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Parnate - raise or augment?

Posted by tensor on October 18, 2013, at 9:16:36

Almost three weeks on 40mg, nine weeks in total on Parnate. I take it for TRD and anxiety. While it works ok for anxiety I'm still anhedonic and anergic. Initially I had some troublesome side effects like nausea, chills, very low bp, sexual dysfunction and constipation. Most of these passed and appr. two weeks after a dose increase the sexual dysfunction and other s/e diminish and libido is increased over baseline.

I still have some orthostatic hypotension and delayed orgasm, I sleep okay though, much I believe thanks to melatonin, it really made a huge difference. I read that 95% of those who respond, respond to 30-50mg (Dr. Ken Gillman), so I'm not sure if I should just increase to 50mg or if I should augment with e.g. Lamictal. Although my pdoc has done his homework, he has no experience of this medication, it's not available here without a license. Ideas greatly appreciated.





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