as a 'bridging' med. Do you have any thoughts on that ?
Posted by undopaminergic on March 29, 2022, at 10:29:08
In reply to Re: combining nardil and parnate » rose45, posted by SLS on March 29, 2022, at 9:28:11
> > >
> > > I think empirical observations trump theory.
> > >
> > >
> > > - Scott
> >
> > Thanks for the warning Scott. Im sure you are not the only one who has had a bad experience.
> > Interesting that Ken Gillman who is an expert on MAOIs seems to think that it is safe to cross-switch.
...
>
> 4. I would be very interested to know how Gillman came to his conclusion. Did he offer evidence for his rationale?
>https://psychotropical.com/swapping-from-one-maoi-to-another-maoi/
I suggest reading it in full and then reporting your experience to him. He might have relevant questions for you to consider, that may ideally lead to an explanation of this mystery.
"Empirical observations" cut both ways. In this case they would seem to suggest a direct switch is perfectly safe in the majority of cases, though without invalidating your experience.
-undopaminergic
Posted by PeterMartin on March 31, 2022, at 17:19:31
In reply to Re: combining nardil and parnate » undopaminergic, posted by SLS on March 28, 2022, at 10:51:55
I so appreciate you and your commentary. I am 100% in agreement over the risk here not being worth any potential benefit.
I've been lurking in the MAOI reddit group and it's scary how careless the posters can be. I don't understand it, really, because in 20 lyrs using this forum people were almost always looking to keep people safe. Over on Reddit it feels more like people are trying to get high.
I'm dreading the day someone dies from dumb advice about combining Nardil/Parnate w things they shouldn't be and it makes national news. Some of us rely on these medicines and they're always at risk based on low usage.
Oh and can totally confirm penial catheter is horrible. However, when you cannot pee and your bladder is full.....that's dangerous.
Posted by PeterMartin on March 31, 2022, at 17:24:27
In reply to Re: combining nardil and parnate, posted by undopaminergic on March 29, 2022, at 10:29:08
for his rationale?
> >
>
> https://psychotropical.com/swapping-from-one-maoi-to-another-maoi/
>
> I suggest reading it in full and then reporting your experience to him. He might have relevant questions for you to consider, that may ideally lead to an explanation of this mystery.
>
> "Empirical observations" cut both ways. In this case they would seem to suggest a direct switch is perfectly safe in the majority of cases, though without invalidating your experience.
>
> -undopaminergic
>Gilman isn't the end all be all when it comes to MAO inhibitors. I think SLS's comment about us not knowing all the properties of these drugs is critical. I was look up studies on Marplan a few weeks ago and was surprised to find it lowers the lethal dosage of Amphetamine by some ridiculous amount whereas Nardil and Parnate didn't......odd considerong everyone always says Marplan is "weak". We just don't know.
Random, by does anyone combine SSRIs? I don't recall hearing of that.
Posted by SLS on April 1, 2022, at 1:23:14
In reply to Re: combining nardil and parnate ) SLS, posted by PeterMartin on March 31, 2022, at 17:19:31
> I so appreciate you and your commentary. I am 100% in agreement over the risk here not being worth any potential benefit.
>
> I've been lurking in the MAOI reddit group and it's scary how careless the posters can be. I don't understand it, really, because in 20 lyrs using this forum people were almost always looking to keep people safe. Over on Reddit it feels more like people are trying to get high.
>
> I'm dreading the day someone dies from dumb advice about combining Nardil/Parnate w things they shouldn't be and it makes national news. Some of us rely on these medicines and they're always at risk based on low usage.
>
> Oh and can totally confirm penial catheter is horrible. However, when you cannot pee and your bladder is full.....that's dangerous.
---------------
Thank you, Peter Martin.I think many people see in themselves a network of pendulums that represent their going back and forth in various aspects of their belief system. This was truer of me in college than in retirement.
Earlier this evening, I was talking with my fiance, and we began discussing alternative depression treatments. A major part of the conversation was looking at hope. There are at least two types of hope that I understand: Blind Hope and Sighted Hope.
