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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Willyee on November 9, 2004, at 22:24:58
Seeing how long and touchy the previous Maoi thread was i kinda feel guilty about this one,i do however have a quick question.
My main augment of parnate for a while was vivaran,it seemed to jumstart the medication,however vivarin of course is not something you wanna take a lot of,so i was looking for something to replace it,mainly because if i take parnate,plus a small beta blocker the two inhibit each other and any stimulate effect is gone.
My question is,and i hope i spell this right,but why start worrying now right??.......Tagamet,the stomach acid medcine thats over the counter,for whatever reason i took it once,felt better and looked in to it.Seems to have some Anti-histamine actions.Nevertheless i have been using it in place of vivarin with parnate,and it seems to work just as well,for the moment anyway.
The jury is still out,with parnate you never know when it will decide to take a sharp u-turn,but what i am curious of is has anyone heard of tagamet being used in any emotional disorder,as an augment,or in any way whatsoever.
I did a search and did not find it mentioned useful for anything but stomach relief.The pharmcology of it however describe some pyscho active action.
So once again anyone hear of using this,more importantly,and my priotrity of the question is ,IS THERE ANY HARM in me taking this medicine daily,anymore harm on the body or liver than say a ssri or any other medication taken daily.
Id hate to have to chuck it,for now it seems to be smoothing out the parnate,i almost hate to even say the words in fear of jinxing it.Thank you.
Posted by Chairman_MAO on November 10, 2004, at 10:39:43
In reply to Not trying to start another Maoi novel,but........, posted by Willyee on November 9, 2004, at 22:24:58
You do not want to take H2 blockers long-term without a reason; there is plenty of side effects, but I am not knowledgeable enough about H2 blockers to give a coherent answer on this topic.
As to enhancing the Parnate, I suspect that raising the pH of your stomach allows for better and quicker absorption. I know that many amphetamine abusers take Tagamet or other antacids to do this, and then also basify their urine to slow excretion. Why not just raise the dose of Parnate? You can take up to 200mg/day without even thinking about toxicity.
--cm
Posted by Willyee on November 10, 2004, at 10:49:27
In reply to Re: Not trying to start another Maoi novel,but...., posted by Chairman_MAO on November 10, 2004, at 10:39:43
> You do not want to take H2 blockers long-term without a reason; there is plenty of side effects, but I am not knowledgeable enough about H2 blockers to give a coherent answer on this topic.
>
> As to enhancing the Parnate, I suspect that raising the pH of your stomach allows for better and quicker absorption. I know that many amphetamine abusers take Tagamet or other antacids to do this, and then also basify their urine to slow excretion. Why not just raise the dose of Parnate? You can take up to 200mg/day without even thinking about toxicity.
>
> --cmThat makes a lot of sense,thank you.Is there any other way to raise the PH in ya belly without an anti-acid.
I am hesititant to raise the parnate anymore than i am,for one reason i would have to explain the raise the my prescribing doc,and i doubt id have an easy time getting another docter to A prescribe it,and b let me control my dosage.
More importantly however,is adjusting my parnate dose has been painstakiing,it does not seem to be a medication as simple as raising,parnate seems to have different effects at different dosages,be it lower or higher,when i raise it to much it becomes more inhibitory and actualy depresses me.What a catch 22 huh lol.
Posted by Chairman_MAO on November 10, 2004, at 11:37:03
In reply to Re: Not trying to start another Maoi novel,but...., posted by Willyee on November 10, 2004, at 10:49:27
I think I recognize your posting style and content from certain groups on USENET. Please email me at gbr12909@yahoo.com if you are who you might guess I think you are. We have a lot to talk about.
Posted by King Vultan on November 10, 2004, at 12:28:31
In reply to Re: Not trying to start another Maoi novel,but...., posted by Chairman_MAO on November 10, 2004, at 10:39:43
> You do not want to take H2 blockers long-term without a reason; there is plenty of side effects, but I am not knowledgeable enough about H2 blockers to give a coherent answer on this topic.
>
> As to enhancing the Parnate, I suspect that raising the pH of your stomach allows for better and quicker absorption. I know that many amphetamine abusers take Tagamet or other antacids to do this, and then also basify their urine to slow excretion. Why not just raise the dose of Parnate? You can take up to 200mg/day without even thinking about toxicity.
