Social Anxiety Support

Medline · 01-22-2009, 09:34 PM

In clinical trials high doses of Parnate were well tolerated. At higher doses Parnate starts to act not just as a MAOI but as a NARI too, therefore reducing the likelihood of a tyramine-induced hypertensive crisis.

Bluemeow · 07-02-2009, 01:22 AM

Quote:

Originally Posted by Medline

In clinical trials high doses of Parnate were well tolerated. At higher doses Parnate starts to act not just as a MAOI but as a NARI too, therefore reducing the likelihood of a tyramine-induced hypertensive crisis.

I know I'm reviving an old thread here, but I would like to know what study you are citing which indicated that Parnate at high doses starts to act like a NARI too?

If you happen to remember that link you found way back in January, I'll be very impressed!

I'm interested in this because I just started Parnate, and well, it hasn't been smooth sailing so far. I need something to spur me on and remind me I need to give Parnate a fair chance. I can put up with a few rough weeks if I believe there's a good possibility of improvement down the road.

Thanks

IllusionalFate · 07-02-2009, 02:30 AM

This thread sounds EXACTLY of what Nardil is like for me (75mg). I can't even see anything since the orthostatic hypotension is so bad, and it persists long after standing up so I only can see bright colors or a dark gray until I can get blood to my head (by leaning forward or lying down for instance). I'm also having comorbid ADD which I've never experienced at ALL before trying Nardil. I think this may be due in part to the cognitive blunting induced by the drug.

Medline · 07-02-2009, 03:14 AM

Quote:

Originally Posted by Bluemeow

I know I'm reviving an old thread here, but I would like to know what study you are citing which indicated that Parnate at high doses starts to act like a NARI too?

If you happen to remember that link you found way back in January, I'll be very impressed!

Thanks

This is data from the German manufacturer of tranylcypromine. The website is www.jatrosom.de , the info is from the section for medical professionals only (http://www.jatrosom.de/jat20mg_log.html), but one can login with Username: jatrosom & Passwort: jatrosom or just jump directly to http://www.jatrosom.de/faq.html

Quote:

Was unterscheidet Jatrosom® von anderen irreversiblen MAO-Hemmern, wie Phenelzin?

Chemisch unterscheidet sich Tranylcypromin von Phenelzin und anderen irreversiblen MAO-Hemmern v.a. wegen einer fehlenden Hydrazineinheit. Das steht im Zusammenhang mit einem sehr geringen Risiko hepatischer Toxizität von Tranylcypromin, wobei aber die älteren Fälle von Lebertoxizität mit Phenelzin zumeist auf die früher übliche Komedikation mit Barbituraten zurückzuführen sind. Höher dosiertes Tranylcypromin ist in präklinischen Tests zusätzlich ein Noradrenalin-Wiederaufnahmehemmer und indirektes Sympathomimetikum (amphetaminartig). Inwieweit dies Relevanz für die klinischen Unterschiede der beiden irreversiblen MAO-Hemmer hat, ist unklar. Bei höheren Dosen, und bestenfalls nur beschränkt auf die kurzen Zeiten der Maximalplasmaspiegel, könnten die zusätzlichen noradrenergen Eigenschaften sowie eventuell auch sehr schwache amphetaminartige Wirkungen auftreten. In diesem Sinne könnte Tranylcypromin als MAO-Hemmer mit zusätzlichen „pulsierenden“ monoaminergen Effekten bezeichnet werden.

Riederer P, Lachmayer L, Laux G. Clinical application of MAO-Inhibitors. Curr Med Chem 2004; 11: 2033-43

I will translate later, if I have to do.

Vincent_32 · 07-02-2009, 05:34 AM

Well my Parnate experience turn to be the worse thing I live in my life...

And sure, above the 40 mg, it have a high effect on the NE...and strangely, it's more sedative.... and more powerfull than the Nardil, since at 20mg of Parnate I had severe hypotension orthostatic problem with hypertensive crisis that happen for no reason (not from the foods to avoid), something that only happen at 90mg of Nardil... BUT the Nardil never leave me with a blood pressure problem after I try it... and never help for the SAD anyway...

I used the Parnate only one month and it leave me with a permanent increase blood pressure... Related to the NE effect??? Maybe... the PDoc or the GP don't know....

