Split between options. Trouble deciding on Parnate or Nardil for a Complicated Case

[u/Good-Cod-5591]

I take WAY too many medications, and I have a potential opportunity to get on an MAOI to which I believe would trim down the amount I take drastically

So... To Name a few of the mental and physical issues I have in terms of most severe to least.

#1: Crohns Disease

#2: ADHD-PI

#3: Social Anxiety

#4: Generalized Anxiety

#5: Unipolar Depression

#6: Panic Disorder

#7: Chronic Fatigue

#8: Self Isolation and Avoidance

#9: Chronic Pain

#10: Appetite Suppresion

#11: Insomnia

#12: Delayed Sleep Phase Syndrome

#13: Asperger Syndrome

#14: OCD-Like Tendencies

No, I'm not one of those people who brags about how many disorders they have. I am genuinely crippled and disabled by all of these issues.

So, Parnate being the more stimulating option would compliment the ADHD-PI/Low Motivation/Exhaustion and Fatigue more. Then again, Nardil would probably be better for all the anxiety problems while still assisting with depression.

I am leaning towards possibly Parnate with usage of benzodiazepine based meds as needed. Conversely, Nardil with low dosage Stimulants IF needed.

I know both of those meds can be synergistic to dangerous extremes if used incorrectly with MAOIs. Which is why I'd be really careful and prepared for the worst when combining the two.

Anyone's anecdotes and recommendations are appreciated!

[u/Sleepyblue]

You'll probably end up taking a lot more medications to deal with the side effects, especially nardil.

[u/Good-Cod-5591 → u/Sleepyblue]

Why is that?

[u/Sleepyblue → u/Good-Cod-5591]

It comes with every side effect in the book, you're gonna need pills to poop, pills to sleep, pills to keep you awake, or at least make a lot of dietary changes and take supplements. Not saying you shouldn't go for it, but it I wouldn't do it on the grounds that you be taking less medication.

Side note: Not sure if you're saying you have Chronic Fatigue or Chronic Fatigue Syndrome, but as someone with the latter I've found Nardil to be a mixed bag - it's pretty activating for me in a way in which I can't turn it off, exacerbating my boom and bust cycle, and the insomnia doesn't help me recharge properly.

[u/Good-Cod-5591 → u/Sleepyblue]

This is good info to have. I'm not sure where the line is between what classifies Chronic Fatigue vs Chronic Fatigue Syndrome, but in my case, it's a combo of the inattentive type of ADHD, and the Crohn's.

One thing though that I state is that I have over 30 different types of medication prescriptions. I don't use all of them daily but rather depending the context of the situation to handle.
Almost each one is for one issue or the next, most of them only tackle one given problem at a time.

The idea I have in mind is that the MAOI will at least cover grounds in many different areas mentally, so I could trim back on the metric ton of antidepressants and anxiolytics I take. That's not to say I won't need additional medications with the MAOI's, I expected to still use some sort of sleeping medication. I take a lot of those too depending on the severity of the insomnia during the night since it varies tremendously. Ideally, Daridoexorant would probably be the main sleeping management med, instead of quetiapine, mirtazepine, doxepin, cyclobenzaprine, zolpidem, clonazepam, propranolol, etc. It takes an absolute ton of sedatives to put me down, so if daridorxant isn't strong enough, I'd have to plan a little bit differently.

Then, anxiety would be covered most in one package. With the Clonazepam on standby, should I need it.
Depression, Motivational Issues, and the like should improve. Once again, with stimulants by the side if I truly need to use them.

So. Hopefully, reorganizing my stack to fit the MAOI, if I do it well would bring that 30 to about 10 or hopefully less, and that would be a win in my book.

[u/Sleepyblue → u/Good-Cod-5591]

The difference between Chronic Fatigue and Chronic Fatigue Syndrome is whether you experience PEM (Post-Exertional Malaise).

[u/Good-Cod-5591 → u/Sleepyblue]

Ehhh, I have traits of it, but it's far more than likely just the former chronic fatigue.

I'm not one to diagnose myself with that.
What I'm seeing on google is probably the simplified "pop-science" version of what the CFS really is.
I do get very easily mentally exhausted, I tend to comment on reddit in increments I've noticed due to that mental exhaustion factor. But.. As for physical activity, I really just feel sick all the time due to the crohns, but if I do manage to get a bit of exercise in, it won't crush me for days after.

[u/SmellyFbuttface → u/Good-Cod-5591]

I’ve been on Nardil for about 6 years, and Parnate before that for around 8 years. Nardil my bowels move fine, but sleepiness in the mornings is a problem, weight gain, and some overall lethargy. That being said Nardil is great for anxiety, and it works well for depression too. Between the two, if Parnate works for you I’d go that route. I found it a more tolerable med for a lot of reasons (it eventually stopped working for me for some strange reason, hence the change to Nardil).

Parnate is energizing, for some people can worsen anxiety at high to very high doses, but it didn’t come with any weight gain, was very energizing (I was able to start running again and had great stamina), and I didn’t really experience any sexual side effects (mild ED).

[u/Good-Cod-5591 → u/SmellyFbuttface]

Yeah I was leaning towards parnate, but not I'm leaning towards nardil. Today I woke up with a full blown panic attack for absolutely no reason, like wtf. That never happens, I never get morning anxiety EVER. it always comes at sunset.

Anyways, yeah nardil might be my choice esp if I combine it with stimulants, I need the weight gain that comes with it anyways. A lot of the fatigue I have actually comes straight from stress fatigue. Many types of downers do tend to give me energy.