Posted by vanvog on May 8, 2013, at 7:30:25
In reply to Re: Optimal Parnate Dosing times, posted by SLS on May 8, 2013, at 3:00:24
I was going to write a post on that.
Gillmann writes:
"If [Parnate] causes subjective symptoms which require action then spreading the dose out will help. In order to understand the how and why of dosing it is useful to understand that the half life of Parnate is very short. It varies in different people but it is generally less than 2 hours (8-10). This is relevant for its possible (non-therapeutic) effects not related to MAO inhibition (e.g. via TAA receptors, see other notes). However because it is an irreversible inhibitor its half life is not relevant to what we think is the main therapeutic effect, which is MAO inhibition.
So, what this almost certainly means is that for MAOI therapeutic effect it does not matter at all whether you take one single dose or split it up. Indeed it is probably possible to take it on alternate days. Is all that matters is whether the total dose taken is sufficient to inhibit any new enzyme which has been synthesised by the body since the last dose. However, to the extent that other effects may be mediated in other ways, those are likely to be dependent on the concentration of the drug in the blood and tissues, then the half life is relevant. Therefore, if the objective is to minimise side effects by spreading the effect as evenly as possible in the first part of the day it is logical to take a dose every couple of hours."
"For many people Parnate has less side effects than most other drugs, but insomnia is one of the commoner undesirable effects. It seems clear that, in the majority of people, the earlier in the day that the dose is taken the less insomnia is experienced. If it is possible to take the whole daily dose first thing in the morning (on waking) that is the ultimate way of minimising insomnia. If that does not work then splitting the dose up into smaller bits taken at intervals of about two hours or so is the next best solution. It is usually best not to take any of the doses after the middle of the day. However, there are no absolute rules and experimenting to find out what is best for each individual usually gives a satisfactory resolution for any problems."
poster:vanvog
thread:1043363
URL: http://www.dr-bob.org/babble/20130501/msgs/1043385.html