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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by zonked on May 8, 2010, at 21:28:55
Hey everybody,
This might be a little long - and I apologize about that. Honestly, I do feel like only some folks on this board will even come CLOSE to understanding me, and I have to let off some steam...
I'm back on Nardil 45mg b.i.d. - from 130mg parnate. No, that's not what I was prescribed - I had to adjust it myself; and ran out early.
Did it work? Yes. It also made me hypomanic, and the really screwed up thing was that 90mg did nothing and there was no "middle ground" between ineffectiveness and hypomanic reaction. (Not needing sleep, SUPER social, life seems great, creativity increase, productive thoughts and planning...)
Ended up filling an old Nardil RX, 45mg b.i.d. dosing. FYI, the reason I went off Nardil in the first place (I took this before ever trying Parnate) was because it lost effectiveness. It's been six days on Nardil now and it's not doing much other than keeping myself out of the hospital. (No, I didn't do a proper washout, so sue me. I've never had a MAOI reaction of any sort.)
Since I've tried pretty much every antidepressant available, and only responded to the MAOIs (plus, ONE round of zoloft - first AD I ever took, ten years ago), and taking a "normal" amount of Parnate is useless, I am considering going on Marplan.... as soon as ten days have elapsed since my last Parnate dose. I am in between pdocs right now; I moved back to San Francisco from the suburbs because the psychiatric care is better here; I won't be assigned a regular psychiatrist for a few weeks. I'll have to march into the crisis clinic and I am so frightened I will get an uncaring jerk who wants to put me on an SSRI, tricyclic or something else that hasn't worked in the past...
But I have to do it. Anyway, I want to know from folks who have taken marplan:
1. How long to take effect, and what dosage?
Lately all I can do is watch things like THIS:
http://www.youtube.com/watch?v=qsaamq0E964and cry my eyes out... For once in the last two to three years, I want to be able to see life through clear glasses - not rose colored, and not grey either... I guess I should be glad I'm still alive, and a part of me [based on having a hypomanic response to Parnate] knows that EVENTUALLY, I'll get the right combo of meds and be able to return to work and enjoy life again, but getting there is so maddening... I have lost so much of my young life to this disorder...
thx
zonked
Posted by SLS on May 8, 2010, at 22:03:01
In reply to Anybody taken MARPLAN? fed up with all this *..*, posted by zonked on May 8, 2010, at 21:28:55
Hi Zonked.
I will be starting Marplan next week. I would like to get up to 60mg within a month if necessary. I don't know of anyone who has gone higher.
Good luck. I hope you get there.
- Scott
Posted by zonked on May 8, 2010, at 22:41:13
In reply to Re: Anybody taken MARPLAN? fed up with all this *..*, posted by SLS on May 8, 2010, at 22:03:01
Scott,
I just wanted to thank you--and Phillipa, and other people I am not thinking of right now--for helping me to realize I'm not alone...
Let's keep each other--and the board--informed about how we do on Marplan.
On the day "the system"'s computers show that I've been off medication that interacts negatively with Marplan, I am headed into that crisis clinic and not emerging without a script. Given how depressed and anxious I am, that's going to be really hard--but I have to do it. I've found that doctors either are impressed and empathetic, or have a terrible ego reaction when they discover that I'm treatment-resistant and pretty self educated about psychopharmacology, neurochemistry, etc...
My goals right now are pretty simple--I want to find a knowledgeable psychopharmacologist who accepts Medicare and Medicaid, isn't afraid of MAOIs, and isn't offended I've done my own homework about my disorder and its treatments.
I've *had enough* of trials of things that doctors were more comfortable with--tricyclics and SSRIs and "other" things like Wellbutrin and Remeron did *nothing* for me, or caused side effects only.
I know you've suffered a lot - can I ask you; how did you find a pdoc you're comfortable working with? [Assuming you have one....]
zonked
> Hi Zonked.
>
> I will be starting Marplan next week. I would like to get up to 60mg within a month if necessary. I don't know of anyone who has gone higher.
>
> Good luck. I hope you get there.
>
>
> - Scott
Posted by SLS on May 8, 2010, at 23:02:10
In reply to Re: Anybody taken MARPLAN? fed up with all this *..*, posted by zonked on May 8, 2010, at 22:41:13
> I know you've suffered a lot - can I ask you; how did you find a pdoc you're comfortable working with?
I have been lucky. When the time comes for a change, I ask doctors who they would send a family member to if that family member were in my position.
I only had one doctor freak out on me because of ego problems. He had brought me in as a research assistant. The guy was brilliant in his own right. However, when I revealed to him my IQ score, he never treated me the same.
- Scott
Posted by bulldog2 on May 9, 2010, at 10:06:22
In reply to Re: Anybody taken MARPLAN? fed up with all this *..*, posted by SLS on May 8, 2010, at 23:02:10
> > I know you've suffered a lot - can I ask you; how did you find a pdoc you're comfortable working with?
