Posted by uncouth on November 22, 2008, at 18:27:05
In reply to Re: Tell Me All About Parnate » uncouth, posted by bleauberry on November 22, 2008, at 18:04:23
where did you get the genetic test? how much did it cost? was it yoru dcotor's idea or yours?
also -- it's very likely not the nicotine which your addicted to. i realized this when i quit with the patch and started feeling like sh*t for a week. cigarette smoke has VERY significant MAO inhibiting factors, on the order of 40-60% I believe. It's not enough to cause serotonin syndrome when smoking with an SSRI, but it's very significant to be the cause of mood improvement, in concert with nicotine.
So parnate might be the right drug for you. If you've had ECT and been hospitalized before, I'm shocked it's taken this long for you to consider parnate. Why did you consider ECT before an MAOI?
Also, i should note, that when I quit smoking, I had to increase my dose of MAOI. I like you have probably a very overactive MAO system. I know this becuase when I came off of the Emsam patch, I didn't taper, and within 2-3 days I had a suicidal depression. It usually takes 2 weeks for the MAO enzyme to regenerate, but I seem to overproduce it. So it's highly possible that that's why you smoke and why parnate might be just the ticket for you. But don't be shy about the dose, and remember that parnate does have significant startup side effects which do eventually go away. But if you stick with it, and push the dose as far as it needs to go to get a response (I don't know if your doctor has experience with MAOIs, but the typical dose range for parnate is 20-60 max, although for TRD studies have shown that big impacts can come if you push it all the way up to even 100-130, if a lower dose doesn't do the trick or is only partially beneficial.).
That's the one suggestion with MAOIs, especially if you overproduce the MAO enzyme. Do not put up with just partial response. You will definitely feel something on parnate, but regardless of what your doctor says or suggests, push hard on him to let you push the dose as high as it needs to go.
Will you be taking anything else besides parnate? Have you tried tianeptine on it's own? MAOIs + Lithium are a very powerful combo, and you may only need 300 - 600mg of lithium which shouldn't cause any cognitive problems in most people.
Can you do chelation therapy to get rid of the mercury?
What are you on right now?