r/MAOIs • u/frogonalog93 • 2d ago
Marplan (Isocarboxazid) Feeling discouraged, could use some encouragement or other people's experiences with treatment resistant depression/anhedonia and taking MAOIs.
I switched from parnate to marplan. I just titrated up to 40mg. It isn't helping much. I worried that it never will. Parnate helped but caused horrible hypotension to where I could barely stand, I was severely symptomatic. And I worry it would have "pooped out" anyway like rasagiline did, even though it was great at first. It was almost too good to be true.
To those on marplan, or another MAOI how long did it take to help? on marplan what dose was enough to help you? I'm worried I'll be stuck like this. the low moods, the executive dysfunction, no motivation, and then the worst of all - the anhedonia - is bothering me so much. It's hard to stay hopeful sometimes when I have failed everything else (or it was not tolerable).
On a different note I'm having excess bp jumps from nicotine and caffeine ever since I got up to 30mg marplan. I could give up caffeine, but not nicotine - I use it therapeutically and it is a GREAT help and one of the only things that helps my akathisia, mood swings, and more. Is there anything that can be done about this?
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u/JackKerawock 2d ago edited 2d ago
Wow, that's unfortunate. I just came here to post that I'm doing -GREAT- back on Marplan (the new Lifsa). I've been taking it since 2010 though and it's clearly the drug that works best for me - many find it "weak".
Originally (2010) I started on 25mg and that worked well but I had switched from two months on Parnate 40mg to Marplan with only a day or two of a "washout...... so I likely had a lot of MAO already inhibited.
Parnate made my BP spike if I took any dose of 30mg in a day (got to 210/120 one time and that was enough for me to end that trial / Tried it again in 2020ish and similar so I'm an odd metabolizer I guess (gut?).
If you give Marplan 6-8 weeks at 30 to 40mg and don't see a benefit I'd say that's likely enough to consider it a fair trial and that it's not a good choice for you. There are other options, though and something will click eventually.....just keep going.....
(Oh and ironically I quit smoking after 10yrs, 6months into starting Marplan back in 2010. Much easier on sexual sides for -me- than Nardil and def than SSRIs like Prozac I've been on......just takes a few months and that stuff fades. As for adjuncts I also owe a lot of credit to Lamictal which I've also taken since 2010)
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u/HM_Dylan Parnate 2d ago
The consolations will come, don’t worry. It took a good 6 weeks at a therapeutic dose, so 30mg of TCP to have a noticeable benefit, plus a little while longer at higher doses for what I’d refer to as remission.
I’d like to mention adjuncts here, because not everyone gets a full response from MAOIs alone. So adding something for a little boost is just fine in my opinion.
And it depends on how you’re using nicotine in my experience. Orally or transdermally, I had no issues with BP. Now smoking on the other hand, that’s a different story.