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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by PCH on July 1, 2004, at 15:50:41
I have been on this med for over five weeks. Quickly worked my way up to 60 mg in two weeks. Very little problems with side effects.
Ever since reaching 60 mg I have had to reduce the dose by about 10 mg every four or five days due to side effects(mainly confusion).
I have been on 15 mg for the past week. Things really seemed to be heading in the right direction. Now I am again confused and feeling over medicated. Plan to drop to 10mg. It only takes a day or two before I clear.
Has anyone had a similar experience or might understand what is happening? Has anyone experienced a positive result with Marplan at 10 mg. Each time the dose is lowered I do seem to benefit from this med for a few days.
Any input would be appreciated. Thanks.
Phil
Posted by bobbiedobbs on July 4, 2004, at 4:48:56
In reply to Marplan Dose Info - Please, posted by PCH on July 1, 2004, at 15:50:41
God, I'd like an answer to this and anything else about Marplan also. Not only can't I find much out, but my posts on this subject rarely even find their way on this site? Have you taken other MAOIs and how did they compare, particularly regarding the dosing. There can be quite a difference at certain levels based on my experience.
Question: What was your initially successful ramp-up dose strategy? Also, do you take the Marplan all at one time, or spread out in evenly divided doses? Hungry for info. Thanks, Phil B.
Posted by PCH on July 9, 2004, at 17:46:44
In reply to Re: Marplan Dose Info - Please, posted by bobbiedobbs on July 4, 2004, at 4:48:56
Sorry to be so late with my reply. I have been having difficulty w/ this med and felt with a few more days I could provide more information as to how it is working for me.
First I am Atypical and have had this depression for over 20 years. I have tried it all. My best response was to Parnate. This lasted for nine years. I had to stop the drug as I was approaching the doseage outer limits at 220 mgs. Even at this dose I was taking Wellbutrin and dexedrine.
After parnate I experienced only partial responses from dozens of other med trials.
As you noted, Marplan is somewhat of a hidden drug. There is information to be found on it though most of it is old. Some good information can be found on this site by doing a goggle search.
The most current studies suggest the best dose to be above 50mg. 60 is max recommended on the insert though I have heard of 80 and above not being uncommon. Suggested titration is 20mg. first week than adding 10mg. every week or so.
Normally I am very sensitive to ALL meds. With Marplan I ramped up to 60 in less than two weeks with mild side effects. After staying at this level for about a week I started to feel over medicated. Confusion, Memory problems, etc. I dropped 10mg and within 1 day noticed a clearing of side effects and began to think I was on to something positive.
After four or five days on a steady dose I would again feel over medicated and drop another 10mg and start to feel better in a day. This trend continued down to 15mg. I dropped to 10mg. and after 4 days I now find myself back in a deep depression.
As I had some positive results with this drug I am not yet giving up on it. I have worked myself back up to 20mg. over four days. Depression has yet to lift though no feelings of over medication. Hoping for a breakthrough in the next couple of days or I'll have to consider moving on to something else.
Ok, bottom line, my experience seems to be a bit bizzare. There has been enough response where I feel the drug is worth working with. I was amazed to see some results at the low end even for a few days. I would suggest you consider it. If it works the side effects seem to be minimal except for my feelings of being over medicated at times. The restricted diet is not a problem for me though it seems to be bothersome for others.
Some people swear by this med. and it is the only one that works for them. Of course as always, some are unable to tolerate it or it simply does not work for them. So far for me it has been a "teaser".
I spread my dose out over the day though I am told it can be taken all at once.
Sorry to make this such a long post though I hope it has been helpful. Phil H.
Posted by bobbiedobbs on July 10, 2004, at 0:06:39
In reply to Re: Marplan Dose Info - Please, posted by PCH on July 9, 2004, at 17:46:44
Thanks for your detailed response. Even though your experience is unique, it is helpful in that it is real life dose info, which I am starved for. I too am concerned about balancing effectiveness with side effects which themselves become problems. I've started slowly at 20 mg/day and already feel better - far less sensitive to what others' think and my overall environment. Thus far side effects have been tolerable but I figure they will hit once I get much higher, judging with my experience with the other MAOs. For me the cliff with Parnate was 40 mg/day, with Nardil, 45 mg. I didn't experience confusion as much as mania and complete sexual dysfunction (or more precisely, non) function. I'm going to gradually increase. Sounds like what you are doing is wise - ramping up to the point of tolerability, than dropping back. Except there's a lot of bouncing. What about remaining at a relatively low level - say 30-40 mg. for a week or so and seeing how that plays out - hopefully, you will become acclamated and less confused/disoriented, while gaining relief from the depression. Anyway, good luck to both of us. I am posting in the Yahoo MAO group but hardly anyone appears to have any experience with Marplan. Phil B.
