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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by hiram2354 on April 11, 2001, at 21:26:57
I can't live like this forever, so I've decided to circumvent my doctor and start parnate, which I'm pretty sure never to be prescribed with the way things are going (no other pdoc options w/ current ins.)The 10 mg tabs arrived today along with some lithium carbonate, which I've decided to try only if the parnate doesn't work.
It's been 10 days since my last effexor (not xr), though I figure I'll still wait another few days just to be safe.
I will try 10 mgs on day 1, and if all goes well I will increase to 20 mgs the next day, with a 10 mg increase each week, probably adding about 500 mgs of lithium if needed at about the 40 mg/day mark.
No prior blood pressure problems (or anything else pertinent), and I'm not too worried as I've been known to ingest huge doses of "other" drugs w/o serious negative affects.
Any yes I've familiarized myself with the food and drugs that shouldn't be taken; also, I know I'm evil for trying to help myself w/o "professional" advice.Anyway, any suggestions, advice, or support are more than welcome. I'll update this thread in a week or so.
hiram
Posted by SalArmy4me on April 12, 2001, at 0:51:25
In reply to starting parnate, posted by hiram2354 on April 11, 2001, at 21:26:57
--I took Tranylcypromine for three months last year. Here is my commentary on MAOIs:
Are MAOIs Dangerous?
Yes, there is a chance of a hypertensive crisis in which blood pressure increases so rapidly that a huge headache occurs. The chance of a hypertensive crisis from eating foods with tyramine is 6% from the last study done on it; modified to only 3% with the application of a special diet. These are pretty low percentages. But even if such a hypertensive crisis occurs, a simple dose of oral nifedipine will stop it immediately... The truth is that most hypertensive crises are mild, if they even occur.
Actually, there is more of a chance of _low_ blood pressure (orthostatic) with MAOIs than with the opposite. This may sound like a terrible illness, but it is merely annoying and does not cause any damage to the body. It may make you dizzy when you go from lying down to standing upright. It is easily remedied with a high sodium diet.
http://www.dr-bob.org/tips/split/Orthostatic-hypotension-on.htmlIf a first or second-line antidepressant fails for you, you should consider an MAOI (Phenelzine, Tranylcypromine, or the now available isocarboxazid. MAOIs are the only medications that work on three chemicals in the brain all at once--thus maximizing chances at relief.
A disadvantage of MAOIs is that they can have severe interactions with other medications. Sometimes a Serotonin Syndrome or Neuroleptic Malignant Syndrome occurs. But to avoid such reactions, all you have to do is remember to ask your doctor before taking any medication with an MAOI. Or, you can use Dr. Koop's Drug Checker at www.drkoop.com.
MAOIs are perfectly safe, that is why they are still used after 40 years of existence. They just require that you get used to the idea of taking them and not erroneously think that they will kill you. Point in case: Nobody ever sees an article about someone dying from an MAOI in the paper.
Other stuff: http://www.dr-bob.org/tips/split/Orthostatic-hypotension-on.html
http://www.dr-bob.org/tips/split/MAOI-diet-update.htmlBlood & Fire: The Salvation Army USA West --the New Frontier
Posted by SalArmy4me on April 12, 2001, at 0:59:03
In reply to starting parnate, posted by hiram2354 on April 11, 2001, at 21:26:57
I think your plan is sound.
Although, it would help to have a doctor to prescribe medications to combat the side-effects of Parnate. {Provigil/methylphenidate for drowsiness; urecholine/Flomax for anticholinergic stuff; Inderal for tremor; nifedipine for emergency hypertensive crises}.
Posted by hiram2354 on April 12, 2001, at 2:55:25
In reply to Re2: starting parnate, posted by SalArmy4me on April 12, 2001, at 0:59:03
> I think your plan is sound.
I thought you might. In fact, I think it was your thread on "attacking depression" that got me started:) I think I'll brave out any of the initial side effects w/o any other meds to complicate matters. Of the many meds I've tried, I've rarely had bad side effects, or at least I'm too bothered to spend more money and time trying to counter them.
fWIW, I stopped my effexor xr about 2.5 weeks ago at about 450-600 mgs cold turkey. Yes there was discomfort, (still is) but I really think some people have a tendency to blow it (effexor wd) out of proportion. I always imagine a heroin user laughing his/her ass off while reading some of these effexor horror stories.
Posted by blackjack on April 12, 2001, at 17:31:30
In reply to Re2: starting parnate, posted by SalArmy4me on April 12, 2001, at 0:59:03
>{Provigil/methylphenidate for drowsiness;
Frowsiness really isn't a problem with Parnate, usually. Quite the opposite. And I'd be REALLY careful mixing it with any stimulant, especially if you're not under direct medical supervision. Tho it can be done, it's delicate and risky.
> > urecholine/Flomax for anticholinergic stuff;
Again, not usually a problem with Parnate. I don't think it has much anticholinergic effect.
Posted by SalArmy4me on April 12, 2001, at 17:44:00
In reply to Re: Re2: starting parnate, posted by blackjack on April 12, 2001, at 17:31:30
From the Canadian tranylcypromine monograph:
"Other possible adverse effects include weakness, _drowsiness_, dizziness, dry mouth, nausea, diarrhea, abdominal pain, or constipation. Tachycardia, anorexia, edema, palpitation, blurred vision, chills, _urinary retention_..."Parnate put me to sleep and almost put me in the hospital so they could stick a catheter down my privates and let the urine out.
> >{Provigil/methylphenidate for drowsiness;
>
> Frowsiness really isn't a problem with Parnate, usually. Quite the opposite. And I'd be REALLY careful mixing it with any stimulant, especially if you're not under direct medical supervision. Tho it can be done, it's delicate and risky.
>
> > > urecholine/Flomax for anticholinergic stuff;
>
> Again, not usually a problem with Parnate. I don't think it has much anticholinergic effect.
Posted by hiram2354 on April 13, 2001, at 13:26:32
In reply to Re: Re2: starting parnate, posted by SalArmy4me on April 12, 2001, at 17:44:00
I took my first 10 mgs very early this morning. Kind of an impulsive thing as I was planning on waiting for the two week washout from effexor, but after a few beers I usually get a bit "wild." Also, figured I'd make sure (with the tap beer and the grilled cheese, of course) whether or not I'm able to tolerate this stuff or should try something else. If I'm gonna react poorly to this stuff I might as well get it over with now instead of worring for the next 6 months if this nibble of cheese is gonna do me in. No reason not to dive right in, I guess.
We'll after about two hours I got a nice headache and puked out the unprocessed sandwich and beer. This stuff also seems pretty stimulating on my system. Didn't sleep for more than an hour (what's new?), but I don't feel the usual walking zombie I usually am in the am and afternoon. No harm done, as my stomach and I don't usually get along after alcohol, w/ or w/o parnate.
So far so good. I think the biggest problem with this stuff is the anecdotal stories on these groups about going to the er and huge bp increases. A bit too much dr.bob created anxiety if you ask me.
I'll lay off the alcohol, in order to at least give this med a fair chance (headaches suck, anyway). And I'm pretty sure not to try new "experiments" with handfuls of ephedrine or some effexor or something. That'd be almost asking for trouble. Another 10 mgs when I get home in an hour or so.
This is the end of the thread.
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