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Parnate ( Tranylcypromine)

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I hear alot of reviews from people that Parnate is the most effective antidepressant ever. People who have been on meds 20 years and finally got relief. Is parnate really all that cracked up to be and the risks worth it? Is parnate and nardil really the last end of the rope before things like ECT and other non-medication procedures? It seems MAOIs have a hand over the newer antidepressants because the increase nearly all the Catecholamines instead of just one or 2. For people on MAOIs and people who have tried MAOIs what is your opinion on this?

Edited by Natasha1

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I was on Parnate a long time ago and felt it was very effective for both depression and anxiety. I truly felt like a different person (in a good way) on this medication. It didn't have many side effects except getting dizzy initially. I can't be on it now as I take other medication that would interact with it. I have tried other antidepressants and was on Prozac for a while, but I found the Parnate more effective. Hope that this helps.

April

I hear alot of reviews from people that Parnate is the most effective antidepressant ever. People who have been on meds 20 years and finally got relief. Is parnate really all that cracked up to be and the risks worth it? Is parnate and nardil really the last end of the rope before things like ECT and other non-medication procedures? It seems MAOIs have a hand over the newer antidepressants because the increase nearly all the Catecholamines instead of just one or 2. For people on MAOIs and people who have tried MAOIs what is your opinion on this?

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I was on Parnate a long time ago and felt it was very effective for both depression and anxiety. I truly felt like a different person (in a good way) on this medication. It didn't have many side effects except getting dizzy initially. I can't be on it now as I take other medication that would interact with it. I have tried other antidepressants and was on Prozac for a while, but I found the Parnate more effective. Hope that this helps.

April

I hear alot of reviews from people that Parnate is the most effective antidepressant ever. People who have been on meds 20 years and finally got relief. Is parnate really all that cracked up to be and the risks worth it? Is parnate and nardil really the last end of the rope before things like ECT and other non-medication procedures? It seems MAOIs have a hand over the newer antidepressants because the increase nearly all the Catecholamines instead of just one or 2. For people on MAOIs and people who have tried MAOIs what is your opinion on this?

interesting. Would you say it was the most effective AD you have taken? Is it worth the risks?

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I've taken MAOIs for over 10 years and am still convinced they were/are a real lifesaver for certain types of depression, especially for those who are suffering from considerable anxiety and/or phobias.

The reason I began taking MAOIs is that I became suddenly and overwhelmingly agoraphobic after 27 years of living in some really crowded places (London, Hong Kong, NYC). After a few months of trying to figure out what was I wrong, I began seeing a psychiatrist. He tried several of the older antidepressants (tricyclics) but they made things worse. So I eventually ended up taking increasingly higher doses of Xanax for the next three years.

It all came to a head when I went home to visit my mother and was unable to get myself back to the airport because of the agoraphobia. My then-husband came to collect me, then literally barged into the psychiatrist's office and demanded he try something new. The doc shrugged and put me on Marplan, another MAOI.

The change was really amazing - in 48 hours I was feeling better. In a week, the agoraphobia was 90% gone.

I eventually had to switch to Nardil when Roche stopped making Marplan, but in the last few years it's become available again. If anyone decides to try an MAOI, I would recommend Marplan first, as it didn't cause the weight gain problems I've had with Nardil. The weight gain isn't impossible to control, but Nardil definitely contributed to the problem. But it was a pretty small price to pay, considering the overwhelming relief the Nardil provided from the agoraphobia.

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This really makes me sad... it is great for you that have had success... it hasn't worked for me every time I go above 3 per day I get the worst headache and my bp goes up and along with that hasn't worked with my depression or phobias at all...I've already been through the ECT. So, I'm going to a local Univerisity Hospital for a second opinion - I'm so down, I have no idea what they are going to say.

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Parnate really worked very well for me for about 3 months then my blood pressure sky rocketed and had to get off imediately. The ER at the hospital in the rural area I live had no experience with MAOI's . Thought I was on" some kind of crazy medicine" that was his words.

I was given meds to bring down the blood pressure quickly but to no avail was shipped quickly to Emory University in Atlanta, Ga where my Pdoc is.

Long story short, I tried Emsam Patches ( another MAOI)for about 2 years worked great until the patches kept falling off, randomly.

I then went to Marplan it has been a good fit for me. The diet restrictions are worth the help MAOI's have given me.

Hope this helps you........