>
> --cm
Taking above 100 mg/day of Parnate seems to increase the risk of abuse and tolerance, and I guess I might also be concerned about a greater risk of mania and/or hypomania in susceptible individuals. Cost is another factor and may be prohibitively high, depending on one's insurance. In the US, the cash price for a month's supply of Parnate even at 100 mg/day is approximately $280, assuming other pharmacies charge about what Walgreen's does.Todd
Posted by Willyee on November 11, 2004, at 19:31:39
In reply to Do you post on USENET? » Willyee, posted by Chairman_MAO on November 10, 2004, at 11:37:03
> I think I recognize your posting style and content from certain groups on USENET. Please email me at gbr12909@yahoo.com if you are who you might guess I think you are. We have a lot to talk about.
If by writing style you mean horrendous grammer and incoherant rambling then yeah im probuably who youre thinking of.
I still use usenet,its just the group in question is no longer a resource,i only post to a group if i feel it is a resource,if either im getting something from it,or someone is getting something from my post,now its just mostly trolls there.There are one or two groups tough that ill ocassionaly post too.
I will e-mail you the moment i have some time and privacy which isnt often enough.
Oh lastly i dident change my handle to be annoymonous,i just wanna move away from that whole name history,i know i had some intense flames wars over there in the past,i dont want anyone thinking thats the type of person i am.
Posted by Chairman_MAO on November 12, 2004, at 7:51:32
In reply to Re: Not trying to start another Maoi novel,but.... » Chairman_MAO, posted by King Vultan on November 10, 2004, at 12:28:31
Why does going over 100mg/day increase the likelihood of abuse? I suppose we have to define what abuse is; it certainly can't be defined as going over 100mg/day for purposes of this discussion ... :) Does it really matter how much Parnate someone takes so long as they're not having any side effects?
I agree with you about the [hypo]mania thing, more or less.
Posted by King Vultan on November 12, 2004, at 21:11:49
In reply to Re: Not trying to start another Maoi novel,but...., posted by Chairman_MAO on November 12, 2004, at 7:51:32
> Why does going over 100mg/day increase the likelihood of abuse? I suppose we have to define what abuse is; it certainly can't be defined as going over 100mg/day for purposes of this discussion ... :) Does it really matter how much Parnate someone takes so long as they're not having any side effects?
>
> I agree with you about the [hypo]mania thing, more or less.
The higher the dosage, the more likely someone susceptible to Parnate's "amphetamine high" will experience this and be tempted to abuse it. The definition of abuse in "Essential Psychopharmacology" is defined as "the self-administration of any drug in a culturally disapproved manner that causes adverse consequences." I certainly don't think people need to stick to the measly 6 pills a day maximum in the PDR, but since the vast majority of Parnate users seem to do pretty well at dosages of 80 mg/day or less, and given that the drug has documented instances of abuse (fairly rare, though--approximately 18 reported cases through 1998), 100 mg/day seems to be a reasonable upper limit IMO, as a general rule. Of course, there may be some individual cases where it is justifiable to exceed that, but as in any situation where one is exceeding a drug's recommended dosage, it seems wise to observe prudence and caution.Todd
Posted by SLS on November 13, 2004, at 7:58:29
In reply to Re: High Parnate dosages » Chairman_MAO, posted by King Vultan on November 12, 2004, at 21:11:49
> > Why does going over 100mg/day increase the likelihood of abuse? I suppose we have to define what abuse is; it certainly can't be defined as going over 100mg/day for purposes of this discussion ... :) Does it really matter how much Parnate someone takes so long as they're not having any side effects?
> >
> > I agree with you about the [hypo]mania thing, more or less.
>
>
> The higher the dosage, the more likely someone susceptible to Parnate's "amphetamine high" will experience this and be tempted to abuse it. The definition of abuse in "Essential Psychopharmacology" is defined as "the self-administration of any drug in a culturally disapproved manner that causes adverse consequences." I certainly don't think people need to stick to the measly 6 pills a day maximum in the PDR, but since the vast majority of Parnate users seem to do pretty well at dosages of 80 mg/day or less, and given that the drug has documented instances of abuse (fairly rare, though--approximately 18 reported cases through 1998), 100 mg/day seems to be a reasonable upper limit IMO, as a general rule. Of course, there may be some individual cases where it is justifiable to exceed that, but as in any situation where one is exceeding a drug's recommended dosage, it seems wise to observe prudence and caution.
>
> Todd
Hi Todd.I was up to 150mg of Parnate for a few months, and never experienced a tendency to abuse it. Of course, I'm just one person. I'm still undecided as to whether or not Parnate is metabolized into amphetamine. The older literature says yes; the newer literature says no. When I discontinued the high-dosage Parnate treatment using a rapid taper, I experienced a profound fatigue that lasted at least one week. From what I can see, though, the potential benefits of using the high-dosage strategy in TRD outweighs the risk of abuse.
