Posted by jms600 on June 25, 2011, at 4:03:32
In reply to Breakthrough Depression - Parnate user, posted by fresh air on June 24, 2011, at 16:26:03
> "Breakthrough Depression"--Please Read My Story
>
> I am posting this message for a male friend named Steve who presently has no easy access to a computer.
> He says, "I am a generally healthy male of 62 who is of ideal weight and blood pressure. I have been taking MAOI anti-depressant Parnate/tranylcypromine for about 25 years (!) at a maintenance dose of 40 mg/day for nearly the entire time. Previous attempts in 2002-2003 to try three other A.D.s were unsuccessful. I've concluded long ago that this A.D. is the only one suitable for my needs.
>
> However, I am presently plagued by lingering up and down "breakthrough" depression and anxiety. How did this happen? In March, I spoke with my pdoc and we decided to see if I could try dropping the dose to 30 mg (for purely practical reasons). All seemed OK for about two months, then I was blasted by several extremely stressful incidents and situations including the possibility of long term incarceration, health/dental worries, theft of personal belongings, etc.--one on top of another.
>
> I started feeling moderate depression and anxiety for the first time in years. I wondered if the decreased dose had made me more vulnerable to such overwhelming stressors and put me below the threshold of resistance--even a mere 10 mg. decrease.
> (What do you think?) My pdoc increased my dose back up to 40 mg. on June 3, yet as of June 21 (18 days later), I was still feeling very worrisome ups and downs, some depression symptoms such as early awakenings, occasional heart palpitations, and a general feeling that on some days, I was OK again, but on others, I was still "wobbly" or somewhat depressed and not out of the woods yet.
>
> I wonder if it would normally take the incremental dose increase as much time to kick in (3-4 weeks, usually) as it does for most any A.D. to kick in initially. Your experience?
>
> On the other hand, would it be unusual/possible for an A.D. to "poop out" after being so successful for 25 years? If not, why does breakthrough depression and anxiety occur?
> And, if I should have no lasting change after about one month at 40 mg., would increasing the dose to 50 mg. be the next step?
> Lastly, what other medication(s) would be safe and viable to augment this MAOI, if necessary? (hopefully not).
>
> Your experiences and input would be very much appreciated."
If anxiety is a major issue, what about switching to Nardil? Parnate is stimulating and can aggravate anxiety in those suffering from it. Just a thought.
poster:jms600
thread:989321
URL: http://www.dr-bob.org/babble/20110619/msgs/989384.html