Posted by g_g_g_unit on February 11, 2012, at 0:47:20
In reply to Re: parnate agitation, posted by SLS on February 10, 2012, at 6:11:15
> Do you think that things might actually get better at a higher dosage? Perhaps you need some pro-serotonergic activity to offset the anxiety, anger, and irritability being produced by stimulation of chatecholaminergic tracts. This would require the achievement of therapeutic levels of MAO inhibition, something you might not see until your reach 40 mg.
That's what I thought. But when I told my psychiatrist that I'd be happy to just push through the side-effects, he said that I can't pursue a theoretical dose nominated by someone who's never seen me clinically (his theory is that I'm exceedingly sensitive to medication). But I also don't think he's especially experienced with MAOIs; he's in his 60s, but has mostly worked as a child psychiatrist.
So, it's frustrating. . I really like my psychiatrist, but I don't want to sit around at a sub-therapeutic dose if these effects might be ameliorated by a higher one. Then again, I'm not sure we have the kind of relationship where I can be like, "oh, hey, I read that MAO inhibition is only achieved at 40mg, so let's try that in the hope the pro-serotonergic activity offsets the irritability." Is it naive to hope that some tolerance might grow to the irritability etc.?
>
> * How about adding an anxiolytic temporarily?
>
> Is there any bipolar stuff going on? If so, Depakote might help.
>That's what I've been wondering about, though my psychiatrist doesn't think so. Still, my mood becomes extremely labile on anything remotely stimulating.
I also hated Depakote, for what it's worth.
poster:g_g_g_unit
thread:1009862
URL: http://www.dr-bob.org/babble/20120202/msgs/1009961.html