Posted by g_g_g_unit on September 11, 2009, at 6:35:19
In reply to Re: question about Parnate insomnia » g_g_g_unit, posted by SLS on September 11, 2009, at 5:58:24
> I guess that depends on the relationship you have with your doctor. Does he give you that kind of latitude? If it were me, I would want to be taking 30mg no later than day 7 of treatment. However, I don't believe you would sacrifice anything by waiting. I doubt that there would be any less chance of your responding to Parnate if you go up in dosage gradually.
well, we've only met once, though i guess his willingness to prescribe Parnate after one meeting is a good sign. my old pdoc let me adjust the Nardil dose as i pleased; maybe i'll let this guy know i never responded until i reached higher doses (60mg+).
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> > my *only* concern is insomnia. i am happy to put up with any other sfx in the meantime. since it seems as likely that the insomnia will be present at 20mg as 30mg, it feels worth moving up.
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> Ugh. That's a tough one. If your doctor is an enlightened prescriber of sleep aids, you should be able to surmount insomnia and not let it be an obstacle to your getting well on Parnate. If insomnia does emerge, try to consider it a condition that must be treated as aggressively as the depression. Combining Parnate and desipramine required me to use another combination to treat the resulting insomnia. Combining Halcion and Ativan worked very well. I guess you can cross that bridge when you come to it.
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> When I was more responsive to drugs, I found that insomnia was a good prognosticator for me. It was associated with a good response to treatment.
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> - Scotti used 25mg of Seroquel last night. since Parnate has also been causing daytime lethargy in me, it's hard to know when the Seroquel 'hangover' eased off, and the Parnate lethargy kicked in, but i have been feeling lazier than usual today. it's strange, Parnate seems to superficially stimulate me (faster heartrate, clearer senses), but not produce any desire/energy to capitalize on that stimulation, which means i find myself acting almost aggressively withdrawn.
anyway, i sleep fine on Seroquel; my pdoc was willing to prescribe benzos as well, but i chose Seroquel because i thought it would be easier to discontinue (on Nardil, i would alternate between not sleeping and shoveling down benzos, but i don't have that kind of energy at the moment, so plan on taking something every night for sleep w/ Parnate). would it be safe to use amitriptyline instead, at a dose of say 20mg?
my only worry is that the insomnia will not pass, and that he will not go high enough dose-wise to allow it to abate naturally. i imagine i could push him to 40 or 50mg, but like i say, i am wondering if that is high enough to take care of the insomnia naturally. i understand i am being excessively anxious about this whole thing, but there are posts by Chairman MAO and ilk who say it never went away, regardless of dose. i just don't know if i have the wherewithal to find that, three months down the track or whatever, i am stuck on an insufficient dose, not sleeping etc. please understand that part of my OCD means i obsess over side-effects; part of that's legitimate (trying to avoid brain fog), but i am also so depressed that i *have* to try and stay on something.
poster:g_g_g_unit
thread:916453
URL: http://www.dr-bob.org/babble/20090902/msgs/916470.html