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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Ana-Anita on March 3, 2006, at 20:47:32
I have been off of Nardil for a month now due to surgery. I am feeling like hell and am ready to get back on meds. Nardil works for me, but I hate it because it makes me eat candy and sweets uncontrollably. I gain weight, feel irritable and tired. I also have no sex drive or any sexual feeling. I have just read that the FDA approved the selegiline patch and I think I want to give that a try.
Has anyone who has been on Nardil tried selegiline? Which has worked better for depression and anxiety?
Thanks for any input.
Posted by Chairman_MAO on March 3, 2006, at 21:43:45
In reply to Nardil versus Selegiline, posted by Ana-Anita on March 3, 2006, at 20:47:32
If you have significant anxiety issues, I hate to say it but Nardil will be much better.
You _CAN_ have sex on Nardil. You may need more meds to do so, but it can be done. You just need a doctor willing to help you with it; it is not an easy thing to treat. Also, my anorgasmia got a lot better after *7-8 months*.
Posted by Ana-Anita on March 3, 2006, at 23:35:31
In reply to Re: Nardil versus Selegiline » Ana-Anita, posted by Chairman_MAO on March 3, 2006, at 21:43:45
Thanks for the info. Without Nardil, I will stay in bed in an ugly sad funk and avoid interacting with others as much as possible. I am extremely irritable. I take Klonopin for anxiety (I also need it to calm down my irritability). Without the Nardil I take Klonopin 3 to 4 times a day. With Nardil I take it maybe once a day. I have been off and on Nardil for years. I find the sexual dysfunction just does not go away. What remedy have you found for this? Do you have any trouble with sugar cravings on Nardil?
Thanks
Posted by Chairman_MAO on March 4, 2006, at 19:35:55
In reply to Re: Nardil versus Selegiline, posted by Ana-Anita on March 3, 2006, at 23:35:31
I believe Nardil has manifold effects on sexual function. Firstly, MAO-A inhibition causes a massive increase in synaptic concentration of serotonin; this (specifically 5ht2 stimulation) has an inhibitory effect on DA release. This is one substrate for anorgasmia (orgasm involves massive DA release). Nardil administered with paracholorphenylalanine (an SE synthesis inhibitor) was shown in an open trial in the 70s to INCREASE sexual desire in sexually hypoactive males. If you have excessive MAO inhibition, DA synthesis falls as well. Nardil can raise prolactin levels, which inhibits testosterone synthesis, resulting in impaired drive/libido. There are some differences here for men and women, but women need proper testosterone levels to get horny. If the ratio of testosterone:estradiol becomes too high in favor of estradiol, your sexual drive and function will go down the tubes.
Another hydrazine drug with (mild) MAO inhibitory properties, the TB drug isoniazid, has caused gynecomastia (feminine breast development) in men. This leads me to believe that there is something about hydrazine drugs that mucks with the endocrine system/hormone balance. Furthermore, one of Nardil's active metabolites is a potent GABA transaminase inhibitor (one of the enzymes that breaks down GABA). This results in increases GABA levels, which results in increased GABA-B receptor activation. This results in decreased DA release; this coupled with the decreased DA release possible from the rise in synaptic SE probably hurts things. Nardil also induces a rise in NE; this can harm sexual function as well, specificall on a physical level (erectile dysfunction in males, decreased vaginal lubrication in women).Testosterone PRN before sex is a great treatment. 1mg is a good dose for women, 5-10mg for men, though good luck getting a doctor to Rx this. Testosterone combined with a D2 agonist (cabergoline) helps. Cholinergic drugs (bethanechol is in the literature) can help. What specifically are your problems?
Posted by naughtypuppy on March 5, 2006, at 10:59:40
In reply to Re: Nardil versus Selegiline » Ana-Anita, posted by Chairman_MAO on March 4, 2006, at 19:35:55
You're probably right about the endocrine/hormone thing. Parnate caused me to loose a lot of hair on my head, but increased body hair. An androgenic thing perhaps?
This is the end of the thread.
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