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My doc is titrating up my Parnate dose v. slowly?

Posted by Rahilka on October 1, 2013, at 22:05:06

Hi everyone,

My name is Rahilka and I have tried many different SSRIs/SNRIs/AAPs etc. for my Major Depression, Generalized Anxiety Disorder, Body Dysmorphic Disorder, and Obsessive Compulsive Disorder. Some I have had a partial response to, but most were unsuccessful, so my doctor has finally put me on an MAOI, Parnate.

Firstly, I know he is a doctor and I really respect and trust his professional expertise/opinion (he ran the Parnate clinic at Yale in the 1970s,) but he has me titrating up on the dose very, very slowly (or at least compared to what I am reading about other peoples' experiences.) He started me on 5 milligrams for the first week, then I will go up to 10 milligrams for the second week, and then I am supposed to see him so we can discuss if I am tolerating the medication/side effects and I guess we will go up from there.

This concerns me because from what I have read, the lowest effective dose of Parnate is 30 milligrams. If I go from 10 to 20 milligrams the third week, and then from 20 to 30 milligrams the fourth week, then that means it will have taken me an entire month JUST to get to the lowest effective dose - not to mention that I will have to be at 30 milligrams for at least two or three weeks to see if there is going to be any benefit. By those calculations it will take me 6 OR 7 WEEKS just to see if the absolute lowest effective dose of Parnate will even begin to work! Does this seem too slow to anyone else? This is my first MAOI experience so excuse my ignorance; I am not really sure how the titration schedule is supposed to go. It's just frustrating because I ALREADY had to wait an entire MONTH with absolutely no AD in my system before I got to even take my first Parnate because my doctor had to leave the country for a family emergency for a few weeks and insisted that he be in the country while I was trying Parnate in case I had a severe adverse reaction. So I am really tired of waiting and I just want to see if the thing is going to work or not.

I am only on dose 5 of 5 milligrams, so I have a while to go.

I am also very concerned, worried, scared, anxious, apprehensive, etc. because I suffer from severe GAD in addition to my depression and after reading many, many first-hand accounts of Parnate experiences online it seems that Parnate is not good for anxiety disorders and actually makes them worse. PLEASE tell me this is not always the case! I absolutely do not want to have to augment it with a benzodiazopene (sorry for bad spelling...) because benzos and I don't really get along. They cause a lot of depression for me and even at tiny, tiny doses make it very hard for me to stay awake, feel clear-headed (as clear-headed as I CAN be since my memory and brain fog has gotten so bad...) and not feel completely sedated.

I am so frightened about this drug. For the past two days I have been having some shortness of breath; it feels like someone is sitting on my chest and it is very difficult for me to breathe deeply and fully which of course is making me freak out more. Is this a possible side effect of Parnate, even at a low dose of 5 milligrams? So far I have also experienced more mental clarity (which only lasted for two or three days, now I'm back to fogginess,) a definite increase in anxiety, dizziness, seeing 'floaters' in my vision when I move my head around, and lightheadedness. I have been able to coast just above deep depression for the past few weeks somehow but now that this Parnate is increasing my anxiety I can feel my mood drop and I am becoming irritable, hostile, snappy, and withdrawn. Some days I even feel more agoraphobic and paranoid, and everyone gets on my nerves even if they're not doing anything wrong.

Did my doctor and I pick the wrong medication? Anyone else with severe anxiety problems helped by Parnate? How about anyone with a lot of irritability problems?


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poster:Rahilka thread:1051551
URL: http://www.dr-bob.org/babble/20130930/msgs/1051551.html