Since my primary problem is SAD with panic disorder, the heart is an issue... I can't stop focusing on this, so I have often panic attacks trigger by this high blood pressure... so when I want to hit the gym and do cardio exercises, I ending almost each time by doing panic attacks... and when I drive the car also... who can be very dangerous because if I do a car accident, I can kill or hurt someone... I don'T care about my self than... but I care about the other peoples....

After the Parnate, I was put on the Clomipramine, an old TCA , but I was not able to take the side-effects of it... blood pressure again...

We try severals meds to reduce the blood pressure, Clonidine is one of them but never succeed to reduce it...

So I had a couple of months free of any AD's... and decide next week to start the Imipramine, who is another old TCA, but more tolerable than the Clomipramine... We all know that TCA's are not good for the SAD... but very effective for panic disorder with agoraphobia and panic attacks (trigger or not)...

For now, i'm on a low dose... 25mg x 2 by day... and it's very easy to take... I also use a Parkinson med at the same time, it's call "Mirapex"... that increasing the DA level (D3 mostly)... since SAD is often linked to a bad DA pathway...

I have no real side-effects, just strange sensations on my head (goosebumps feeling)... and no effect on my heart, who is strange cause the Tofranil (Imipramine) produce a metabolite who is call Despiramine (another old TCA affecting more the NE than anything else)... so the High blood pressure is maybe not related to the NE effect...

I suspect that the Parnate just leave me in a bad mental state, increasing my panic disorder problem and starting me focusing only on my heart.... and since the panic disorder can make a person more easy to always focus on the body sensations, I figure out that my panic attacks and high blood pressure is purely psychological... Well, I have HBP, since I monitor it often each day, but it's produce by psychologicals issues more than physicals issue.

They do on me a ECG or EKG (heart test) and everything is ok...

Anyway... what I can say is that peoples are very different... someone can deal with MAOI's... others don't... the heart effect (hypotension or hypertension) is a major problem for the MAOI's meds...

Why I choose the Imipramine, even if I know it's less effective for the SAD? Because my main problem for now is panic disorder (including panic attacks that happen suddenly or sometimes because of negatives thoughts about the heart issue)... I think the SAD can be well treat in CBT when the panic disorder is well treat with a good med, or sometimes a combo (2 meds at the same time)...

TO be honnest, I will never return on a MAOI's... Parnate or Nardil or even the Emsam patch, who are very expensive for nothing anyway...

Dealing with a lot of comorbidities (SAD, GAD, panic disorder with agoraphobia and panic attacks, body dismorphic...) make the choice of a med to be very complicated...

Anyway... that's an old thread... I didn't even remember that I start it !!! lol

Poor memory... thanks for the benzos drugs to make me acting like a dumb!!! ;-)

Well, I wish good luck to everyone who try the Parnate... it can be very effective... but also very nasty... just be sure to monitered your blood pressure often on it and make sure everything is ok... if you feel that something is wrong, or have severals hypertensives crisis without foods interractions, just stop it, that med is not for you ... Consider to try the Nardil first, who have less side-effects...

Bluemeow · 07-02-2009, 10:42 PM

Medline, thanks for the information. I plugged the text into Google translator and I think I got the gist of it.

Vincent 32, thanks for sharing your experiences. I now how tough it is to find the combination of med's when you've got more than one issue to deal with. I have a some endocrine disorders which makes my med search a challenge too.

