Posted by g_g_g_unit on February 11, 2012, at 7:39:32
In reply to Re: parnate agitation » g_g_g_unit, posted by SLS on February 11, 2012, at 5:45:51
> > 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.
>Yeah, I guess he is. But if it's common knowledge that Parnate has two separate mechanisms - MAO inhibition and an independent stimulant effect - then I don't see why he'd at least shoot for MAO inhibition, with the understanding that what I'm experiencing is probably a reaction to the latter.
Really, though, this is just a case of my OCD wildly playing up, because I keep thinking, "What if he never raises the dose?" .. "What if he stops the trial based on misguided information?" etc. I feel like it's somehow my responsibility to ensure the trial proceeds correctly.
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> > 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.
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> 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.Yeah, I'll wait it out and see. Given that the irritability is short-lived - it only lasts 2-3 hours after each dose and is absent in the evening - it seems likely that it's the result of the stimulant effect. If it is an indicator of bipolarity, however, then that might not be such a bad thing either, because it would finally explain why I have such bizarre reactions to ADs and stimulants.
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> One step at a time.
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> > > Is there any bipolar stuff going on? If so, Depakote might help.
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> > 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.
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> That was the reason I asked. Is there any bipolar disorder in your family history?Not that I know of. My mother has ADHD and my father suffers from migraines (which I think I read might be linked to bipolarity). My great uncle committed suicide due to excessive gambling debts, which again might suggest BP, but he was never diagnosed as far as I'm aware.
I did have one 9-month episode which I really feel resembles hypomania, but my psychiatrist thinks it was complicated by alcohol (ab)use.
He also said that if I was bipolar, he expects my depressive episodes would've started at a younger age (as opposed to 20-21).
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> 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.Thanks :)
>
> How do you react to Wellbutrin?
>Never tried it.
poster:g_g_g_unit
thread:1009862
URL: http://www.dr-bob.org/babble/20120202/msgs/1009968.html