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differences between MAOIs?

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i've been taking parnate for a year.  i take 70mg, which is more than the recommended dose already.  so there's no going up on the dosage to see if things get better. 


it (in combination with other meds) has kept me from being suicidally depressed, which is great - i didn't end up IP during my expected time this year.  however, i'm still not fit to work or have anything resembling a normal life.  i've just been in limbo, depressed or cycling but not needing to die over it.


since i've been through the usual bipolar negative experience with the other classes of ADs, i am wondering if a different MAOI would be better.  has anyone here ever switched MAOIs and found one to be better than the other for you?  i'm used to the diet now, so that's not a consideration (although i'd absolutely love to eat pickled olives or aged cheese again!).  it would be a bonus if it didn't make me so damned nauseous too.


if this idea doesn't work i'll be on the hunt for a new AAP that's good for depression but doesn't either sedate me to zombieland or make me hypomanic.  i'm already taking zyprexa and i'm quitting it next week.  it's not doing a damned thing for depression and is making me gain weight very rapidly, even though i'm already dieting and most days getting some exercise.  but i digress.




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I didn't like Parnate  as it was too stimulating for me and caused anxiety but I gave it a try for a couple months.  I then went to Nardil and found it was too sedating and put me in a fog state but gave it a try for a couple months. Marplan was next and it worked well enough and didn't have any side effects and I was on it for a few years until the manufacturer stopped making it in 93. 


I have found nothing that comes close to Marplan.  I've even tried again Parnate and Nardil and in me it's not even close. 


I've tried in my lifetime every single AD to include all the tricyclics, tetracyclics, SSRI, SNRI, atypical AD, just everything to include off label AD use of many non AD meds.


I wish you the best.


I tried the Emsem patch once, it did nothing for me and I plan on trying it again if I can get my insurance to pay for it again.  I did enjoy being able to eat what I wanted on the Emsem patch as it delivers the med directly to the bloodstream and then to the brain bypassing the GI tract which is great for a MAOI.



'Emsam's development was spearheaded by J. Alexander Bodkin, M.D. ,[5] Director of the Clinical Psychopharmacology Research Program at McLean Hospital in Belmont, Massachusetts, in conjunction with Harvard Medical School.[4][6][7][8] Currently, it is the only MAOI on the market used in the treatment of depression that is absorbed through the skin into the bloodstream and thereby to the central nervous system.

The patch "is a matrix containing three layers consisting of a backing, an... adhesive drug layer, and a release liner that is placed against the skin."[1] The primary advantage of delivering selegiline in this manner is to bypass the gastrointestinal tract and liver, specifically the small intestine, thereby limiting the chance of hypertensive crisis (very high spike in blood pressure possibly leading to stroke).'

Edited by Brian803
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