Posted by bulldog2 on October 27, 2009, at 13:13:18
In reply to Post Parnate update. Info for other Parnate users, posted by delna on October 27, 2009, at 12:50:51
> Hi,
> Hope people are doing well.
>
> Much to my surprise, my pdoc actually came home to see me because i was in such a bad state. I'm off the Parnate totally, now. Although he has seen me being a zombie before (as we have worked together on projects before, when I was in a drug company) he was quite taken aback to find me lying in bed half-dead.
>
> Anyway, he said that from my reaction to Parnate (well, more the fact that I hardly reacted positively at all) he felt that it was the right decision to give it up for the time being (since I am too suicidal to hang on through the erratic period). He had planned to augment with Nortriptyline and was NOT convinced that 200mg Provigil was the highest dose one can take with Parnate.
>
> I think I underestimated his knowledge on the drug (I thoroughly grilled him) and he seemed to know what he was talking about. But still the fact that he is usually unavailable made Parnate not the ideal drug for me. So it is on hold for now.
>
> For other Parnate takers out there, he simply confirmed a few things which I wanted to share:
>
> 1) It behaves erratically in the beginning (especially giving mild 'highs' that poop out) but then it finally settles done, eventually lifting the mood very well and improving energy levels. 6 months is what he told me today. He said he has seen miracles on it (This may be especially useful for Sunbath to hear and is what Gayle has been saying all along)
>
> 2) Low dose, nortriptyline augmentation makes a HUGE difference! This again echos what Gayle said.
>
> 3) He uses small dose amytripyline for insomnia but said that there are many other meds that can be used safely. I'm sorry to those suffering from insomnia but I didn't press him for more options
>
> 4) It has good action against obsessions even though they are not documented.
>
> 5) If you fail on Parnate, Nardil may well help you instead.
>
> 6) Stimulants can be added and really help response alot. For me (since I like Provigil) he maintained that i could be on a high dose.
>
>
> Also, I found this link about the sedation and hypotension being transient: Pg 494 if the link is not working fully:
> http://books.google.com/books?id=kyS-bfvJvVUC&pg=PA87&lpg=PA87&dq=tranylcypromine+sedation&source=bl&ots=giSdsFSK_p&sig=c0LFGIZ93PEgPedgFK0cbuW4hDQ&hl=en&ei=kXfhSq7nMZPVkAWvv_y4AQ&sa=X&oi=book_result&ct=result&resnum=11&ved=0CDQQ6AEwCjgU#v=onepage&q=tranylcypromine%20sedation&f=false
>
>
> As for me, he has given me low dose nortryptyline just to cover this period till I can start the effexor (because I am in a critical state). He has lots of plans for augmentation with effexor (like some suggested my by favorite scientist, Stahl!). He said Nortyptline will not really help the anxiety so I am to take clonazepam as needed just for these 15 days.
>
> He also told me that there are many permutations and combination's left to try so to not give up hope. I think I needed to hear that.
>
> Well, just thought I'd update. Thanks for reading.
> Love
> DHi Delna
Thanks for the update on parnate. I think your info has me leaning towards starting parnate again and augmenting with low dose nortriptyline.
The one time I gave parnate a short trial the insomnia actually disappeared which surprised me. It sounds like this is a drug that can have a high success rate but you need a p-doc that undestands this compicated drug.I think I read somewhere that the success rate is over 90% for those who don't drop out due to sides.
But your choice of Effexor is excellent. It has a good track record and works relatively fast. The higher the dose the more it will work on norepinephrine plus serotonin from the beginning.I forget what other drugs will be in your combo?
Your p-doc sounds very knowlegable and I think you are in good hands. You know in this forum you may be barraged by anti-med people. But keep your eye on the ball and don't get distraced. Have confidence in your p-doc. You only need one p-doc.
But I think you will succeed and attain remission.Now that you know more about parnate keep it in your bag of things to try if needed. But I think your current combo will work. Now I know you will do high dose effexor. Was it also Wellbutrin and provigil? I'm testing my memory.
Love and Good Luck
Bulldog2
poster:bulldog2
thread:922895
URL: http://www.dr-bob.org/babble/20091021/msgs/922898.html