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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by matt66 on April 8, 2003, at 20:08:47
I've tried everything including ect. nardil is the only thing that worked (at 45mg kicked me out of chronic deporession for three weeks, then lagged, then we switched). in hindsight, i probably should have just upped the nardil at the time, not switched meds, but I've tried nardil on higher doses and for longer periods and can't get it to work. keep having paradoxical reactions. now the plan was to stick with parnate for three months, since its another maoi, and I've been chronicaly depressed/ocd/sp for 12 years (Im 22 now), the thought is maybe i just need to sit on an maoi for a long ass time. anyway, that's what I'm going with. The Nardil was the real deal, TCA's make me miserable and I've sat on paxil, prozac, celexa etc. So, starting the parnate i felt ok. Bad insomnia, but I don't even care about fixing that. I want to stay on this med. it is just so fucking hard. It's been two weeks and I'm real cumpulsive, biting my gums and picking my nails. Usually I can act a fake happy personality, but that's getting harder to do. I have positively no motivation. I realize this is partly the depression/ partly the med. anyone find they had initial good reaction, then bad reaction and then wait it out for the good to overcome the bad full force? I feel like that's what could have happened had I stayed on the nardil the first time, and since my first few days on Parnate, i seemed to calm down a bit, i hold out some hope fr it. the present is just so hard to deal with, even as I know, and tell myself constantly that I need to sit on meds and give them time for my body to adjust to start seeing beneficial results. it's just that the nardil hit me overnight, i get so frustrated so quickly. anyone have similar experiences? If I can't take this shit any more, I'm going to Manerix which I've only tried once for eight days, and then to nardil again, this time with the plan of titrating the dose slow as hell, so I don't get as spacey/withdrawn as I was last time I was on it when we bumped it up to 90mg the first week.Most people I've asked on this forum don't see it as a typical poopout, since I was only rerally on it for a month, three weeks of which it brought the most dramatic changes that have left me obsessing every moment for four years since how bad i need it back and how pointless my life is depressed vs. how easy everything was when I came up for air. any reply would be helpful. even just to tell me to sit on the fucking parnate and be patiernt and don't think about it and put blind trust in something for once, even as road signs make it look like I'm moving in the wrong direction.
much love,
matt
Posted by utopizen on April 8, 2003, at 21:17:36
In reply to STORM BEFORE THE CALM? NEED PARNATE SUCESS STORY, posted by matt66 on April 8, 2003, at 20:08:47
I don't know how long you've been on Parnate, but keep in mind you shouldn't bother evaluating its benefit to you until 4 weeks after you have started the target dose.
Before this comes, anxiety is typical. Like pus in a wound, that means the med is gathering up all the bad guys and taking inventory before it can tell the troops to aim for their targets.
And keep in mind that whenever you're switching meds, it's impossible to know whether the med you're switching to is causing the side effect, or you're experiencing withdrawl symptoms from the latter.
Parnate should help your concentration, from reading other people's experiences with it, because it is activating. So this seems to indicate you need to give it more time, since you'll probably notice this part of it when it kicks in. And since you have OCD, the OCD biting the nails, etc. appears to be a case of the drug making things worse before it's able to get better. Of course, this doesn't mean it's going to work, but if it will, it's going to exacerbate symptoms a lot of the time.
Posted by matt66 on April 8, 2003, at 21:58:55
In reply to Re: STORM BEFORE THE CALM? NEED PARNATE SUCESS STO, posted by utopizen on April 8, 2003, at 21:17:36
> I don't know how long you've been on Parnate, but keep in mind you shouldn't bother evaluating its benefit to you until 4 weeks after you have started the target dose.
>
> Before this comes, anxiety is typical. Like pus in a wound, that means the med is gathering up all the bad guys and taking inventory before it can tell the troops to aim for their targets.
>
> And keep in mind that whenever you're switching meds, it's impossible to know whether the med you're switching to is causing the side effect, or you're experiencing withdrawl symptoms from the latter.
>
> Parnate should help your concentration, from reading other people's experiences with it, because it is activating. So this seems to indicate you need to give it more time, since you'll probably notice this part of it when it kicks in. And since you have OCD, the OCD biting the nails, etc. appears to be a case of the drug making things worse before it's able to get better. Of course, this doesn't mean it's going to work, but if it will, it's going to exacerbate symptoms a lot of the time.you don't know how helpful that was. the med is "gathering up the bad guys to take up inventory before the army sets in on its target." I know there are no guarantees, but I'll try fighting my obsessing with that thought for a while. Can't hurt. By the way, I've been on Parnate for two weeks, as of today. 30mg for a week, and now 40mg for a week. This is my fourth trial of the drug, but as I may not have mentioned, I never gave it more than two weeks in the past. I'm terrible when it comes to being patient. One negative thing that happens during the day, and I'll obesess about it for the rest of the day, and mark it as an indicator that I'm moving in the wrong direction. Thanks for the wisdom
much love,
matt
Posted by Questionmark on April 8, 2003, at 23:51:38
In reply to Re: STORM BEFORE THE CALM? NEED PARNATE SUCESS STO, posted by matt66 on April 8, 2003, at 21:58:55
Matt, hey. Let me/us know how this works out for you. It's interesting-- i have the same problems/diagnoses as you do (and ADD) and i'm 22 too. Been depressed for almost just as long also. But anyway..