- Scott
Posted by Dreyfus on November 13, 2004, at 11:43:41
In reply to Re: Not trying to start another Maoi novel,but...., posted by Chairman_MAO on November 12, 2004, at 7:51:32
CM,
How long did it take you to get from 80mg to 200mg? Any side effects on the way up?
Michael
Posted by King Vultan on November 13, 2004, at 11:51:52
In reply to Re: High Parnate dosages, posted by SLS on November 13, 2004, at 7:58:29
>
>
> Hi Todd.
>
> I was up to 150mg of Parnate for a few months, and never experienced a tendency to abuse it. Of course, I'm just one person. I'm still undecided as to whether or not Parnate is metabolized into amphetamine. The older literature says yes; the newer literature says no. When I discontinued the high-dosage Parnate treatment using a rapid taper, I experienced a profound fatigue that lasted at least one week. From what I can see, though, the potential benefits of using the high-dosage strategy in TRD outweighs the risk of abuse.
>
>
> - Scott
>
From what I've read, I don't think Parnate is metabolized to amphetamine. I think its stimulant ability is due to its similarity to amphetamine, but that the cyclopropane ring in Parnate restricts and changes the orientation of the NH2 group compared to the propane chain in amphetamine such that Parnate winds up not not being able to bind as effectively to whatever sites are involved. It's also clear that Parnate has a much lower abuse potential than amphetamine, which is to be expected, as it's my understanding that tranylcypromine came about because of a desire to develop a stimulant with less abuse potential than amphetamine. In this case, the stuff also turned out to be a very potent MAO inhibitor.
My pdoc says he encountered a Parnate abuser while at Michigan State. This was a fellow who always seemed unusually eager and excited to get his prescription and then would go off to study in the library for a kazillion hours at a stretch without sleep. I don't know how much Parnate the guy was taking to take this kind of effect, but what he was doing would seem to clearly fall into the abuse category. I will frankly admit to some paranoia, or at least excessive caution, on the issue of drugs and their abuse/dependency potential, as I have never even tried either tobacco or marijuana, and it took me years just to accept the notion of using something to help me sleep from the insomnia caused by various antidepressants I have tried. So my views might be considered those of someone who tends to be overly cautious.
Todd
Posted by KaraS on November 13, 2004, at 17:03:15
In reply to Re: High Parnate dosages » SLS, posted by King Vultan on November 13, 2004, at 11:51:52
I had been wondering if Parnate would produce a false positive for amphetamines on a drug test for employment. I did a bit of research and could find nothing to back this up. It's not included in any of the very comprehensive lists of meds or over-the-counter drugs that can produce false positives. This leads me to believe that it doesn't metabolize to an amphetamine (though admittedly there may be a lot more to it that I don't understand).
Posted by SLS on November 14, 2004, at 6:42:21
In reply to Re: High Parnate dosages » SLS, posted by King Vultan on November 13, 2004, at 11:51:52
Thanks for the explanation, Todd.
Your "excessive" cautiousness represents an important counterweight to those of us who are trying to push the envelope, and promotes a more balanced perspective. Don't stop!
- Scott
Posted by SLS on November 14, 2004, at 6:43:49
In reply to Re: High Parnate dosages, posted by KaraS on November 13, 2004, at 17:03:15
> I did a bit of research and could find nothing to back this up. It's not included in any of the very comprehensive lists of meds or over-the-counter drugs that can produce false positives.
Hi Kara.Can you provide any links?
Thanks.
- Scott
Posted by KaraS on November 14, 2004, at 16:36:53
In reply to Re: High Parnate dosages » KaraS, posted by SLS on November 14, 2004, at 6:43:49
> > I did a bit of research and could find nothing to back this up. It's not included in any of the very comprehensive lists of meds or over-the-counter drugs that can produce false positives.
>
>
> Hi Kara.
>
> Can you provide any links?
>
> Thanks.
>
>
> - Scott
Scott,Here are a few links. None of them have Parnate/tranylcypromine. Surprisingly (for me anyway), amineptine was on the list for causing false positives.
http://uk.geocities.com/brown_addict/drug_testing.htm
http://www.erowid.org/chemicals/mdma/mdma_testing.shtml
http://www.passyourdrugtest.com/false-positives.htm
http://passdrugtest.tripod.com/
http://www.ipassedmydrugtest.com/false_positives.asp#AMP
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