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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by pryor8 on September 8, 2004, at 10:00:31
Regarding Parnate problems: I've read a few posts about others starting Parnate recently. Here's my update; please share if you have any ideas:
I was massively zone-out after a few days at 40, so went back down to 30. This is a pain, since this fatgue seems to be only serious side effect. Still no real benefit, but no problems either (other than tiredness) which is a change from other ADS for me.
I'm at bit over 2 weeks at 30-40, staggered in various ways through day, usually 1/1/1 through day. Any ideas on how to combat fatigue? It's the sort that doesn't bring sleep, but only spaciness. Xanax-induced 8 hours of sleep at night doesn't make a difference. Anyone ever try adding Wellbutrin or Reoxetine? (SLS, I saw your combos above; I don't think I could handle 160 mg!!)
Posted by quarterwit on September 8, 2004, at 13:33:27
In reply to Parnate problems and possibilities, posted by pryor8 on September 8, 2004, at 10:00:31
stick it out, I am !
Posted by King Vultan on September 8, 2004, at 14:29:56
In reply to Parnate problems and possibilities, posted by pryor8 on September 8, 2004, at 10:00:31
> Regarding Parnate problems: I've read a few posts about others starting Parnate recently. Here's my update; please share if you have any ideas:
>
> I was massively zone-out after a few days at 40, so went back down to 30. This is a pain, since this fatgue seems to be only serious side effect. Still no real benefit, but no problems either (other than tiredness) which is a change from other ADS for me.
>
> I'm at bit over 2 weeks at 30-40, staggered in various ways through day, usually 1/1/1 through day. Any ideas on how to combat fatigue? It's the sort that doesn't bring sleep, but only spaciness. Xanax-induced 8 hours of sleep at night doesn't make a difference. Anyone ever try adding Wellbutrin or Reoxetine? (SLS, I saw your combos above; I don't think I could handle 160 mg!!)
Does caffeine have any effect?--realizing, of course, that you don't want to take excessive amounts of caffeine while on this drug for safety reasons. I am also on 30 mg/day Parnate and do drink a moderate amount of coffee every day, though.Todd
Posted by iris2 on September 8, 2004, at 16:14:46
In reply to Parnate problems and possibilities, posted by pryor8 on September 8, 2004, at 10:00:31
I was on and off Parnate for a lot of years. Check your blood pressure to see if it is running low. That might be making you tired and the Parnate would cause that. What helped me with the blood pressure and fatigue was some ritalin sr. You have to be careful because it can cause hypertension but I never had a problem with it. Also coffee helped. If your doc will not prescribe ritalin my pdoc told me to take half of a (I cannot remember the da** name) anyway its a small OTC red allergy pill. Maybe you will remember the name. Sorry. It really ticks me off that my memory is so bad. Anyway be careful as this can cause the same hypertensive crisis as the ritalin.
Are you having problems sleeping? I always had to weigh the pros and cons but in the end it really was the only med that ever helped.
Posted by Piquet on September 8, 2004, at 16:45:02
In reply to Parnate problems and possibilities, posted by pryor8 on September 8, 2004, at 10:00:31
> Regarding Parnate problems: I've read a few posts about others starting Parnate recently. Here's my update; please share if you have any ideas:
>
> I was massively zone-out after a few days at 40, so went back down to 30. This is a pain, since this fatgue seems to be only serious side effect. Still no real benefit, but no problems either (other than tiredness) which is a change from other ADS for me.
>
> I'm at bit over 2 weeks at 30-40, staggered in various ways through day, usually 1/1/1 through day. Any ideas on how to combat fatigue? It's the sort that doesn't bring sleep, but only spaciness. Xanax-induced 8 hours of sleep at night doesn't make a difference. Anyone ever try adding Wellbutrin or Reoxetine? (SLS, I saw your combos above; I don't think I could handle 160 mg!!)It could be just a matter of waiting. I went from zero to 40 in 4 days, so I can understand what you're saying about being zoned out! However, after 4 weeks at 40 mg I was over most of the side effects except insomnia, and I was even getting a handle on that. My mood was a lot better, too. After another 2 weeks my doc raised the dosage to 60 mg and there was a repeat of the startup effects, but to a lesser degree and shorter lived. Now, after 3 weeks at 60 I'm having very little daytime tiredness and once again getting my sleep routine stabilized. I take 40 am and 20 midday. Parnate is really helping to lift my treatment resistant atypical depression, and I'm feeling better than I have done in years. Hope this helps.
Piquet.
Posted by cybercafe on September 9, 2004, at 0:46:01
In reply to Re: Parnate problems and possibilities, posted by Piquet on September 8, 2004, at 16:45:02
> > Regarding Parnate problems: I've read a few posts about others starting Parnate recently. Here's my update; please share if you have any ideas:
> >
> > I was massively zone-out after a few days at 40, so went back down to 30. This is a pain, since this fatgue seems to be only serious side effect. Still no real benefit, but no problems either (other than tiredness) which is a change from other ADS for me.
> >
> > I'm at bit over 2 weeks at 30-40, staggered in various ways through day, usually 1/1/1 through day. Any ideas on how to combat fatigue? It's the sort that doesn't bring sleep, but only spaciness. Xanax-induced 8 hours of sleep at night doesn't make a difference. Anyone ever try adding Wellbutrin or Reoxetine? (SLS, I saw your combos above; I don't think I could handle 160 mg!!)