Posted by PCH on July 10, 2004, at 1:15:38
In reply to Re: Marplan Dose Info - Please, posted by bobbiedobbs on July 10, 2004, at 0:06:39
I would not be too concerned with potential side effects. I think you may be surprised at how tolerable this med is. I have experienced no sexual dysfunction and little weight gain. Other than the confused states and some carbo cravings I give it an A+.
For more info. check out www.oxfordpharm.com
What is the link for the Yahoo MAO group?
Yes, good luck to us both.
Phil H.
Posted by bobbiedobbs on July 10, 2004, at 11:39:53
In reply to Re: Marplan Dose Info - Please, posted by PCH on July 10, 2004, at 1:15:38
Thanks for the encouraging info. The link - sorry it doesn't seem to paste - is:
http://health.groups.yahoo.com/group/maois/
Let me know if you still can't get to it.
Posted by bobbiedobbs on July 11, 2004, at 15:58:15
In reply to Re: Marplan Dose Info - Please, posted by PCH on July 10, 2004, at 1:15:38
another link for the MAO group on Yahoo is:
Posted by PCH on July 11, 2004, at 17:19:07
In reply to Re: Marplan Dose Info - Please, posted by bobbiedobbs on July 11, 2004, at 15:58:15
Thanks Phil. I note that you are / considering taking Klonopin w/ Marplan. I take .5 to 1.0mg of Klon for sleep. During the day I take either .25 of Klon or the same of Xanax as needed for anxiety. I prefer Xanax during the day as it works faster and has a shorter half life than Klon. Neither do I feel have caused any adverse reactions with Marplan. For myself I also do not
consider either of them to augment the antidepressant effect of Mar.As a curious side note, I have increased Mar dose from 10mg. (after finding myself going back into a serious depression)to 20 mg. for a couple of days and than 30mg. yesterday. Though things are still on the dark side, I do notice the beginings of a lift today. Hoping this continues without experiencing the side effects of over medication from the past.
Pdoc has also added Zonegran, a relatively new and interesting anticonvulsant that is starting to be used as a mood stabilizer. It is an add on for me as there are reports of it having antidepressant qualities. It's apparent that Marplan may represent only a partial solution for my situation.
Posted by bobbiedobbs on July 15, 2004, at 19:57:17
In reply to Re: Marplan Dose Info - Please, posted by PCH on July 11, 2004, at 17:19:07
PCH - How are you finding life on 30 mg. Marplan? That's the level I've been taking for about a week. It's definately diminished social anxiety; down side has been some mania and a bit of a haze/disconnection. I'm trying to acclamate at this level. The MAOIs bounce my neurons around in a way that the SSRIs couldn't touch. Phil
Posted by PCH on July 16, 2004, at 1:42:11
In reply to Re: Marplan Dose Info - Please, posted by bobbiedobbs on July 15, 2004, at 19:57:17
Thanks for asking. Wish I could report some positive results. Been at 30mg. for five days. After the initial small lift I have started to fade again. The side effects are also a bit different this time around. More somatic in addition to the confusion. This could be from the addition of the 50mg of Zonegran. Hard to tell. This is a low dose though I am very sensitive to most meds.
Not much left to try with Marplan, at least with regard to dosing strategies. For now I am stopping the Zonegran and raising the Mar to 35mg.
Hard to decide what to do. I know 40 is too much. I also may not have given 30 enough time. With several weeks under my belt I thought I would have seen more by now on this dose with less side effects, particularly as it's the second time up the ladder. If 35 doesn't provide some relief over the next week or so,(before possibly becoming over medicated)I may have to move on.
It's been a real teaser. Hope it works out for you. Keep in touch. Phil
This is the end of the thread.
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