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MAOIs, and PDoc Rant » JadeKelly

Posted by Questionmark on October 31, 2008, at 17:31:41

In reply to Re: MAOI Experts: Combining Parnate with Selegilin, posted by JadeKelly on October 31, 2008, at 11:51:29

"Its always strange what pdocs will do. Seems its way over the top, or their stingy to the point of not being effective."
Hah, well said. That So often seems to be the case. Yeah, going from Nardil straight to Parnate the very next day is Not a good idea, even only being on it for a week and a half. They are entirely different drugs. But of course i'm sure the dr just assumed (note: change dialect) "Well this hEre's an MAOI, and this HERE's an MAOI, so it must be fine to switch the two right away." I mean, i'm glad s/he's willing to use MAOIs, but come on.
And why the h*ll would s/he start uncouth on 90mg of Nardil within the first two weeks?? Of COURSE a person's gonna have bad side effects!! You know, i swear to god there are a number of PsychoBabble posters here who would be better psychiatrists than the average one out there-- including myself, i believe (maybe not w/ all the paperwork and all the other b.s. that probably goes with it, but in terms of helping people better their lives and their psychological well-being, absolutely). Where do these guys come from?? What do they actually Learn in Medical School for !@#$'s sake?
I guess it just illustrates how there's only so much you can learn conceptually compared to experientially.
Well, real quick, all you current or future psychiatrists out there (and other medical doctors for that matter), lesson #1 in Questionmark's "Clinical Psychiatry" course: *Always remember that whatever you have read or been taught about a drug's effects only goes so far without actually having had experienced the effects first-hand.*
Okay that's not exactly completely relevant to the example here with uncouth's pdoc, but, it is very very often relevant. .. Ok i'm an idiot. Sorry for ranting.
Anyway, uncouth, best of luck with the Parnate, but if it happens to not work for you, please don't hesitate to try Nardil once again except at a lower dose-- like 45 or 60mg. I would say everyone should always start with a maintained dose of 45mg for at least a month, with Nardil, until trying to determine if you might need a higher dose.
Be well.


> > Well, I've been on parnate for two months. I moved to 40mg of parnate from 90 mg of Nardil which wasn't working (though I only gave the nardil 90mg for about a week and a half). I had bad side effects on Nardil. however, my pdoc did a overnight switch to 40mg of parnate, so I think the nardil effects were still somehow in my system for a week or two, as I had really bad side effects (orthostatic hypotension) at 40mg. That eventually went away after about three weeks, though I admit my mood was the best when i had the physical side effects.
> >
> > Thats why i'm going back up to 50mg of parnate, and maybe 60. I think at 40 i definitely feel something and it is helpful, but it is only partial, i do feel a bit of a poop out.
> >
> > I'm also on abilify and lithium. The abilify did help with the obsessive thoughts when i added it to parnate. I'm taking it at 5mg which seems to be the standard for a/d augmentation, though 10mg and 2mg are also used. It's a weird drug but I think it's worth every penny.
>
> Its always strange what pdocs will do. Seems its way over the top, or their stingy to the point of not being effective. I've only had one but I've read a lot of stories here. How strange that he would switch you overnight.
>
> Like you, some of my best days on Parnate are full of side effects! Ex: I've been up all night and here I am, babbling on...:). Insomnia plagued me the first time around but only for a few days. I suspect it will be gone soon. I always have to laugh when I see a poster who ditches an effective dose of MAOI because of the diet! Maybe its just me, but I'd eat blueberries all day if this depression would go away!
>
> Well I'm sorry to hear your Nardil & Parnate aren't what they were, but you got me thinking about weight. Do you know if MAOI dose is at all based on that? Because if it is, I started at 30mg, and you're only at 40? Seems you may have plenty of room to go up.
>
> I know someone who was on abilify for Bi-Polar, his dose would have been much larger than yours but he was a walking zombie on that stuff. He went from slim to a 25lb weight gain. He's great now, on 30mg of seraquel, he lost about 1/2 the weight and acts like himself.
>
> I have to say I'm surprised that Abilify would enhance an AD. Doesnt it block dopamine, especially for mania? Maybe its the low dose?
>
> Sorry for the lengthy post. I blame it ALL on Parnate. Good luck to us, heh?!
>
> Jade


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poster:Questionmark thread:858948
URL: http://www.dr-bob.org/babble/20081027/msgs/860100.html