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Parnate ( Tranylcypromine)

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Hey Syrinx,

It depends on the person, really, but I can tell you from personal experience Parnate worked again for me (it's the only antidepressant to EVER work for me!) after I was in the hospital and ripped off of 60mg cold turkey (I was unconscious so I didn't know they did something so horrible until I woke up three days later). I was put on a mood stabilizer instead for no reason, as well as Wellbutrin (no matter how many times they put me on it, it's just NOT going to work). Once I got out, I went back on Parnate, and it took a longer time and 20mg higher in dosing, but finally worked again just like it used to. Now I am not letting ANYONE take me off of it no matter what. They always want to switch me to Nardil because I have very serious anxiety, but just 1mg Klonopin, split in half, for the day is exactly what I need to abate both conditions. It also took a bit longer for Parnate to work, and was nerve-wrecking, but hang in there! It did and does work again indeed!

In solidarity,

Liliah

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I have been on sooo many meds for treatment resistant depression..anxiety. I ended up in the hospital where i finally agreed to ECT....After the black clouds .lifted they put me on parnate. This was almost 2 years ago and it is still working, it did take about 8 weeks for me to feel the change. dealing with depression is not and easy road but parnate makes the travel so much more tolerable. There are a lot of food restrictions but I have found that not all bother me. I take the whole 30ml in the morning so it does not effect my sleep plus I take 75ml of Seroquel at bed time and 25ml of Seroquel in the morning for anxiety. Hope this helps/////

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IN A NUTSHELL:

I stopped Parnate 3 weeks ago, but am feeling severely sick. I feel extremely nauseated, have:

insomnia, heart palpitations, night sweating, memory problems, difficulty coping with stress of any kind (extremely exaggerated response to it), feel faded and "out of it," emotionally numb to everything when the stress kicks in, nauseated eating, vomiting, feel close to confusion, feel like passing out all the time when the anxiety gets bad, and so on.

I was given

Klonopin and Xanax, but I don't want to become dependent on it... I have already been taking klonopin and xanax here and there for a few weeks to help deal with tapering off - now I can't get to sleep without it most nights. I read about PAWS (protracted withdrawal syndrome) and it scares me because it says it can be permanent. I can't imagine living a whole life like this :'( . I came to the Parnate because of depression, anxiety, and panic attacks, but how I used to feel even in that state is heaven compared to this. Some days I feel like I am going to die.

I have been trying to be conservative with the xanax and klonopin. I only take a fourth of a xanax pill if necessary if I have an instant panic attack or something. I take like a half of a klonopin (I think that it's 0.5mg so a half would be 0.25mg) to help sleep and get through rough patches but I seem to be needing more and more. I try to keep a "lid" on it, but sometimes the symptoms become so severe that I feel myself fading out due to the anxiety and I become so panicked that I don't know what else to do... Sometimes the Klonopin makes me feel "out of it" too. Zofran (anti-nausea) helps sometimes with eating. I'm trying to eat and drink to be healthy even if it means nibbling at something until it's gone.

Is it really true that this will continue on for 6 months to 10 years? I honestly am amazed that I have survived this week. I feel like my cognitive abilities and memory are slowly fading. Now I can't really even do simple logical things and put words together like I want to. :'(

I guess I'm posting because things are so severe that I am desperate for some sort of hope and reassurance... Sometimes I look online to get rid of the uncertainty but sometimes that just makes things worse because I read things like "may continue indefinitely." I used to be so solid in my logic and analytical skills, but maybe I was just using that to mask this problem and it's obsession... I'm trying so hard but this is so severe that I am amazed that I am still alive. Anybody have any advice or has anybody experienced something like this and gotten over it? I'm really scared :'(

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I had a reaction on Parnate after being on it less than 6 months. I had a horrible headache along with very high blood pressure. ER where I live gave me anough of some type of pills so I could make it to Atlanta, Ga. 5 hours away. Emory Hospital Psch Wing.

There they took me off the Parnate gave me enough meds to rest for about 3 days, got the blood presssure down and started me on the Emsam Patch. Stayed inhospital about 2 weeks.

I was on the Emsam Patch for about 2 years then had trouble with the patch staying on, in the heat and sweat of S. Ga. I then switched to Marplan for the last 8 or 9 years.

Hope this a Help. Hoping the best for You

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Wow. I was able to taper quickly off Parnate in October of 2012 no problem.

I once stopped Celexa cold turkey. For about 10 days I was a little headachy, a little nauseous, and had a weird visual disturbance where it was very irritating to rotate my eyeballs. And anytime I turned my head to look at something different, it took my brain about a second to catch up with whatever my eyes were looking at.

The worst experience I had was stopping Zoloft cold turkey. For two months I was dizzy, anxious, couldn't think, couldn't do much of anything. I was just zonked. Good thing I was unemployed at the time. But after two months it was all over.

