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Re: Parnate giving up- Sunbath/ Maxime » delna

Posted by Sunbath on October 16, 2009, at 7:20:31

In reply to Re: Parnate giving up- Sunbath/ Maxime, posted by delna on October 15, 2009, at 11:51:39

Hi Delna,

how are you doing?

> I wrote a letter to my doctor(hand delivered by my dad) but he hasn't replied/ called back . I wrote exactly what I wrote in my post here about giving it up and the reasons for doing so. My mum has tried calling him several times but he is not answering. She thinks he is washing his hands off me and doesn't want to see me anymore....I probably ask too many questions and doctors here HATE that.

That's really unacceptable!! I'm sorry that you have such a doc.. are you really absolutely sure that there's no other doc available who's also educating himself and is up to date? But I can't imagine a doc would want to wash his hands off of you!?

> Honestly, I do not want to give it up because that means I only have one other option left (efexor ++) and I'm not looking forward to that.Plus I don't know if it will even work considering that I was on Lexapro when this suicidal depression emerged (and welllbutrin, lamictal, provigil). So I really wish there was a way to make this drug work as it is almost my last resort. Plus the next 15 days are not going to be pleasant if i do give up.

You are right in my opinion! If you haven't so many options left you really should give it enough time!! Of course tht's not always easy :(
Before the extreme tiredness passed, I was kind of frightened and wasn't sure whether this was the right med.. I also already had thoughts of giving it up, but then after 10days (and the first on 40mg) the tiredness suddenly faded.. I still got some hypotension from time to time (but since a few days I didn't have it anymore..) and even now I have some afternoon fatigue, but that's perfectly bearable! Maybe your brain needs a bit more time to get rid of most of the tiredness? What's your most troublesome side effects at the moment?Is it the hypotension when you take 20mg at once or is it more a psychological exhaustion/tiredness that lasts the whole day (like I had the first 7-10days)?

> I appreciate what you guys are saying- that perhaps I need to go up faster and frankly I have read that the starting dose is 30mg (Stahl) but my doctor is so incompetent and indifferent. He's not answering his phone, not calling back. This is not a drug I can titrate up myself and all the info I have on what to expect from this drug I have gotten from this board. My pdoc is just dragging this out and not giving me any feedback or telling me what to do.

Again.. unbelievable :(
But even when you're on your own you can make it! After all you are not really completely alone ;)

> As far as the effects of this drug go I cannot tolerate the sedation.I slept all today even though my last dose was at night. If he knows that higher doses give better/ more activating results why isn't he doing anything? My guess is that he knows nothing (having given this drug to 7-15 people during his 30 years of practice). Incidentally I found this out after he had started me on it already!

How did you find out?
What I believe -from my very short experience that is- is that Parnate is indeed stimulating and activating.. but at the same time it seems to be calming too. The most energizing effect I notice now is when I wake up in the morning.. But after my first 20mg I calm down which is not unpleasant!
But it also acutely seems to lowers blood pressure in many patients an effect which -I believe- is transient. So if you get strong hypotension I don't think it's a good idea to titrate up faster!Your doc might think it's necessary to wait that out..
How's your blood pressure? Did you try taking 10mg every few hours?Like 7am, 10am, 1pm, 3pm?
I think Scott once suggested that if ones blood pressure was dropping much after a bigger dose of Parnate.

> It's sad and scary but he is supposed to be the best pdoc in Mumbai (possibly India-wide) and I have found him to be MUCH better than the rest. I don't think there is another pdoc here who even prescribes Parnate.

I understand, but it's really not so good when he isn't available and not answering your questions!

> Sunbath, I could try taking small doses all day to avoid the hypotension (that makes sense) if I was continuing it. Without my pdoc I cannot move forward. I don't even know if I should take it tonight as I haven't had any all day (and its 10pm here. If I continue it I will try daytime dosing as you are suggesting...

It would be interesting to know whether your sedation is partly from a low blood pressure.
But what I think would really improve when you took it during the day is your sleep! If you sleep only 5 hours a night I think you can't be anything but sedated during the day! At least it might worsen your sedation considerably..
But please don't take it spread over the whole day. I think you are suppsoed to take everything before 3pm to avoid worsening of sleep.
BTW: I'm now sleeping better and better it's really great!

> I'm not sure what I will do....this is not a drug I dare take/ play with without a pdoc's input and guidance.

Please tell us your decision and how you are doing.

I wish you all the best and good luck!!
Looking forward hearing from you,
Sunbath


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