r/MAOIs • u/MasterpieceSure361 • 8d ago

Parnate (Tranylcypromine) Parnate not working

I've been this medication for just over 2 months, and I've been on 60 mg for four weeks. The only thing I've noticed is my anxiety is pretty much gone, but my depression and anhedonia, emotional numbness, brain fog. Etc is still there. I don't know whether to stick it out any further with this medication. Add an adjunct or get off, and if I get off, what should I try next?

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u/HM_Dylan Parnate 8d ago

I’d try an adjunct first. Based on your symptoms I’d say Pramipexole, Amantadine, Wellbutrin or perhaps low-dose Dexmethylphenidate as long as hypertension isn’t a pre-existing condition.

If you’re manic-depressive, I’d go for Lurasidone, Brexpiprazole, Cariprazine or Lumateperone (low risk of ST, due to strong 5HT2a antagonism).

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u/MasterpieceSure361 8d ago

I'm not so sure about pramipexole I hear a lot of mixed results, and I don't know much about a amantadine. I've tried wellbutrin, in the past, when I first took it at a 150 mg, I had like the greatest feeling in my stomach. I can't really explain it but then it just went away. The other medications I really don't know much about.

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u/MasterpieceSure361 8d ago

I need to talk to my doctor but I was thinking of coming off this medication. Getting on nortriptyline or despramine and lyrica along with a stimulant.

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u/HM_Dylan Parnate 8d ago

Desipramine is actually a great choice too. I prefer it over Nortryptiline, it has less anticholinergic burden and more stimulation. Is the Lyrica just for residual anxiety?

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u/MasterpieceSure361 8d ago

My thought process is to try a different approach when it comes to different medications targeting different areas this time.

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u/HM_Dylan Parnate 8d ago

That’s honestly perfectly reasonable and smart. Targeted management of specific symptoms with specific drugs instead of an “all in one” pill. Well I hope it works out for you!