GOD BLESS

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Well, I went to my 2nd opinion appointment and as far as I can understand or remember the Dr. didn't think since I can only take 10mg 3x a day that it was doing much good so she recommednded adding Lythium (?) while coming off of Parnate to start Cymbalta and Abilify (I think)... I was so nervous because guess what... My regular Psych Dr.'s records never made it to her. I know at least one time I was in the hospital my Dr. had tried me on Cymbalta and apparently something didn't work because he took me off - This Dr. would have had sooooo much more important information if his records had made it to her. I don't blame him, I blame the social worker that was taking care of my referrals.... My regular PCP (God love him) sent his records, but of course they didn't have as much detail in them, at least he did tell her that I have been suffering from severe migraines since I was 15 and a little about the depression. I am so upset. I feel like I'm falling through the cracks. This referral Dr. gave the best she could I guess with the info she had, but I feel like it was wasted time. I'm not sure I told her I've been in the hospital 3 times, already, ect... She doesn't know that I feel like this is the end of the road for me. I won't hurt myself, I am just so exhausted trying to find the right combo - and Lord knows I've tried she asked me what meds I've tried and I gave her a piece of paper that she had to make a copy of, she didn't feel like hand writinig the whole list...see what I'm saying? I told her as much as I could under the circumstances. I don't remember a lot and I get that dang social phobia, so there is a lot of "uh huh" "uh huh" I apologize for going on and on....

Thanks for listening...

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I'm glad to read all of your posts. I'm probably starting Parnate in 2 weeks and I'm bummed out about the dietary restrictions and scared witless about the symptoms and results of a possible hypertensive crisis. But it seems at least some of you have good things to say about irreversible MAOIs.

Is the risk of hypertensive crisis related to the dose of the med you're on? Does the risk decrease at all over time? Does your body become able to handle an occasional presence of both the MAOI and some tyramine? Giving up cheese and pepperoni pizza would seriously suck. Of course, depression sucks too.

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Hi

I was on a high dose 90mgs and I was still able to eat marmite, cheese and red alcohol, but struggled with Coffee, I felt that the symptoms got worse the higher the dose of parnate. Once I did drink a strong coffee and a hour or so later became very nausious, dizzy a headache that felt that my brain was going to explode and my Blood Pressure went sky high. I was on my own when it happened and the only way to deal with it was to go to sleep for a couple of hours, my symptoms then lessened but my BP remained high for a couple of days.

From this experience I learnt that the dietary recommendations are there, but some of it is trial and error, and I have since learnt that if I had gone to ER they would have given me IV drugs to control the symptoms.

All of us are different, so even though I had a reasction when drinking coffee, it does not mean you will have that reaction - the same as pepperoni pizza, I could eat it, but someone else might not be able to.

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I've been doing a lot of reasearch into Parnate, and I've read a lot of good, and a lot of bad. It seems that some people have had good experience with it, but I went checking in my fridge for things that I couldn't eat anymore.

Imperial cheese is out, because it's an aged cheese, and my pepperoni is an aged meat so it's out.

I looked for things that have soybean oil, and I found: Soy sauce (obviously), Teriyaki sauce (naturally), French's Red Hot sauce, Loblaw's frozen chicken wings, ice cream, Eggo waffles, Nutrigrain cereal bars, Wonder bread, Schneider's hot dogs, and Pillsbury frozen microwave pizza.

After discovering this, it seems Parnate isn't an antidepressant as much as a chemical/biological weapon.

The only things in my fridge that didn't have cheese or aged meat or soybean oil were water, orange juice, milk, raspberry jam, Dijon mustard, Coke, Sprite, Tetley Iced Tea, Lay's regular potato chips, and Heinz ketchup.

So, it's like researching antidepressants in general. There's people who say they're great, and can help a lot, with minimal risk, then there's the warnings that you get with the medication which discounts probably 75% of everything humans eat.

I'm still reeling from the withdrawal effects of Zoloft, so I may delay going on Parnate another week. I hope Parnate is really good stuff, I really do. If I have to avoid obvious stuff like sauerkraut or tap alcohol or pure poy sauce, fine, I can handle that. I guess I just don't know what to expect.

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Hi,

I just started parnate yesterday, took 10mg in late afternoon. I felt GREAT yesterday, tons of energy, almost like I did when I first started wellbutrin.

I took 10mg this morning and 10 mg this afternoon and today I have felt nausea.