07-02-2009, 05:34 AM	#25 (permalink)
Vincent_32 Status: SAS Member Join Date: Dec 2008 Location: Quebec, Canada Gender: Male Posts: 6	Parnate (the pros and cons) Well my Parnate experience turn to be the worse thing I live in my life... And sure, above the 40 mg, it have a high effect on the NE...and strangely, it's more sedative.... and more powerfull than the Nardil, since at 20mg of Parnate I had severe hypotension orthostatic problem with hypertensive crisis that happen for no reason (not from the foods to avoid), something that only happen at 90mg of Nardil... BUT the Nardil never leave me with a blood pressure problem after I try it... and never help for the SAD anyway... I used the Parnate only one month and it leave me with a permanent increase blood pressure... Related to the NE effect??? Maybe... the PDoc or the GP don't know.... Since my primary problem is SAD with panic disorder, the heart is an issue... I can't stop focusing on this, so I have often panic attacks trigger by this high blood pressure... so when I want to hit the gym and do cardio exercises, I ending almost each time by doing panic attacks... and when I drive the car also... who can be very dangerous because if I do a car accident, I can kill or hurt someone... I don'T care about my self than... but I care about the other peoples.... After the Parnate, I was put on the Clomipramine, an old TCA , but I was not able to take the side-effects of it... blood pressure again... We try severals meds to reduce the blood pressure, Clonidine is one of them but never succeed to reduce it... So I had a couple of months free of any AD's... and decide next week to start the Imipramine, who is another old TCA, but more tolerable than the Clomipramine... We all know that TCA's are not good for the SAD... but very effective for panic disorder with agoraphobia and panic attacks (trigger or not)... For now, i'm on a low dose... 25mg x 2 by day... and it's very easy to take... I also use a Parkinson med at the same time, it's call "Mirapex"... that increasing the DA level (D3 mostly)... since SAD is often linked to a bad DA pathway... I have no real side-effects, just strange sensations on my head (goosebumps feeling)... and no effect on my heart, who is strange cause the Tofranil (Imipramine) produce a metabolite who is call Despiramine (another old TCA affecting more the NE than anything else)... so the High blood pressure is maybe not related to the NE effect... I suspect that the Parnate just leave me in a bad mental state, increasing my panic disorder problem and starting me focusing only on my heart.... and since the panic disorder can make a person more easy to always focus on the body sensations, I figure out that my panic attacks and high blood pressure is purely psychological... Well, I have HBP, since I monitor it often each day, but it's produce by psychologicals issues more than physicals issue. They do on me a ECG or EKG (heart test) and everything is ok... Anyway... what I can say is that peoples are very different... someone can deal with MAOI's... others don't... the heart effect (hypotension or hypertension) is a major problem for the MAOI's meds... Why I choose the Imipramine, even if I know it's less effective for the SAD? Because my main problem for now is panic disorder (including panic attacks that happen suddenly or sometimes because of negatives thoughts about the heart issue)... I think the SAD can be well treat in CBT when the panic disorder is well treat with a good med, or sometimes a combo (2 meds at the same time)... TO be honnest, I will never return on a MAOI's... Parnate or Nardil or even the Emsam patch, who are very expensive for nothing anyway... Dealing with a lot of comorbidities (SAD, GAD, panic disorder with agoraphobia and panic attacks, body dismorphic...) make the choice of a med to be very complicated... Anyway... that's an old thread... I didn't even remember that I start it !!! lol Poor memory... thanks for the benzos drugs to make me acting like a dumb!!! ;-) Well, I wish good luck to everyone who try the Parnate... it can be very effective... but also very nasty... just be sure to monitered your blood pressure often on it and make sure everything is ok... if you feel that something is wrong, or have severals hypertensives crisis without foods interractions, just stop it, that med is not for you ... Consider to try the Nardil first, who have less side-effects...

01-22-2009, 09:34 PM	#21 (permalink)
Medline Status: SAS Member Join Date: Sep 2008 Gender: Male Posts: 1,865	In clinical trials high doses of Parnate were well tolerated. At higher doses Parnate starts to act not just as a MAOI but as a NARI too, therefore reducing the likelihood of a tyramine-induced hypertensive crisis.

07-02-2009, 02:30 AM	#23 (permalink)
IllusionalFate Status: Equilibrian Epicurius Join Date: Sep 2008 Location: Western NY Gender: Male Age: 20 Posts: 783	This thread sounds EXACTLY of what Nardil is like for me (75mg). I can't even see anything since the orthostatic hypotension is so bad, and it persists long after standing up so I only can see bright colors or a dark gray until I can get blood to my head (by leaning forward or lying down for instance). I'm also having comorbid ADD which I've never experienced at ALL before trying Nardil. I think this may be due in part to the cognitive blunting induced by the drug.

07-02-2009, 10:42 PM	#26 (permalink)
Bluemeow Status: SAS Member Join Date: Apr 2009 Posts: 37	Medline, thanks for the information. I plugged the text into Google translator and I think I got the gist of it. Vincent 32, thanks for sharing your experiences. I now how tough it is to find the combination of med's when you've got more than one issue to deal with. I have a some endocrine disorders which makes my med search a challenge too.