Posted by CaptainAmerica1967 on December 31, 2008, at 11:22:22
In reply to Re: Parnate-update Jade to D/R, posted by JadeKelly on December 30, 2008, at 22:59:55
Monamine oxidase breaks down neurotransmitters throughout the day/night so taking your Parnate in varied doses should help and if you're missing the morning and afternoon dose until 1 or 2pm, it seems like it could definitely affect you.
If I wake up in the middle of the night and am not sleepy, I just stay up for that day. Remember, sleep deprivation is highly effective (no REM or other sleep so the neurons stay on overdrive producing various neurotransmitters that would otherwise slow down production) as an antidepressant and augments them just like taking cold showers and exercise does.
The Parnate may be making you wake up during the night as it suppresses REM sleep and in some cases virtually eliminates REM to almost 100% (one needs very little REM to survive) which is one of the other mechanisms believed to produce the antidepressant effect.
Maybe not taking your Parnate too late in the evening or only early/late afternoon can help or taking something else to help you sleep like a small dose of amitriptyline or something else your physician may recommend.
Maybe some trazodone as many don't have any interaction with MAOI's with a small dose of trazodone (some not even at higher doses) and many psychiatrists use trazodone to help when switching or going off one MAOI to another.
Maybe Benadryl (antihistamine) prior to bedtime if your depression isn't atypical. MAOI's tend to enhance histamine and work well with atypical depression where as TCA's block histamine and don't tend to work as well with those suffering from atypical depression.
Adding lithium or lamictal should augment the Parnate along with your Ritalin and along trazodone or amitriptyline .
20mg-60mg of Parnate is just a general dosage that is written in the PI (package insert) for physician recommended dosage, but others like David Sheehan, M.D. (lives in Tampa), who is one of the foremost authority on anxiety with depression (The Anxiety Disease) will use 80mgs of Parnate a day, and even others like Ivan Goldberg, M.D. (lives in NYC), suggest using 90 mg to 170 mg of Parnate daily based on a study.
http://www.psycom.net/depression.central.resistant.html
http://www.ncbi.nlm.nih.gov/pubmed/2710808?dopt=AbstractI live in Houston, TX and had to educate my physician on the dosage range used for normal and treatment resistant depression based upon what I found online (spoke quite a few times via email with Dr. Goldberg..he'll answer your questions).
Hope this helps and hope you have a great New Year.
Jeff
poster:CaptainAmerica1967
thread:868231
URL: http://www.dr-bob.org/babble/20081223/msgs/871626.html