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I had severe withdraw SSRI & SNRI too. I'm currently on Parnate. I think all the antidepressants give withdraw symptoms regardless of what the doctor tells you. Hang in there. It will get better.

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For TRMD some 'rogue' Dr's are rx'ing 120mg/d++ Parnate w/ positive results.

Anyone have high dose experience? Please elaborate.

60mg/d of Parnate for years never, ever lifted my severe lifelong TRMD.

FDA say's 60mg/d is max dose, however I wish I had had an enlightened MD who was in the know re/ dosage a decade ago.

Parnate was pure HELL to w/d off of which makes me reluctant to try again w/o reviews from others who had success on a high dose.

Hope this helps someone.

gravity

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For TRMD some 'rogue' Dr's are rx'ing 120mg/d++ Parnate w/ positive results.

Anyone have high dose experience? Please elaborate.

60mg/d of Parnate for years never, ever lifted my severe lifelong TRMD.

FDA say's 60mg/d is max dose, however I wish I had had an enlightened MD who was in the know re/ dosage a decade ago.

Parnate was pure HELL to w/d off of which makes me reluctant to try again w/o reviews from others who had success on a high dose.

Hope this helps someone.

gravity

Shamless BUMP....

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Re ddog's question: I have not had to go through what you have experienced with ADHD, so I cannot say from experience that Parnate would help with the attention deficit. However, I know that when I was severely depressed I could not read a book (and I have been an omnivorous reader all my life), or pay attention to anything, or remember anything, or think through a problem. So, if Parnate helps lift the depression you may find that some aspects of the cognitive problems get better. And then you and your doc will know what you need to tackle for the ADHD and OCD without the complicating cross-symptoms of the depression. My best wishes there.

Re gravity's question: I thank my stars that I have a doc who can be persuaded to try something she never tried before. I've been through the SSRIs, SNRIs, atypicals, two series of ECT, and two experimental trials. In most cases I got some benefit from the drugs, but the depression came back despite max dosages. Finally I went on Parnate. At 60 mg I had a modest response. My doc was thinking we would have to try a different MAOI, but I did some research on the web and found one or two medical papers and some forum chat about ultrahigh dosing. I don't have the URLs anymore, but see, for instance, this abstract: "Pharmacopsychiatry. 1989 Jan;22(1):21-5. High dose tranylcypromine therapy for refractory depression. Amsterdam JD, Berwish NJ. Department of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia." If you Google High Dose Parnate or High Dose Tranylcypromine you should be able to find more stuff. My doc agree to try higher doses with weekly meetings so she could monitor me. She had me take my blood pressure daily. She asked both my wife and me to agree to a very restricted diet until I was stabilized. And then we went up in dosage, slowly, to 120 mg/day. Twelve pills per day, since they only come in 10 mg! My pharmacist called my doc a couple of time to make sure the prescription was accurate! I've been on a high dose (100 mg/day at present) for over three years with no major recurrence of depression. This is about six times longer than I lasted on any other med. Next month I'm going to talk to my doc about dropping to 90 mg/day.

Insomnia is probably the major side effect, but I've gotten sort of used to it. There are some fairly new cognitive behavioral treatments for insomnia that have helped me some. Sleep meds just cause a rebound effect and I don't use them anymore. For days when I have to be highly alert all day I've tried Provigil 100 mg. It's a non-amphetamine med for people with narcolepsy or those who have to change the shift that they work, or who cross multiple time zones and have to stay awake. I can't say that it helped a lot, but I only took it once or twice.

Best of luck to all of you.

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I had severe withdraw SSRI & SNRI too. I'm currently on Parnate. I think all the antidepressants give withdraw symptoms regardless of what the doctor tells you. Hang in there. It will get better.

I've been on Parnate for about 5 years. It's worked a good deal longer than countless other ADs I've taken in the past, although like most people here these meds lose effect over time. I'm no stranger to AD withdrawal, but I feel stuck on Parnate because the Withdrawal is so devastatingly awful. I made it down to 20mgs a day, but had to go back up.

My only option would be to take 3 months FMLA from work, although I've not been able to save enough money to be out of work that long. Other meds in the past were rough in the withdrawal but Parnate I've found is 100% debilitating in it withdrawal. There is a newer SNRI I want to try, but I must be off Parnate for a few weeks before starting this new drug. Even then a gamble that in several weeks it would work for me. It's a shame as I did get a solid 3 years out of Parnate. I would warn anyone thinking of Parnate to understand when the time comes you need to change meds that the Withdrawal from this MAOI is about as close to Hell as can be imagined. I'm pretty sure once I do get completely off Parnate that I could even expect extremes such as hallucination, not to mention very little ability to stay awake.

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I have been on Parnate for 63 days (2 months, 4 days, started Feb. 2nd). Started at 10mg with an agonizingly slow titration of +10mg/~2 weeks. Now at 50mg, soon 60mg. I missed about 4 days in late March but reinstated.