Hey i know how much easier said than done this is, but yes SIT on it, stay w/ the parnate for awhile. If you don't you'll always wonder whether you should have or not. i have not been an an MAOI but still-- stick with it.
Oh, is stuff like biting your gums and picking your fingers and sh*t really OCD-related?? i do that crap SO much and it drives me NUTS sometimes, but i always attributed it to ADD. Or is there an overlap here? Do you or anyone know? i'd really like to know.
Well anyway good luck with the Parnate, Matt.
Posted by Caleb462 on April 9, 2003, at 3:01:46
In reply to Re: STORM BEFORE THE CALM? NEED PARNATE SUCESS STO, posted by Questionmark on April 8, 2003, at 23:51:38
> Oh, is stuff like biting your gums and picking your fingers and sh*t really OCD-related?? i do that crap SO much and it drives me NUTS sometimes, but i always attributed it to ADD. Or is there an overlap here? Do you or anyone know? i'd really like to know.It is an OCD thing for some folks, and I assume it could also be somewhat of an ADD thing for others. It could also be nothing at all. I, myself, am both OCD and ADD... and am a terrible nail-biter/skin-picker, etc. I attribute it to OCD, because I know what compulsions "feel like", and they are definitely compulsions.
Posted by utopizen on April 9, 2003, at 7:23:34
In reply to Re: STORM BEFORE THE CALM? NEED PARNATE SUCESS STO, posted by Caleb462 on April 9, 2003, at 3:01:46
> It is an OCD thing for some folks, and I assume it could also be somewhat of an ADD thing for others. It could also be nothing at all. I, myself, am both OCD and ADD... and am a terrible nail-biter/skin-picker, etc. I attribute it to OCD, because I know what compulsions "feel like", and they are definitely compulsions.
>I have ADD but not OCD. I can still easily say that if you're doing something you don't desire to do but find you're doing it anyway (like my roommate who turns the light on and off for 5 minutes some nights) it's OCD. ADD can really only distract you from doing stuff, or impulsively have you do stuff. I never had impulses, but have observed children with severe ones, and even they were able to "step back" from them and realize they acted on an impulse like 5 seconds after doing the impulse.
Posted by cubbybear on April 9, 2003, at 12:07:33
In reply to Re: STORM BEFORE THE CALM? NEED PARNATE SUCESS STO, posted by utopizen on April 9, 2003, at 7:23:34
Matt,
I can identify with your lack of patience. I too, want instant gratification. BUT, somehow, you've got to find the strength to wait it out.
I've had success with Parnate for the past 18 years. I just went back on it a month ago and my severe depression went --poof!--Gone. I was lucky this time--it took "only" 3 weeks to kick in, but a few years ago, during another depression episode, I had to wait nearly a month for it to kick in. You should give ANY anti-depressant 4-6 weeks for a fair trial.
Posted by denise528 on April 9, 2003, at 12:27:15
In reply to Re: STORM BEFORE THE CALM? NEED PARNATE SUCESS STO, posted by cubbybear on April 9, 2003, at 12:07:33
Hi Matt,
Sorry can't really give you any advice. I'm trying Nardil myself, have been on it for almost a week and so far nothing. I know what you mean about wanting it to work straight away. In the past both prothiaden and Paxil worked for me within days it was almost instant and even later on though it took a few weeks I sort of felt that they were trying to work. This time round I feel nothing. I hate all this waiting, sometimes to no avail.
Denise
Posted by denise528 on April 9, 2003, at 12:39:03
In reply to Re: STORM BEFORE THE CALM? NEED PARNATE SUCESS STO, posted by cubbybear on April 9, 2003, at 12:07:33
Hi,
Can I ask you a question. When I first took paxil I noticed an effect immediately, a few years later when I took it again it took about 3 weeks to kick in but I sort of felt it trying to work, something told me it was going to. This time round it hastn't worked at all and I knew if wastn't going to. I am now trying Nardil, I've been on 45mg for almost a week now and I don't feel it doing anything. You were saying that once with Parnate it took about a month to kick in but didn't you sort of feel it working before the month was up or did you feel nothing and then a sudden lift of the depression?
