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Parnate + Orthostatic Hypotension

Posted by uncouth on September 7, 2008, at 10:17:41

Hi, I'm taking parnate 30mg after switching from Nardli 90mg down to Parnate 40 overnight per my doctor's orders. Parnate has had a dramatic but incomplete effect on my mood (helped especially with drive, anhedonia, desire), but at 40 I immediately got very intense and debilitating orthostatic hypotension. Went down to 30, but it's still pretty bad. Can't exercise, get lightheaded everytime I stand up and it often doesn't go away for minutes, and I've had a few close calls where I've needed to get on the ground horizontal otherwise I'd pass out.

I'm wondering what to do. I don't want to ditch the parnate, does this side effect go away in time?

Also, are there any other antidepressants I can add at a low dose that might help? From my research this has something to do with the alpha receptors, can anyone clarify? And if so, what would I need to add to deal with this effectively?

Would a low dose of desipramine help? Adderall/Ritalin? Abilify? Amantadine?

I should note I'm also having anorgasmia and some urinary hesitation/constipation, but latter two have responded to the dose decrease to 30mg.

I also take Lithium 450mg at night and trazodone 50mg. Both I've taken for some time without adverse effects so I can't imagine they would be interacting with the Parnate to produce the orthostatic hypotension. I also started on n-acetyl-cysteine twice a day about a month ago.

I didn't have the intense orthostatic hypotension on Nardil 90, but was only on it for a week and wasn't responding, so we switched to parnate. I had other bad side effects on Nardil (anorgasmia/ED and hunger) but i'd consider trying Nardil again, we may have not given it enough time at 90 to work, but my doctor wasn't too confident it would work if I hadn't felt anything for 3 weeks at 60 and 1 week at 90.

Thanks for the insights....really appreciate it.

 

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