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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 don_bristol on December 10, 2003, at 6:58:54
Hi all, please help me with some advice. How do I swap from Nardil to Parnate?
Can I do what I might call "hot swap"? In other words going from a low therapeutic dose of Nardil to a low therapeutic dose of Parnate. This would save the need to taper off the Nardil and then to build up the Parnate. I know this can be done with SRRIs (although it very rarely is) but can it also be done with MAOIs?
My current daily dose is 45 to 60mg of Nardil and I guess a low dose of Parnate would be about 10 to 15mg. Could I go straight over (within one day or two) to about 10 to 15 mg Parnate?
Do you have any advice or info?
----
By way of background .... I've been taking Nardil for 13 weeks at a daily dose of approximately 45 to 60mg. Nardil has kind of worked in general with some subtle improvements (anxiety especially and mood to some extent too) but the results have not been anything particularly noticeable.
I guess I might be sensitive to Nardil because it took a *full* 3 weeks to get to 3 to 4 tablets daily and I can't stay on a dose of 60mg or 4 tablets for more than a three or four days without getting troublesome side effects.
So next week, my p-doc is going to switch me from Nardil to Parnate at my request.
How do I prepare for that switch? Should I start to taper off the Nardil or will I be able to "hot swap"? If I have to taper off then at what sort of rate would I do it?
Thanks for any info.
Don.
Posted by SLS on December 11, 2003, at 0:02:12
In reply to How do I swap from Nardil to Parnate?, posted by don_bristol on December 10, 2003, at 6:58:54
The conservative approach is to wait 14 days between your last dose of Nardil and your first dose of Parnate. Some people have gotton away with waiting less time, or even taking both drugs at the same time, but I would offer no guarantees as to the absolute safety of doing so. Who do you listen to? I have always taken the conservative approach. It is probably more dangerous to switch from Nardil to Parnate than it is to switch from Parnate to Nardil. It seems to take longer for MAO activity to recover after taking Nardil. You might actually feel better briefly while coming off the Nardil. This is known as a drug discontinuation rebound improvement. I experience this upon discontinuation of Nardil and tricyclics.
- Scott
Posted by don_bristol on December 11, 2003, at 10:32:57
In reply to Re: How do I swap from Nardil to Parnate?, posted by SLS on December 11, 2003, at 0:02:12
Scott wrote:
>> he conservative approach is to wait 14 days between your last dose of Nardil and your first dose of Parnate.<<
Scott, thanks for your reply.
How slowly should I taper off the Nardil if I want to discontinue it completely?
I have been taking 45mg to 60mg for about 10 weeks plus and extra 3 weeks to build up to that dose.
Posted by SLS on December 12, 2003, at 11:39:02
In reply to Re: How do I swap from Nardil to Parnate? » SLS, posted by don_bristol on December 11, 2003, at 10:32:57
> How slowly should I taper off the Nardil if I want to discontinue it completely?
>
> I have been taking 45mg to 60mg for about 10 weeks plus and extra 3 weeks to build up to that dose.Hi.
I think it took me about a week to work down from 75mg last time. That's pretty quick. I guess you could decrease by 15mg every three days. That might be a good framework from which to work. You will probably experience REM rebound, which will cause you to have vivid dreams. I usually experience some "brain zaps" along the way. They feel sort of like a static electric shock in your head. You should be OK. Good luck.
- Scott
Posted by don_bristol on December 13, 2003, at 4:56:05
In reply to Re: How do I swap from Nardil to Parnate?, posted by SLS on December 12, 2003, at 11:39:02
> > How slowly should I taper off the Nardil if I want to discontinue it completely?
> >
> > I have been taking 45mg to 60mg for about 10 weeks plus and extra 3 weeks to build up to that dose.
>
> Hi.
>
> I think it took me about a week to work down from 75mg last time. That's pretty quick. I guess you could decrease by 15mg every three days. That might be a good framework from which to work. You will probably experience REM rebound, which will cause you to have vivid dreams. I usually experience some "brain zaps" along the way. They feel sort of like a static electric shock in your head. You should be OK. Good luck.
>
>
> - Scott
Thanks for your reply Scott. It is appreciated.
This is the end of the thread.
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