Posted by Robert_Burton_1621 on March 2, 2015, at 9:20:15
In reply to Re: Progress on Parnate - Three-week point » Robert_Burton_1621, posted by ed_uk2010 on February 22, 2015, at 15:19:29
I appreciate your reply, Ed. I thought it best to wait another week so that I would be in a position to respond constructively.
> Thought it would work :) You can buy other antihistamines but they are not generally as effective.... or they cause more adverse effects.
>Thanks again for your suggestion. I haven't been taking the zyrtec daily for a week now. Just once a week seems sufficient.
> >I have progressed up to 80mg daily, as of today. I am having no side-effects to speak of.
>
> Good to hear you're tolerating it well. How are you doing in terms of weakness/dizziness and insomnia?
>The physical weakness is no very mild. No dizziness at all. No troublesome orthostatic hypotension. Parnate has been the most side-effect minimal medication I have ever taken.
> >But there has been no improvement in mood.
>
> I'm sorry to hear that. What were you depression ratings before you started tranyl?
>Good question. The psychiatrist who started me on parnate did not take them (and neither did I self-assess), but I suspect they would have been significantly higher than HDRS = 35 and MADRS = 47, especially given the marked degree of psychomotor fatigue and retardation I experienced over December and January. I took my most recent self-assessment on 27/2 and scored HDRS= 23 and MADRS = 25. Those scores can be described as nothing other than improvements, though there is a way to go.
> >I did manage to do some low-intensity weight and core training. This was reasurring, though it resulted in no improvement in mood or my "default" state.
>
> It promising you were able to go. I imagine you'd have to go regularly to get the most benefit, both mentally and physically.
>Another good point. I kept my appointment last week, too, even though I anticipated failing miserably at the prescribed tasks. I was able to go to the gym, and to participate with moderate capacity. I was quite pleased. My PT is clearly very intuitive, and is adapting the routines to my observed physical and mental state. I find the low-intensity, repetitive tasks (especially those which help regulate breathing) to be the most beneficial.
> It's the case with all amine elevating antidepressants (SSRIs, tricyclics, MAOIs etc) that clinical improvement is delayed, even though elevation of monoamines occurs rapidly. All theories appear to revolve around the idea that adaptations must occur in the brain following the increased amine levels, in order for the full AD effect to occur.
>That is a very succinct summary. It had been bothering me why I had not experienced with parnate - after a week, after two weeks - the sudden "the lights are on!" experience I had with fluoxetine and effexor. I still have not reached that point. However, the effect both of fluoxetine and effexor was very short-lived. Parnate is at least consistent, in my experience thus far.
From my experience with fluoxetine and effexor, I am inferring that I haven't quite yet had the benefit of parnate's serotonergic potency. But I don't know whether that is a legitimate conclusion to draw. For instance, parnate is definitely anxioloytic (though I find myself getting more irritable and angry, too, but it may well be that such responses are wholly explicable by objective triggers: the depression may well have suppressed the normal range of emotion, particularly reactive emotion, I was capable of feeling and acting on).
I think the most positive benefits I have experienced thus far are attributable to dopamine (my movement has improved - I have not had one day of pronounced psychomotor retardation since starting parnarte, whereas before I would have such days at least twice a week) and noradrenaline (I have kept all of my appointments, and during my appointments my attention and cognitive focus and capacity for articulation has improved noticeably).
I actually went up to 100mg five days ago. I did find that dosage the closest I have experienced in inducing the kind of positive effects I associated with fluoxetine and effexor (on serotonin?), but I decided to go down because I do not wish to push the boundaries with my doctor.
I note that treatment-resistant patients are prescribed up to 120 - 160 mg per day.
At the moment, I am taking 50mg in the morning and 20 mg in the late morning. I find the more I take in the morning, the better I feel through the day.
The insomnia is definitely improving, though I find I need an hour to two hours' sleep in the late afternoon. I am not fighting this.
> Are you still getting headaches?
No headaches at all anymore, thankfully!
poster:Robert_Burton_1621
thread:1075968
URL: http://www.dr-bob.org/babble/20150223/msgs/1077246.html