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Max dose Parnate in the UK is only 30 mg !! SLS

Posted by don_bristol on July 22, 2004, at 13:22:01

In reply to Re: What max dose of PARNATE before giving up? don_bristol, posted by SLS on July 17, 2004, at 6:08:23

Don Bristol wrote:
>> 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?

Scott wrote:
> 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.

Scott, thank you for the reply. I am in the UK and we have the BNF as our doctor's guide. It is sort of equivalent to the US's PDR. (Go to and click BNF 47 and then search away.)

The BNF says this of Parnate/tranylcypromine:

"Dose: initially 10 mg twice daily not later than 3 p.m., increasing the second daily dose to 20 mg after 1 week if necessary; doses above 30 mg daily under close supervision only; usual maintenance dose 10 mg daily"

This is sort counter what most people here seems to have experienced that I have no idea how it is that we in the UK suggest such low doses. However it means that I might have an uphill struggle to convince my psychiatrist to go much above 30 mg for me.

If you or anyone else here have any other authoritative sources of info which I could print out then I would like to know about them.

Of course, I will also do as you wisely suggested and show the doc I am knowledgeable about the dietary risks and am a responsible patient.

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




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