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Re: parnate agitation » g_g_g_unit

Posted by SLS on February 11, 2012, at 5:45:51

In reply to Re: parnate agitation » SLS, posted by g_g_g_unit on February 11, 2012, at 0:47:20

> > 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

He is right, of course.

There used to be a blood test available to assay MAO inhibition in platelets, which was assumed to represent MAO inhibition in the brain. The test may have been discontinued for lack of demand. I don't think it is necessary for someone experienced with titrating Parnate to use it, but it might allay concerns and help guarantee an adequate trial dosage.

> Is it naive to hope that some tolerance might grow to the irritability etc.?

I don't think that it is naive to hope that irritability is a temporary startup side effect that will dissipate. For instance, a lot of people experience anxiety as a startup effect of SSRI therapy that usually disappears in 1-2 weeks. Of course, your irritability may persist. It might be an idiosyncratic reaction or an indicator of bipolarity. However, I don't think that you will find a study or a series of anecdotal reports indicating that irritability persists in every case in which it emerges. Whenever I start Parnate, I experience some stimulation that disappears within a week or so. However, I do raise the dosage to 40 mg withing 5 days.

Having said all of that, your doctor may have a legitimate concern. Who can say for sure in your case? Let's hope that the irritability dissipates quickly.

One step at a time.

> > 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.

That was the reason I asked. Is there any bipolar disorder in your family history?

I hope that you start feeling better as soon as you finish reading this sentence. :-) In the event that you don't, I hope that your patience eventually pays off.

How do you react to Wellbutrin?


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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