I finished chemo of 1/09 and have changed meds from prozac, to celexa, to effexor back to prozac. Long story, prozac is interfering with tamoxifen a breast cancer drug I take. Anyway I had to lay off prozac for 5 weeks before trying the EMSAM patch. It made me irritable.

Almost all of these meds made me have nausea. This is about the last resort, so I don't know if my stomach is extra sensitive because of chemo and I can't handle the meds and I'll have to rely on the good ole exercise or if I should stick it out a couple of weeks.

I'm about to the end of my rope with meds. I just don't understand because I felt soooo good yesterday. I didn't sleep as well as sometimes that makes me upset to my stomach too.

Thanks!

Jana

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Hi,

I just started parnate yesterday, took 10mg in late afternoon. I felt GREAT yesterday, tons of energy, almost like I did when I first started wellbutrin.

I took 10mg this morning and 10 mg this afternoon and today I have felt nausea.

I finished chemo of 1/09 and have changed meds from prozac, to celexa, to effexor back to prozac. Long story, prozac is interfering with tamoxifen a breast cancer drug I take. Anyway I had to lay off prozac for 5 weeks before trying the EMSAM patch. It made me irritable.

Almost all of these meds made me have nausea. This is about the last resort, so I don't know if my stomach is extra sensitive because of chemo and I can't handle the meds and I'll have to rely on the good ole exercise or if I should stick it out a couple of weeks.

I'm about to the end of my rope with meds. I just don't understand because I felt soooo good yesterday. I didn't sleep as well as sometimes that makes me upset to my stomach too.

Thanks!

Jana

Hi Jana,

Are you still taking Parnate? How is it going for you? Can I ask what you take it for? I am considering this med after most SSRI's and mirtazapine have failed for anxiety and depression.

As I havent tried parnate, I can only say that nausea can be a common side effect from any antidepressant in the beginning. I have experienced on nearly every med I have tried. Sometimes it goes away, sometimes it doesnt. My suggestion would be to take it after food, or, if it doesnt give you insomnia, take it at night.

I wouldnt be surprised if the chemo is contributing to your nausea.

Best wishes,

Miracle

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Hi,

I'm looking to ask people who are currently taking Parnate about the dietary restrictions they have due

to it being a MAOI.

Did you cut off a lot of things that you enjoyed eating?

Do you find it is worth being on Parnate despite the dietary restrictions?

Did it help with your current condition?

I am asking these because I am considering changing medications and/or possibly adding Parnate.

I am just a bit skeptical about it because I have heard and some info about it being dangerous(due to the tyramine)

if you eat certain foods while on it.

I don't eat cheese at all really and I don't drink alcohol however I am aware there are more food/beverage products than

just that.

I would appreciated any opinions on this, particularly people on Parnate.

Thanks.

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Helios:

I don't have experience with Parnate. I hope others that do provide you a helpful response.

Keep the conversation going with your doctor. It will help if he/she has experience with Parnate.

Wishing you the best,

Tim

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I am currently on EMSAM (12 mg), a transdermal MAOI formulation that is much safer in terms of dietary restrictions.

Although anything above the 6 mg/24 hr EMSAM dosage theoretically requires the same dietary restrictions as oral MAOIs, I have not experienced any reactions. After testing with small amounts, I now consume soy sauce, cheese, etc., as I did prior. This is just my experience, please don't take my word for it, talk with your doctor.

Parnate restrictions are much more serious and you really have to be diligent. That said, the statistics on MAOI-related injury don't match up with the popular fear.

Parnate specifically (as opposed to Nardil, Marplan, etc.) is supposed to be the best medication out there for certain types of depression, from what I've read. If other options have failed, I would definitely say try it.

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Hey,

I am currently on Parnate and it has worked in ways no other medication has. I am presently climbing to 80mg, and we really think this is the dosage that will do it. You have to take it slowly to test its effectiveness, just because MAOIs take some time to work. I should say Parnate was working for me completely perfectly; mind-blowingly, as the terrible urges and even thoughts were not there in the same dangerous way.

Here's what's not to great, personally. I had an allergic medical interaction, they took me off the Parnate "by accident." Then, they administered the wrong drugs, and by the time I made it to the psychiatric hospital, I had blood toxicity from the other hospital; an arm that was broken in five places (I eventually ripped a hospital gown and made a sling because it was not set for a week despite my pleas. Seriously. What, like, movie is this?)

I mean $hit, right?