I relied on my eyes and intellect to find hope through the collection of information. I always had 1-3 drugs "on-deck" if the one I was trying failed. My doctor always said that we should just concentrate on the current treatment. Little did my doctor know that I had the ability to walk and chew gum at the same time. Sighted hope for me came in the form of a list of treatments that offered a potential success.
It is only when I am down to zero alternatives on my list that I default to blind hope in order to keep suicide off the list.
And herein lies a very real source of sighted hope that anyone can see the simple common sense being exercised...
One of my clinical research physicians at the NIH and I had a conversation that is perhaps the most hopeful of hopes:
For every new drug that becomes available, a certain percentage of people who had not responded to any previous treatmentx will respond to it who had been refractory to treatment.
- Scott
Posted by SLS on April 1, 2022, at 1:48:51
In reply to Re: combining nardil and parnate, posted by rose45 on March 29, 2022, at 9:30:12
> > > thank you all for your good wishes. I dont know what to do.
> >
> > http://www.dr-bob.org/babble/20220128/msgs/1119153.html
> >
> >
> > - Scott
>
> Ken Gillman suggests noritryptiline as a 'bridging' med. Do you have any thoughts on that ?
I would say the choice of a bridge drug would depend on the symptom cluster being treated. For instance, in the cases of a bipolar mixed-states, anger, or agitation, I think Zyprexa would make a better bridge than nortriptyline. However, nortiptyline would make a good bridge with a depression where melancholic symptoms predominate. I would also consider using an atypical neuroleptic - my tentative choices being asenapine (Saphris) and olanzapine (Zyprexa).
- Scott
Posted by Lamdage22 on April 1, 2022, at 1:50:13
In reply to Re: combining nardil and parnate ) SLS » PeterMartin, posted by SLS on April 1, 2022, at 1:23:14
True, you can also try Psychotherapy or lifestyle changes. Hope does not have to rely solely on new drugs. I only get excited when really new stuff comes out that does not go into the me-too category. Some meds are less 'me too' than others. Those are the ones that excite me. I would get excited for a Neuroleptic without metabolic side effects for example. Or PH94B for social anxiety.
> For every new drug that becomes available, a certain percentage of people who had not responded to any previous treatmentx will respond to it who had been refractory to treatment.
>
>
> - Scott
>
>
Posted by SLS on April 1, 2022, at 2:28:14
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 1, 2022, at 1:50:13
Hi, Lamdage.
> True, you can also try Psychotherapy or lifestyle changes. Hope does not have to rely solely on new drugs.
Absolutely! Great point. Thanks for adding it.
Obviously, you have a longer list of treatments than I do. It is so easy for me to forget about healing the psyche in order to prevent the psycho-social stress that can feed depression. I'm pretty sure there are lots of people who have a healthy brain and an injured psyche. AND there are people who need to target both the brain and the psyche.
- Scott
Posted by Lamdage22 on April 1, 2022, at 2:39:13
In reply to Re: combining nardil and parnate ) SLS » Lamdage22, posted by SLS on April 1, 2022, at 2:28:14
Well, I have basically declared my psychopharmaceutical treatment finished 6 years ago. I told myself all further improvement needs to come from non pharmaceutical measures. Med trials destabilized me and the bottom line is: Meds are just not that good for me.
Posted by Lamdage22 on April 1, 2022, at 2:42:54
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 1, 2022, at 2:39:13
I got personality issues, too though. You are not going to fix those with meds. It is not just strictly a mood or thought problem that is easy to fix medically.
Posted by undopaminergic on April 1, 2022, at 3:54:18
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 1, 2022, at 1:50:13
> True, you can also try Psychotherapy or lifestyle changes. Hope does not have to rely solely on new drugs. I only get excited when really new stuff comes out that does not go into the me-too category. Some meds are less 'me too' than others. Those are the ones that excite me. I would get excited for a Neuroleptic without metabolic side effects for example.
>There are already neuroleptics with low risk of weight gain. In a nutshell, they are drugs without antihistamine effects. Examples are haloperidol and amisulpride.
What would excite me more is antipsychotics without antidopaminergic effects.
-undopaminergic
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