Denise
Posted by utopizen on April 9, 2003, at 14:22:59
In reply to Re: To Cubbybear, posted by denise528 on April 9, 2003, at 12:39:03
I am now trying Nardil, I've been on 45mg for almost a week now and I don't feel it doing anything.
>My doc said "it's not rational to think that way" when I claimed I found effect from a drug within a few days. Apparently, unless it's an anticonvulsant or benzo, you can't notice actual change for at least 3 weeks.
Posted by Questionmark on April 9, 2003, at 15:20:53
In reply to Re: To Cubbybear, posted by utopizen on April 9, 2003, at 14:22:59
> My doc said "it's not rational to think that way" when I claimed I found effect from a drug within a few days. Apparently, unless it's an anticonvulsant or benzo, you can't notice actual change for at least 3 weeks.
>That's bullsh*t. Ask you doctor how many meds he's actually been on. i understand that it cAn often take a few weeks or so, but it can also have noticeable effects the first day.
Also, thanks for your comments on the compulsive stuff (OCD vs. ADD stuff). Good points.
Posted by denise528 on April 10, 2003, at 11:04:16
In reply to Re: To Cubbybear, posted by utopizen on April 9, 2003, at 14:22:59
That's rubbish. My Doctors have said the same thing to me. When I first started taking prothiaden and it worked straight away I told my Doctor and he said it wastn't possible that they don't work like that, that it must have been a placebo effect. There is no way it was a placebo effect, I'm the last person who would get a placebo effect from anything, I'm not at all suggestible and the feeling of them working was so incredible, it was miraculous.
Just goes to show how much these people really know, they just go by what they read in the clinical studies.
Denise
Posted by utopizen on April 10, 2003, at 14:25:21
In reply to Re: To Utopizen, posted by denise528 on April 10, 2003, at 11:04:16
> Just goes to show how much these people really know, they just go by what they read in the clinical studies.
>
> DeniseIn my case, my doctor wouldn't believe the clinical trials I showed him, even though even his colleagues told me they didn't know why he wouldn't give me Klonopin. One had a really confused look on his face after seeing me and saying, "I have no idea. Obviously he's not concerned about abuse if he's giving you methamphetamine!"
J Nerv Ment Dis 1996 Dec;184(12):731-8 Related Articles, LinksA 2-year follow-up of social phobia. Status after a brief medication trial.
Sutherland SM, Tupler LA, Colket JT, Davidson JR.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
Although social phobia is thought to be a chronic disorder, little is known about its long-term course in patients who engage in brief treatment studies. We, therefore, conducted a follow-up study of social phobics who had participated in a brief, placebo-controlled treatment trial of clonazepam. Of the original 75 subjects, 56 were assessed through telephone interview and self-report questionnaires that evaluated current social phobia symptoms. Information was also gathered about treatment received in the 2-year interval since the initial pharmacotherapy trial. The group as a whole showed maintenance of the gains acquired during initial treatment. On a number of symptom scales, subjects initially treated with clonazepam exhibited significantly less severe scores compared with placebo subjects. This study provides evidence of long-term benefit for social phobics when treated with a brief medication trial.
Publication Types:
* Clinical Trial
* Controlled Clinical Trial
PMID: 8994456 [PubMed - indexed for MEDLINE]
Discontinuation of clonazepam in the treatment of social phobia.
Connor KM, Davidson JR, Potts NL, Tupler LA, Miner CM, Malik ML, Book SW, Colket JT, Ferrell F.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
Patients with social phobia who responded well to 6 months of open-label treatment with clonazepam were assigned to receive either continuation treatment (CT) with clonazepam for another 5 months, or to undergo discontinuation treatment (DT) using a clonazepam taper at the rate of 0.25 mg every 2 weeks, with double-blind placebo substitution. Clinical efficacy was compared between the CT and DT groups using three different social phobia scales. Benzodiazepine withdrawal symptoms were also measured. Relapse rates were 0 and 21.1% in the CT and DT groups, respectively. Subjects in the CT group generally showed a more favorable clinical response at midpoint and/or endpoint, although even in the DT group clinical response remained good. With respect to withdrawal symptoms, the rates were low in both groups (12.5% for CT and 27.7% for DT) with no real evidence suggesting significant withdrawal difficulties. At the end of 11 months of treatment with clonazepam, however, a more rapid withdrawal rate was associated with greater distress. This study offers preliminary evidence to suggest that continuation therapy with clonazepam in the treatment of social phobia is safe and effective, producing a somewhat greater clinical benefit than a slow-taper discontinuation regime. However, even in the DT group, withdrawal symptoms were not found to be a major problem. The study can be taken as supportive of benefit for longterm clonazepam treatment in social phobia, as well as being compatible with a reasonably good outcome after short-term treatment and slow taper.
Publication Types:
* Clinical Trial
* Randomized Controlled Trial
PMID: 9790154 [PubMed - indexed for MEDLINE]
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