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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by SDW on December 5, 2004, at 11:14:02
I’m a new poster, though I’ve been lurking for a week or two….
Here’s my deal…For the last 2 years I have had a mild chronic depression (dysthymia)characterized by severe fatigue, apathy, lack of motivation, anhedonia. I have been taking Amphetamine in order to function with the fatigue, but it did nothing for the depression. I’m reached the limit of my tolerance for walking around half alive (half dead?).
I have an excellent doc (psychopharmacologist) and I just restarted *Parnate* 2-3 weeks ago after a 5-month break with the hope of a renewed response.
*History…*I first took Parnate for severe major depression while in college (after failures with Prozac and negligible results with Nortryptiline). About 3 weeks after I started Parnate (30-40mg) I had a dramatic response, and by 6 weeks I was free of 90-95% of symptoms with very few side effects. Parnate is a tremendous and shamefully underused drug IMO, but that’s another issue altogether.
I was very well for about 1 year, and then the effects began to diminish. I was able to up the dose to 60 mg and got another year out of it. I have been on and off Parnate several times; it works, but after 6 –12 months it starts to poop out.
I have tried 5-6 other ADs with minimal results or no response. I have also tried augmentation of Parnate with 1-Lithium, 2-Lamictal,
3-Cytomel(T3). Cytomel was the only thing that offered any additional benefit, but it was modest.*Current Plan…*
Since I know Parnate has the potential to work for me and I have tolerated it well, my doc is prepared to go up to 90-100 mg, but he wants me to hold steady at 60 mg for a few weeks first to see if stopping and restarting made a difference. We have discussed eventually adding Wellbutrin or a dopamine drug to the mix.
I’m hungry for any thoughts/suggestions/questions and I look forward to contributing…
Thanks in advance for your insight,
Stephen (Steve)
Male, 36 y/o - USA
Posted by jclint on December 5, 2004, at 12:46:23
In reply to New Poster-Dysthymia/Anhedonia/Parnate, posted by SDW on December 5, 2004, at 11:14:02
Hi Steve.
Just wondering, have you tried Nardil? I know that may be an obvious suggestion for someone so experienced with ADs, sorry :)
You say you were on parnate in college... if you don't mind me interrupting your threat for a moment, did you find the dietary restrictions particularly distressing at that age? I'm at college and have the chance to start Nardil... just trying to get some opinions.
All the best
J :)
Posted by SDW on December 5, 2004, at 13:49:27
In reply to Re: New Poster-Dysthymia/Anhedonia/Parnate, posted by jclint on December 5, 2004, at 12:46:23
I have actually not tried another MAOI such as Nardil, but that could be a possibility if Parnate does not remain effective. I was given Parnate because I tended to have hypersomnia, low energy, and other "atypical" symptoms, and Parnate tends to be more activating for most people.As far as the diet goes-it was a little difficult to get used to at first, but since 1996 there are fewer restrictions. I drank alcohol, including white wine, but not beer, though I know some people have. I have had pizza without sausage, and things like avocados with no problems. The most serious potential for interactions are really with some OTC drugs, so I definately recommend caution there. You can get used to the diet, and it's a small price to pay for relief from depression. I wish you luck with Nardil. Keep us posted.
Posted by jclint on December 5, 2004, at 13:58:28
In reply to Re: New Poster-Dysthymia/Anhedonia/Parnate, posted by SDW on December 5, 2004, at 13:49:27
Cheers man I will. It will be good to have another experienced user on board.
I'm glad that you have had success with your meds.
BTW, before I meant to say 'sorry for interrupting your *thread*', not *threat* ;)
J
Posted by lia mason on December 6, 2004, at 9:40:10
In reply to New Poster-Dysthymia/Anhedonia/Parnate, posted by SDW on December 5, 2004, at 11:14:02
I also had a great response to Parnate, but found the sexual dysfunction insurmountable. Re: Nardil... I think it is, like Parnate, an exceptionally good, powerful antidepressant that gets underused because of side effects. The side effects I experienced on Nardil were worse than on Parnate, specifically: swelling/water retention (my shoes got tight, even) and drops in blood pressure that were really pronounced and troubling... felt like I was going to black out. So Parnate was much "cleaner" for me, but that may be specific to me. There's also Marplan and (overseas) meclobemide in the MAO class, but they didn't work as well for me. I think Meclobemide has no dietary requirements.
Lia
Posted by jclint on December 6, 2004, at 9:43:37
In reply to New Poster-Dysthymia/Anhedonia/Parnate, posted by SDW on December 5, 2004, at 11:14:02
Have you read about EmSam? Its a basically the MAOI selegiline in a patch form, significant as this method seems to bypass the dietary restrictions. Its been marked approvable by the FDA so I think you will probably see that some time next year.
In the UK on the other hand...
This is the end of the thread.
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