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Re: What max dose of PARNATE before giving up? don_bristol

Posted by SLS on July 17, 2004, at 6:08:23

In reply to What max dose of PARNATE before giving up? King Vultan, posted by don_bristol on July 17, 2004, at 4:50:40


I hope you don't mind if I jump in here.

> I suppose my question is not really "what is the upper limit" but what dose of Parnate should I go to before I determine it is not working for me?

No psychiatric specialist should be afraid to go up to 60mg of Parnate (tranylcypromine). 60mg is stated quite clearly in the PDR to be the maximum recommended dosage.

The range usually quoted is 30-60mg. However, for severe cases, I think you will find that people are more likely to respond in the range of 40-80mg. High-dosage strategies are sometimes employed in cases of treatment-resistant depression (TRD). This involves using dosages of 100mg and higher. I have been up to 150mg. To that was added desipramine 300mg + amphetamine 20mg + thyroid hormone. While I wouldn't blame the average psychiatrist for being hesitant to do this, I would blame him were he not to explore Parnate to at least 60mg.

Perhaps you could print out a few things that you have found on the Internet and cue him in on the PDR regarding the maximum recommended dosage of Parnate. Tell him that you understand his desire to be cautious, but that you are willing to go higher. I would also bring in a list of the foods and medications you are avoiding to demonstrate to him the responsibility you are taking for your own safety when using this drug.

Not many people with severe depression respond to 30mg of Parnate. 40mg is the minimum.

- Scott




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