I'm in the process of a medical malpractice case. It is triggering and awful but essential.

Sorry for that little tale...but that's why I am on Parnate for the second time...in two months.

The depression afterward was absolutely horrendous. I was put back on Parnate immediately, but even that week and a half off made a huge difference. I had to drop my dose and climb up again. This time, we are finding I need a little more, which my doctor thinks is natural and even reasonable, given post-psychosis PTSD (which can be helped!), and thus I am going to 80mg tomorrow. I think it's just wonderful. I have few side effects: seriously suppressed appetite and insomnia (but I have had long long insomnia, to be honest; this just dropped into high mode). At first, I felt heavy afternoon fatigue and hypotention that caused headaches and the like, but was fine after maybe a week. Just gone. I also take a wealth of vitamin supplements, as they are vital for health—especially on something like Parnate. I still take .5Klonopin for Anxiety, and also Sonata 10mg to sleep. I still barely sleep. In fact, I a, having a sleep study next because this is all too crazy.

Take a good look at the diet and think what is NOT on there. Truly, it is not a challenge, and somewhat good. It really forces you to eat more fresh foods and vegetables and fruits. I admit, though, that I have been vegan for years, so the only change I had to make was no more soy sauce, miso soup, tempeh. You can eat fresh tofu without issue but limited it to about two nigthts weekly. Yeah, those are all bummer. But nothing is worst than that dark fear; as bad as I've seen it get for me.

But the AD itself is fabulous, I think. I am excited to be back at the dose that I can notice is fully working. I literally noticed it. Strange moment, but who cares? :)

If you need information on Nardil, I have that as well (it finished runner up).

Feel free to send me a PM if you want.

Sincerely,

Liliah :flowers:

Edited by Liliah

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Hi

I've been on Parnate now for about four and a half weeks. I have been researching MAOI's since around 2004 and have only just managed to have a "pdoc" prescribe it. They all wanted to "try this first, or that first" -including ECT. I admit I gave up on some of the pdocs (who MIGHT have EVENTUALLY) agreed, and some of them gave up on me, (partly because I gave up on myself.

I had ( I guess I still do have, but I feel like it's finally managed) severe chronic "atypical depression". Slept way too much. Ate way too much. Wanted to die. (For a long time it meant I couldn't make it to appointments 'cos I couldn't even get out of bed). I feel like a different person now thanks to the Parnate, (yes, in that short amount of time!). And nothing has ever made this kind of difference to me. I've tried SO many other meds, SSRI's, SNRI's, Mood Stabilisers, Amphetamines, Sleep Meds, -You name it. Anyhoo, I'll answer your questions...

*Did you cut off a lot of things that you enjoyed eating?

So far, to a degree I have, but the more I read, the more confident I am to reintroduce a lot of the foods I've been avoiding. I really want to say here, research, research, research. Why? I could tell you what is ok and what is not, but who am I? Don't trust everything you read. Find the info on sites written by docs, researchers, drug companies as well as peeps like me. and of course, talk to your pdoc about it. For example, I thought I could only have ricotta & cottage cheese but I am now confident that I can have mozzerella (the fresher the better), american, processed, farmers, cream cheese & other cheeses in certain quantities. This means I CAN have my lasagne! And pizza (from major chains), etc. Some of the lists are SO outdated!!! Oh, and unless you eat rediculous amounts of chocolate, it's fine! Yay! Oh, and I can't do without my cups of tea! (some lists say no...pffft!)

*Do you find it is worth being on Parnate despite the dietary restrictions?

So far, OMG YES! I should add that for me, the dietary restrictions have played second fiddle to the Side Effects which have been more of an issue, but STILL WORTH IT! I've experienced insomnia (which I've never had before in my life!), but pdoc has given me some short term sleeping tabs. Another SE is hypotension... just gotta get up slowly so I don't feel like I'm going to black out. I've had some slight vision probs where I have to concentrate to focus on things rather than it just happening naturally. And at certain times of the day, pretty bad fatigue, (but different and not as bad as the type of fatigue caused by the depression itself). I have less appetite too, but seeing my appetite was rediculously high, it is a welcome SE.

*Did it help with your current condition?

So far, it has helped me more than any other medication I have ever been prescribed!!! The fact that I am up during the day, and have the energy and motivation to even write this is for me unbelievable. After all those years (half my life & I'm 35), I believe that I have found the med that corrects the problem in my brain. I still have issues, and am probably not even at my optimum dose yet, but I highly recommend this to ppl with "atypical" or "treatment resistant" depression.