The constant physical fatigue, weakness, and laziness started day 1 and hasn't improved. It is debilitating. My body feels so heavy. Also, libido and natural erections 90% reduced.

All (inconsistent) benefits: initially more positive, humorous, sociable and hopeful. Lowered social anxiety, more care-free, less irritable, less existential suffering.

It only minorly relieved anhedonia and did nothing for motivation. I've augmented it with Modafinil or caffeine which are mostly ineffective (I remain weak/tired).

Should I give it more time, and if so how much more time, and if the fatigue will go away, and if it will eventually give me motivation (of which I have none). Lack of motivation is my worst symptom. I want a natural drive to do things, and I used to get it with Adderall, which I obviously can't take right now.

Currently, I am majorly depressed and feel like it has "pooped out" almost completely. I am anhedonic and apathetic, but extremely tired 24/7.

I was just diagnosed with POTS/dysautonomia and they wanted to treat it with Effexor and Ritalin, so that would be my next option. I really can't stand this fatigue any longer, and I am extremely bored and sick of waiting around.

Edited by JCastro

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1 hour ago, JCastro said:

I have been on Parnate for 63 days (2 months, 4 days, started Feb. 2nd). Started at 10mg with an agonizingly slow titration of +10mg/~2 weeks. Now at 50mg, soon 60mg. I missed about 4 days in late March but reinstated.

The constant physical fatigue, weakness, and laziness started day 1 and hasn't improved. It is debilitating. My body feels so heavy. Also, libido and natural erections 90% reduced.

All (inconsistent) benefits: initially more positive, humorous, sociable and hopeful. Lowered social anxiety, more care-free, less irritable, less existential suffering.

It only minorly relieved anhedonia and did nothing for motivation. I've augmented it with Modafinil or caffeine which are mostly ineffective (I remain weak/tired).

Should I give it more time, and if so how much more time, and if the fatigue will go away, and if it will eventually give me motivation (of which I have none). Lack of motivation is my worst symptom. I want a natural drive to do things, and I used to get it with Adderall, which I obviously can't take right now.

Currently, I am majorly depressed and feel like it has "pooped out" almost completely. I am anhedonic and apathetic, but extremely tired 24/7.

I was just diagnosed with POTS/dysautonomia and they wanted to treat it with Effexor and Ritalin, so that would be my next option. I really can't stand this fatigue any longer, and I am extremely bored and sick of waiting around.

 

You've been on it just a little while longer than I have! lol I wish my pdoc had let my titrate up to the dose you're at, I'm only at 40 mg, and I still feel like I could use more.

I would see what your pdoc thinks about just adding Ritalin to your Parnate (stimulants, contrary to popular belief, can be taken with MAOIs). The Ritalin should not only help with the POTS/dysautonomia, at least somewhat if not fully, but also potentiate the antidepressant effect of Parnate, and would assist with the anhedonia and lack of motivation. If the Parnate remains ineffective after a period of time determined by your pdoc (I can't say as I'm not a professional), then you'll at least have the Ritalin on board to bridge you while you wash out the Parnate for two weeks and transfer to Effexor.

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I am considering switching to Parnate after failed attempts at nearly every other kind of medication including Ketmaine and ECT. I'm really scared about coming off my current medications because I am at least somewhat functional but not really alive. Did you have a problem with this? I'm very afraid of going to the dark place while I tapper off the SSRI's but I'm willing to do it if it gives me my life back  How is working for you now?

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On 6/2/2011 at 2:51 AM, Helios said:

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.

This is from info on Dr. Gillman's site, psychotropical.info 

I know this is a response to a very old question, but it may help someone out. 

Basically, it's all about quantity - yes, a small bite if cheese, no problem. A whole block of cheese, you'll end up in the Emergency Room. So be careful and very frugal with the foods on the no no list. You should be fine. 

On 6/2/2011 at 2:51 AM, Helios said:

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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On 6/2/2011 at 3:26 AM, Tim 52 said:

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

Parnate at 30 mg per day really made me, lose social phobia and I felt a sense of well-being. I a man and was able to feel emotions again. I could cry again and could do things impossible when  I was on SSRI's  as I suffer from social phobia. Parnate got rid of that pronto. Unfortunately after 3 months It "pooped out" om me.

Am scheduled for dTMS in a week so , but if it doesn't workout I will change to Nardil. I am pulling out ll the stops and will consider Vagus nerve stimulation  VS  as a option. ECT will be my last stop, as I dont wish to lose memories.

 

 

 

 

 

 

 

 

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ranger

I'm so sorry that Parnate stopped working for you.  it is so frustrating when a medicine that was helping stops helping.  I've had that experience twice. It sounds like you have a plan.  dTMS has helped alot of people and I hope you are one of them. 

Tim 

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On 5/24/2019 at 5:01 AM, ranger5500 said:

Am scheduled for dTMS in a week so , but if it doesn't workout I will change to Nardil.

How did it go!?

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