Posted by Scott L. Schofield on January 8, 2000, at 20:35:29
In reply to Re: Parnate "properties" :), posted by Elizabeth on January 7, 2000, at 8:54:00
> Aha. Okay. I'm still on Marplan right now, but considering returning to good ol' Parnate because of that insidious weight gain.
>
> One thing my therapist suggested when I mentioned this to him was to try adding verapamil or some other Ca++ antagonist to the Parnate to keep my BP stable.
>
> I'm ambivalent about switching -- like anybody, I don't relish the idea of ballooning like I did on Nardil, but at the same time, switching MAOIs is truly painful due to withdrawal symptoms and that pesky waiting period (I thought those were for handguns!). I can't decide whether it's worth the risk, especially since the spring semester begins in a couple weeks. (I *don't* want to have to go to the hospital right now!)
Do you discontinue MAOIs all at once or do you gradually taper off of them? I know it would protract the time necessary to wait before starting Parnate, but might not weaning prevent any disturbances that would otherwise affect function? I have discontinued MAOIs abruptly many times. Unfortunately, the withdrawal syndrome seems to be less severe now than it was early on. I’m not sure I like the idea of a drug leaving less of an “impression” on the system as to allow for reduced side-effects or a milder withdrawal. Anyway, I am curious as to which withdrawal phenomena bother you most. I no longer seem to experience either the REM suppression during treatment or the REM rebound of withdrawal. I do continue to have the “lightening bolt” type thing going on, though.The verapamil sounds pretty good, especially since it may offer some mood-stabilizing properties. There was some thought initially that the L-type calcium-channel blockers, such as nimodipine, might be more effective at regulating mood. The more recent stuff I have come across does not support this contention. What’s more, nimodipine is prohibitively expensive to use on a regular basis. (I believe its primary use is to mitigate the damage that immediately follows a CVA). You may want to look into how ACE-inhibitors compare to CA++ channel blockers regarding their efficacy in counteracting sympathomimetics in general and amphetamines in particular.
My gut feeling is that it might be wise to continue the semester without making any major changes, the results of which, for you, are unpredictable. When I was younger, and a bit more handsome, I was confronted with a similar situation. I began seeing a new doctor about a month before I was to be married. After a battery of psychometric exams (pretty cool stuff) and a detailed review of my history, he wanted to try a combination of Parnate and Norpramin. I was not receiving any treatment at the time. However, I knew that I could count on what little I had to work with to remain available and stable. The wedding went great (unfortunately, the marriage did not), and I waited until I felt the time was right to take the risk of losing some degree of function. I believe it was the right decision for me.
If Marplan has helped you, I imagine you feel smarter because of it. It might be a good idea to use the extra smartness to ace your courses, then wait until summer to lose the extra weight. I dunno. I sure wish I had some extra smartness to work with.
Good Luck !!!
Get Well.
- Scott
poster:Scott L. Schofield
thread:17762
URL: http://www.dr-bob.org/babble/20000101/msgs/18421.html