>
> It could be just a matter of waiting. I went from zero to 40 in 4 days, so I can understand what you're saying about being zoned out! However, after 4 weeks at 40 mg I was over most of the side effects except insomnia, and I was even getting a handle on that. My mood was a lot better, too. After another 2 weeks my doc raised the dosage to 60 mg and there was a repeat of the startup effects, but to a lesser degree and shorter lived. Now, after 3 weeks at 60 I'm having very little daytime tiredness and once again getting my sleep routine stabilized. I take 40 am and 20 midday. Parnate is really helping to lift my treatment resistant atypical depression, and I'm feeling better than I have done in years. Hope this helps.
>
> Piquet.
>
for some reason i find even a small dose (1 mg every 2 days) of abilify to counteract parnate insomnia at night ... if this helps at all ...also clonazepam really seemed to help with the antidepressant effect ....
sorry though ...never had daytime fatigue aside from the low blood pressure thingy first time around
Posted by iris2 on September 9, 2004, at 10:32:04
In reply to Re: Parnate problems and possibilities » pryor8, posted by iris2 on September 8, 2004, at 16:14:46
> If your doc will not prescribe ritalin my pdoc told me to take half of a (I cannot remember the da** name) anyway its a small OTC red allergy pill. Maybe you will remember the name. Sorry. It really ticks me off that my memory is so bad. Anyway be careful as this can cause the same hypertensive crisis as the ritalin.
>
I apologize profusely for not remembering this. The name of the OTC I was talking of is Sudafed. I did try it and it worked, but like I said you have to be aware of the possibility of hypertensive crisis!I reread your post and it does sound very possible that your blood pressure being depressed is the problem. The Ritalin or Sudafed even coffee will increase your blood pressure and stop the fatigue if this is what is causing it. I think that after four weeks you should see some shift in mood. I was not typical but on 30mg to start I had a total about face in three days.
Keep me posted.irene
Posted by TomV on September 9, 2004, at 15:05:34
In reply to Re: Parnate problems and possibilities, posted by Piquet on September 8, 2004, at 16:45:02
Man oh man. Your post is the kind of story that should push my butt to start this parnate. I filled the script, but so far I'm just chickening out, letting it sit on the shelf.
I've read so much about people sticking this one out and finally getting relief. But I hate the idea of having to watch my diet! What's a t.r.d. individual like me supposed to do? (That's rhetorical:)
Tom
Posted by Piquet on September 9, 2004, at 17:34:10
In reply to Re: Parnate problems and possibilities » Piquet, posted by TomV on September 9, 2004, at 15:05:34
> Man oh man. Your post is the kind of story that should push my butt to start this parnate. I filled the script, but so far I'm just chickening out, letting it sit on the shelf.
>
> I've read so much about people sticking this one out and finally getting relief. But I hate the idea of having to watch my diet! What's a t.r.d. individual like me supposed to do? (That's rhetorical:)
>
> TomHi Tom.
I doubt if you're being a chicken. You should be sure in your own mind that once you start you will see it through, in the sense of taking a high enough dosage for a long enough period of time. My own view is that currently the lack of depression in my life more than makes up for the lack of cheese, etc. Once you get used to watching your diet, it's no real biggie, and I've yet to meet up with any AD that doesn't have some drawbacks to its use. As a rhetorical reply to your rhetorical question, a t.r.d. individual is supposed to get better and start living again. :)
Whatever you eventually decide, I hope it goes well for you.Piquet.
Posted by quarterwit on September 10, 2004, at 8:43:12
In reply to Re: Parnate problems and possibilities » pryor8, posted by iris2 on September 8, 2004, at 16:14:46
Hi Folks, and thanks for helpful responses -- how much Ritalin did you take, by the way? I think that will be the solution I'll try to convince my pdoc to undertake. My blood pressure seems fine OVERALL, but there are times when the Parnate definitely reduces it. Pulse is chronically low, however, which may be contributing to lethargy.
I'm going to stick it out. I know that barely 3 weeks at 30 (after trying 40 for a few days, deciding on a slower tiration) isn't enough. Plus, I think it may be starting to help. Today it's tough to determine, though: I switched benzo sleep aids last night from xan to klonipin; the klonipin created serious nausea. I need something since the Parnate has caused insomnia...
Never heard of sudafed being a help -- aren't the red ones the no drowsiness formula? I had allergies as a kid and used to take those by the pound!
> I was on and off Parnate for a lot of years. Check your blood pressure to see if it is running low. That might be making you tired and the Parnate would cause that. What helped me with the blood pressure and fatigue was some ritalin sr. You have to be careful because it can cause hypertension but I never had a problem with it. Also coffee helped. If your doc will not prescribe ritalin my pdoc told me to take half of a (I cannot remember the da** name) anyway its a small OTC red allergy pill. Maybe you will remember the name. Sorry. It really ticks me off that my memory is so bad. Anyway be careful as this can cause the same hypertensive crisis as the ritalin.
>
> Are you having problems sleeping? I always had to weigh the pros and cons but in the end it really was the only med that ever helped.
>
>
Posted by iris2 on September 10, 2004, at 11:59:31
In reply to Re: Parnate problems and possibilities, posted by quarterwit on September 10, 2004, at 8:43:12
My first pdoc that prescribed Ritalin was 5 or 10mg but it was not slow release. I would get a huge rush and talk incessantly and then after about an hour start to cry. I would suggest taking the slow release. I would also suggest starting with the smallest dose, which I think is 10mg but it might be 20.
It is the no drowsy form of Sudafed. My current pdoc, who was not treating me at the time, suggested it because we were not sure the pdoc I had would prescribe the Ritalin. I did try it and it worked. Again it has the same drawback as the Ritalin about hypertensive crisis and it was half of one of those little red pills.
By the way if you do start any of this I would also suggest investing in an inexpensive blood pressure gage. If you start getting a headache take your blood pressure. I would take it now and then at first just to make sure my blood pressure was still okay and take it several times before you start anything to get a baseline.irene
This is the end of the thread.
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