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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by anodyne on February 12, 2005, at 11:19:35
I was wondering if anyone knew why it was neccessary to have a washout between Parnate and Nardil. It seems like they have almost identical methods of action.
I am on day 5 of a washout from a very low dose (10mg) of Parnate and anxiously counting down the 2 weeks my doc recommended I wait before starting Nardil.
Thanks
Posted by SLS on February 12, 2005, at 12:32:17
In reply to Why the washout between MAOIS?, posted by anodyne on February 12, 2005, at 11:19:35
> I was wondering if anyone knew why it was neccessary to have a washout between Parnate and Nardil.
I don't.
> It seems like they have almost identical methods of action.
Yes and no. Although both drugs occupy a spot (not necessarily the same spot) on the MAO enzyme that serves to irreversibly (for the most part) disable it, they possess additional properties. It might be that these additional actions would produce an exaggerated negative reaction should they be introduced while a MAO blockade has already been established rather than having both establish together during a gradual titration.
10mg is such a low dosage and produces such a small percentage of MAO blockade, it probably wouldn't matter much if you were to wait 14 days or 1 day. However, I am not going to recommend that you do that because, like your doctor, I wouldn't want to be responsible for the sequalae were I to be wrong.
As an aside, the elimination half life of Parnate is 2-3 hours. However, its effects in the body will persist for the period during which the system can manufacturer enough new MAO to replace that which has been disabled by the drug. This period is probably variable from person to person and depends on the magnitude of the percentage of MAO inhibition established. My guess is that it takes 10 days ± 3 to regain normal levels of MAO activity from a therapeutic dosage that has resulted in 80% or greater inhibition.
- Scott
>
> I am on day 5 of a washout from a very low dose (10mg) of Parnate and anxiously counting down the 2 weeks my doc recommended I wait before starting Nardil.
>
> Thanks
Posted by Maxime on February 12, 2005, at 20:16:37
In reply to Re: Why the washout between MAOIS?, posted by SLS on February 12, 2005, at 12:32:17
My pdoc is in his 60's and has been using MAOIs for many, many years. I went from Parnate to Nardil with no washout.
Maxime
Posted by anodyne on February 12, 2005, at 20:56:43
In reply to Re: Why the washout between MAOIS?, posted by Maxime on February 12, 2005, at 20:16:37
Thanks for the info. I figured 2 weeks was a bit excessive given the low dosage of Parnate that I was on and the fact I had only taken it for a week.
I think I will wait 7 days just to be safe. Hopefully Nardil will be a little less stimulating.
Posted by alienatari on February 12, 2005, at 21:26:03
In reply to Re: Why the washout between MAOIS?, posted by anodyne on February 12, 2005, at 20:56:43
Its weird, on low doses (10mgs) of parnate i found it quite stimulating. But then when I went upto 30mgs which is still a low dose i guess, i found it caused me a lot of fatigue. I have read that this is common though, the afternoon fatigue on Parnate that is.
Posted by anodyne on February 17, 2005, at 21:25:46
In reply to Why the washout between MAOIS?, posted by anodyne on February 12, 2005, at 11:19:35
As a follow up, no problems whatsoever swithching at 6 days from 10mg of Parnate. The Nardil is definetly much less stimulating than the Parnate, although I am having trouble sleeping. Nothing a little Klonopin can't take care of though. Parnate felt like a caffeine pill, not exactly what I need.
Now how long should expect to feel as strange as I do? I guess you could call it a "hazy" feeling or being somewhat detached. I felt the same way on the Parnate.
I do seem to be feeling a bit less anxious around people but I am not going out of my way to be social or anything. Does anyone have experience with when the full benefits start to show up? Will I always have this medicated feeling or does that subside?
Other than the insomnia and "haziness" the only side effect as of yet is really great, positive, vivid dreams! Not the worst thing in the world.
Thanks for all the info.
Anodyne
45mg Nardil
.5mg-1mg Klonopin
This is the end of the thread.
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