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DrHelen, Doctor
Category: Medical
Satisfied Customers: 61
Experience:  UK Family doctor with special interest in Palliative Medicine
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Hi, I am currently prescribed Nardil (60mg) as I have treatment

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Hi, I am currently prescribed Nardil (60mg) as I have treatment resistant anxiety/depression issues.

Unfortunately it completely destroys my ability to have sex. I have read that its sister chemical Parnate has a lesser incidence of this. I would also like to switch as it apparently it has a positive effect on motivation, whereas on Nardil motivation is somewhat lacking.

My doctor has refused to prescribe it, as it many more time costly than Nardil according to the BNF, and says I need to get a private prescription. Medically he would, but guidelines (whether local or national) prohibit him from doing so.

I would like to ask a) how does someone go about getting a private prescription, and b) is there any why to get it prescribed on the NHS, is there a right of appeal or another way to fund it. It will cost a little less than my mortgage monthly and unfortunately I need it medically but financially would have huge problems meeting that bill.

Many thanks

I've been working hard to find a Professional to assist you with your question, but sometimes finding the right Professional can take a little longer than expected.

I wonder whether you're ok with continuing to wait for an answer. If you are, please let me know and I will continue my search. If not, feel free to let me know and I will cancel this question for you.

Thank you,


Customer: replied 4 years ago.

Hi Shantal, if we could wait that would be great. Many thanks Ben

Hello Ben,

Thank you for getting back to me. We will continue to look for a Professional to assist you.

Thank you for your patience,


Hello, this is Dr Helen, a UK doctor.


I'm afraid that, as you say, Parnate is very costly compared to Nardil and GPs are usually not allowed to prescribe it.


Are you under the care of a psychiatrist? The only thing I can suggest is that you discuss this with him/her (or ask your GP to refer you to a psychiatrist if you are don't have one). If a psychiatrist decides it is in your best interests to change to Parnate they may be able to action it on the NHS or provide it on a private script.

There is no guarantee of this though.

I'm sorry that this is probably not the answer you want to hear. Drug budgets are very tightly controlled now in the UK and doctors usually have very little say in the matter.


Best wishes.



I joined JustAnswer in June 2013 and am a UK doctor. I have been qualified for 23 years and have widespread experience in GP and cancer care.'

Customer: replied 4 years ago.

Hi Dr Helen,


Thanks so much for answering. Would it be possible to let me know under what circumstances the NHS would fund it.


I had a consultation with a pychiatrist who agreed that I should be on Nardil and informed my GP to prescribe it. Unfortunately this consultant has now left his position, however I am due to see another private pysciatrist within the next fortnight,


Many thanks



Hello, The psychiatrist would have to feel that this was the only drug suitable for you and make tne case with your particular NHS trust. It varies around the country...the postcode lottery I'm afraid. Parnate is black listed in some areas but not others. It is possible that the psychiatrist can recommend something else that is fine to have on an NHS prescription. I would not want to second guess his or her advice but if it really proves impossible to have parnate than the psychiatrist should explore what other options you have. I do hope this works out for you.

DrHelen, Doctor
Category: Medical
Satisfied Customers: 61
Experience: UK Family doctor with special interest in Palliative Medicine
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