Good luck with everything, Helios!

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Parnate has been the best antidepressant I've been on. I tried (in many different combinations and with other atypical & antianxiety drugs) all of the SSRIs, SNRIs, and all the Tricyclics. I started ECT a little over a year ago, which helped an incredible amount, but as the results started to fade, my doc added Parnate (in combination with maitenance ECT).

Parnate has been pretty good. I've been on in for aprox 5 months. The highest dose I've been on was 60 mg, but I began having a few blood pressure problems so we lowered it a little.

I'm only 17 years old, so I haven't had any alcohol problems. But the worst my blood pressure got was about 150/95. And that only happened a few times.

Overall, I haven't had too many problems. And I think it's helped more than its hurt. It's been the only antidepressant that's helped at all, which is saying something. It makes me have more energy and just sort of feel more positive overall. I would definitely recommend it, but be aware that taking it might involve some sacrifices. If you have soy sauce & alcohol every night and can't live without them, it might not be the right drug for you. But, I think there are a lot of benefits, and, though it takes a bit of extra effort to do so safely, I would definitely recommend taking Parnate if you've tried a few other antidepressants without any success.

Good luck!

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Hi swimfan

I'm interested in your pdoc suggestings ECT before parnate (I'm just starting parnate now). Do you know why it was this order?

Thanks!

TJ

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Hi swimfan

I'm interested in your pdoc suggestings ECT before parnate (I'm just starting parnate now). Do you know why it was this order?

Thanks!

TJ

I believe it was because I needed help FAST. I've been extremely suicidal for years, and I started ECT after a major overdose. The effects of ECT are felt pretty fast usually, and Parnate is a bit complicated to start I t hink because of the drug interactions. I felt the positive effects of ECT after about 1-2 weeks, and I attribute most of positive progress to ECT. I take a lot of meds in addition to ECT, but who knows if they're really helping. I haven't been off psych meds since 4th grade!!!

Currently I am taking 300 Seroquel XR, xanax, 900 lithium, 40mg Parnate, 125 mg Synthroid with 2-3 ECT treatments aproximately every 5 weeks...and this has been working pretty well for me.

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hi

Parnate is rather stimulating compared to Nardil and other MAOIs.

I read, that Parnate less likely causes hepatotoxicity as Nardil does.

I think you should talk to your pdoc about changing and adding meds like Parnate.

Regards

David

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Hi,

During my last session with my psychiatrist, I brought the subject that I always feel tired and fatigue on the following day after I take Mirtazapine 90mg.

He is reluctant to prescribe me stimulants ( like Ritalin, Modafinil and Dexamphetamine, as they are the only 3 medications used for ADHD and Narcolepsy).

The reason is, Because I am diagnosed as having anxiety, Panic Disorder and Depression.

So augmenting it with stimulants is a bad idea.

But, he said that he is willing to change all my medication, and put me on Parnate.

My question is, to those who are using Parnate:

1. Does it give insomnia?

2. Do you find it worthy to sacrifice your favorite food just for Parnate?

3. We all sometimes go out for Dinner with friends, and sometimes we can not choose the food that is low in Tyramine. So, Has anyone suffer from hypertensive crisis while having Dinner out with friends?

Thanking each one of you who will give an opinion about this subject.

Kind Regards,

Dave

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Hey there,

I have been on Parnate since January (I am currently on 80mg) and it has given me my life back. For me, this has, by far, been the most effective medication I have ever been on; prior to this, I had taken Emsam, which ultimately pooped out, and a slew of SSRIs and the like that did absolutely nothing to improve my depression. After being hospitalized and taken off of three medications that were a great disservice to my mind and body

Tyramine Menu Book 06227101.pdf

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Hey there,

I have been on Parnate since January (I am currently on 80mg) and it has given me my life back. For me, this has, by far, been the most effective medication I have ever been on; prior to this, I had taken Emsam, which ultimately pooped out, and a slew of SSRIs and the like that did absolutely nothing to improve my depression. After being hospitalized and taken off of three medications that were a great disservice to my mind and body

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Oh i forget something, Liliah.

So, Does your Pdoc prescribe you with Adalat?

( btw, until now, I don't know what Pdoc stand for. Is it Psychiatrist Doctor?)

Kind regards,

Dave

Edited by lindahurt

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