Posted by dragonblack on July 24, 2011, at 17:04:46
Hi All,
So, I've been at 60 mg of Parnate for several months now and I am pretty sure I am going to throw in the towel. The main problems for me are a very partial response, with my remaining symptoms (I'm BPII/GAD/PD) being deal-breakers, and extreme daytime fatigue, which is killing whatever benefit I'm getting from it or any drug (also take Ativan, .5 mg/day; Abilify, 2mg/day; just stopped Klonopin). If I was able to either increase or augment Parnate with a stimulant, I would stick with it. I've explored both options and neither is feasible. My new augment/mood stabilizer, Abilify, does suggest that I should wait and titrate up before discarding Parnate, but I hate the idea of holding onto this drug with major downsides and little efficacy as I trial Abilify - to the extent Abilify acts as an AD augment, I want an AD that I think is doing something on board. Otherwise, maybe I get a benefit from Abilify and it gets rationalized as helping Parnate "kick in," when in fact that's just speculation. Anyway, I digress.
So, I think I want to pick another AD to switch to. I feel like I've been on the med-go-round forever, and my life is slipping away before my eyes, so I've decided that I've got to set some sort of deadline. I can try med combos forever. So, I want to give the med route maybe another year or two and then just seek ECT. So now I am thinking that I need to have enough AD experience under my belt to justify resorting to ECT at some point. I've been on 3 or 4 SSRI's, Effexor, Wellbutrin, and now Parnate. I've never tried a TCA or Remeron.
I'm thinking that Remeron is my next stop, despite the fact that fatigue and tiredness are huge issues for me. I have them anyway, might as well be expected sides. Is there a case for asking for a TCA? I've never sought one, and one has never been offered or suggested by any provider, I would guess due to the increased risk of manic switch, but this represents a major class I have no experience with. Is it necessary for me to try one before asking for ECT down the road, if it turns out to be necessary? Just trying to to think beyond this week.
Since Remeron is known for weight gain, it makes me wonder if I ought not consider Nardil (which I would normally pass on due to the weight gain issue, which is big for me). But Parnate left me completely unimpressed with the MAOIs. Maybe I have like tons of MAO.... : )
All replies appreciated!!!
poster:dragonblack
thread:991723
URL: http://www.dr-bob.org/babble/20110714/msgs/991723.html