>
> I have been lucky. When the time comes for a change, I ask doctors who they would send a family member to if that family member were in my position.
>
> I only had one doctor freak out on me because of ego problems. He had brought me in as a research assistant. The guy was brilliant in his own right. However, when I revealed to him my IQ score, he never treated me the same.
>
>
> - ScottGood Luck Scott. Marplan is a good choice as you have responded to maois in the past. I've read the archives and the responses are very positive.
Bulldog2
Posted by Phillipa on May 9, 2010, at 13:48:49
In reply to Re: Anybody taken MARPLAN? fed up with all this *..*, posted by zonked on May 8, 2010, at 22:41:13
Zonked thinking of you and what script did you receive? Love Phillipa
Posted by stargazer2 on May 9, 2010, at 22:19:41
In reply to Anybody taken MARPLAN? fed up with all this *..*, posted by zonked on May 8, 2010, at 21:28:55
Hi Zonked...
I wanted to watch the video tonight but couldn't as it is too late and if there is any sound associated with it, my dogs will hear it and start barking.
I took Marplan pre-1993 and did very well on it. Unfortunately it was discontinued and I was forced to quit cold turkey and find another med which was an impossibility, as my depression has never esponded to typical AD's either. I think this is true of many of us.
I wasn't sure you have to have a wash out from one MAO to another, as I think that is what you are doing, right?
Good luck with getting your script...just explain that only MAOs work and you feel certain that your best bet is to try another one. NO one would chose that route unless they have exhausted all other choices. It's not like there is any high to taking a MAO so you shouldn't be looked at as "drug seeking", but docs can be resistent to prescribing any med they are not familiar with. At a large hospital, they should have knowledge of MAOs or can call a colleague, who is familiar with them. If it is a rookie, I would ask if there is a more senior resident who you can speak with about your history.
Stargazer
Posted by JayBTV2 on May 9, 2010, at 22:25:21
In reply to Re: Anybody taken MARPLAN? fed up with all this *..*, posted by bulldog2 on May 9, 2010, at 10:06:22
Just wanted to chime in that I've been on Marplan for the last 2 months with good success. I was on Parnate just prior but had to come off of that quickly as it was causing BP spikes(as high as 170/115) after every 10mg dose.
Anyway I've been doing very well on Marplan. I'm a lot more focused and optimistic. It's not as much I feel good (body buzz type thing) but I like myself more....
I've stayed at a really low dose too actually. I know I'll get yelled at for this but we didn't do much of a washout between Parnate and Marplan. Perhaps that's why I had success at just 20mg a day (less MAO at start). That's basically where I've stayed though. I went up to 30mg for a couple weeks but I can get really manic and I felt a little "fragmented" so to be safe we backed down to 25mg. That seems to be perfect for the time being.
As for side effects the main one believe it or not is appetite loss. I doubt this is common for everyone but it's been welcome for me (and I'm happy it's not like Nardil). I've lost about 7lbs due to eating much less. Maybe that's not super healthy but it's motivated me to hit the gym so I'm taking advantage while I can :)
I really don't think it's related to Marplan but I have also developed a ringing in my left ear the last two weeks. That started about a month and a half after I was put on Marplan (I created a different thread specific to this issue). I've done a lot of research and I can't find any source saying Marplan can cause ear ringing (tinnitus). Anyway since I can't rule it out yet I figured I'd make mention - if it is the cause I'm probably the 1 person out of 10,000 who'd get it. We're going to take me off Lithium and see if that helps my ear issue. There's also a chance it's related to a jaw issue (TMJ) so...I dunno.
Bottom line is I'd definitely recommend a trial of Marplan. I'd love to hear if others have success. I'll try to update my progress as well although I haven't been around as much - probably a good sign :)
My current med cocktail:
Marplan 25mg (Morning)
Lamictal 100mg
Lithium 600mg (coming off)
Seroquel ~100mg (night for sleep)
Fish Oil (Minami MoreEPA)
Magnesium 400mg(glycinate)
Posted by zonked on May 11, 2010, at 11:47:50
In reply to Re: Anybody taken MARPLAN? fed up with all this *..*, posted by JayBTV2 on May 9, 2010, at 22:25:21
Encouraging! How long before you noticed antidepressant effect? Had you taken any other MAOIs before? I just hope I can get away with a "normal" dose (Parnate DID work, but required 120-130mg/day to work, and my doc at the time was unwilling to script me that much, plus, after awhile it pushed me into hypomania...)
Nardil stopped working after a while on 90mg...
I never tried the emsam patches but did take the selegiline pills for awhile--gave me a feeling similar to wellbutrin--marginally helpful with depression but made me angry and anxious, and revved up my sex drive. Interestingly, I have a theory that medications too norepinepherinergic make me panicky and anxious (nortiptyleine, effexor xr and cymbalta, respectively, all revved up my anxiety to hellish levels.)
Just confirmed, it is completely covered by my drug plan and ready at the pharmacy. Gulp.
This is the end of the thread.
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