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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Don_Bristol on May 10, 2006, at 18:00:50
I have been on 50mg of Parnate for the last two years for dysthymia. A few months ago I had my second major depressive episode; it was very bad.
I like my Parnate but my psychiatrist now wants to change my medication.
One big reason for him seems to be that the Parnate did not seem to do anything to prevent the major depression occuring and so may not be the right med. (I have a little bit of OCD which I think he wants to try and medicate.)
Is he correct when he says that the Parnate should have prevented the major depression I recently experienced?
Thanks for any info.
Don
Posted by linkadge on May 10, 2006, at 18:09:48
In reply to Will Parnate *prevent* a major depression?, posted by Don_Bristol on May 10, 2006, at 18:00:50
No medication is guarenteed to prevent major depression. You could go through all the withdrawl and transition only to find another drug that doesn't prevent it.
I think that if you are happy with the drug overall, you could stick to it, and maybe augment it.
Linkadge
Posted by JaclinHyde on May 10, 2006, at 18:23:06
In reply to Re: Will Parnate *prevent* a major depression?, posted by linkadge on May 10, 2006, at 18:09:48
I think it all depends on what the major depression is from. Obviously no drug will keep us on an even keel if heaven forbid we suffer a loss or any other major life issue comes up. There are other chemical factors too for instance as a woman I was thrown for a loop when I began going through menopause, MAOI and all. An addition of neurontin at the time did the trick for me. Maybe you just need a switch to a different MAOI since you know that that class of drug works for you. That would be my suggestion anyway. :-)
JH
Posted by blueberry on May 10, 2006, at 20:13:08
In reply to Will Parnate *prevent* a major depression?, posted by Don_Bristol on May 10, 2006, at 18:00:50
I tend to agree with your doctor. The antidepresant, or I should say the right antidepressant, is supposed to prevent relapse or worsening of symptoms. Though you may have liked your med for some time, it appears to not be doing its job anymore.
Posted by linkadge on May 10, 2006, at 20:44:24
In reply to Re: Will Parnate *prevent* a major depression?, posted by blueberry on May 10, 2006, at 20:13:08
The whole idea of a drug preventing a episode of major depression is difficult since if it prevents an epsiode you will never know about it.
Suppose the possibility that parnate has been preventing many episodes (which you will never know about) but that this one slipped past.
I don't think there is a drug out there that can prevent every episode of depression.
Linkadge
Posted by Phillipa on May 10, 2006, at 21:11:02
In reply to Re: Will Parnate *prevent* a major depression?, posted by linkadge on May 10, 2006, at 20:44:24
Not prevent them help you get over them? Love Phillipa
Posted by willyee on May 10, 2006, at 22:29:20
In reply to Re: Will Parnate *prevent* a major depression?, posted by Phillipa on May 10, 2006, at 21:11:02
I agree with linkadge,a long depression episode doesent neccsarly mean the drug did not do its job,like he said for all unknown purposes the med could have prevented numerous breakdowns,unfortantly depression does break through most barries,meaning even the best drug is unlikly to keep one from totaly relapse ever.
To change it that quickly is drastic,id instead see if it continues,unless u respond well in the past to most meds,u wanna stay on a drug if possable.
If not,consider overall if u feel the drug is no longer effective,on a daily basis,i know personaly parnate has stopped major depressive episodes for me,overall however its no longer effective enough,my options are to simply go off it to nothing,as i see at this time no other viable alternatives now that the patch for me isnt living up to its expectations.
I am intolerant to ssris which totaly narrows my window,so take time in making a decision of such.
Posted by Don_Bristol on May 11, 2006, at 8:52:45
In reply to Re: Will Parnate *prevent* a major depression?, posted by willyee on May 10, 2006, at 22:29:20
> I agree with linkadge,a long depression episode
> doesent neccsarly mean the drug did not do its job,
> like he said for all unknown purposes the med could
> have prevented numerous breakdowns, unfortantly
> depression does break through most barriers, meaning
> even the best drug is unlikly to keep one from
> totaly relapse ever.
>
> To change it that quickly is drastic, id instead see
> if it continues, unless u respond well in the past
> to most meds,u wanna stay on a drug if possable.Willyee thanks for your reply and thanks to others too who have replied. I'll reply only to you (but I also intend this to be to the other people too) as you have sort of included some of the other comments.
I have dysthymia and anxiety attacks. I also have an obsessive personality (which is not OCD). I had a major depression after my father died 5 years ago.
This year I had all sorts of stuff happening in my life like suicides of family members an my girlfriend leaving me (I then became isolated as Ihave no other friends locally) etc etc etc. I slipped into a really bad major depression.
I got a new p-doc. He is experienced and is the head p-doc of a reasonably large psychiatric hospital. But he is not perfect and he is also very busy with hospital things and he can not spend a lot of time on each of his patients.
He says that in some parts of the world there are people going through mega-crises (such as civilians in horrific war zones) and many of those people do not need the degree of support I seem to need and they don't go into depression the way I did.
He kind of sees it as inevitable that I (as a more fragil eperson) went into depression on account of the life crises which occurred.
He then says that this is due in large part to my neurological makeup (I think he doesn't want me not to feel too much personal blame for life experiences and traumas and all that formative stuff so he is sticking to biochemistry).
And so he then concludes that the meds were no help to me and so I should change them.
WELL .... I kind of feel that most people in the same circumstances might well have gone into depression as I had no community support and the health services did not provide any social support which most people would have in normal life.
Who is to say any othe med might have been better in my case? I want to know from him why some sort of supportive interventions were not undertaken. but this is the UK and we have state health provider and not having enough resources is sort of acceptable in the way that it migth not be an acceptable explanation from a private health provider who gets money precisely to provide a result.
So my question is ... will a med (Parnate in my case) prevent depression because if so then he might be right in switching me away from it as it didn't work. However I am only on 50mg Parnate so I suppose he could increase it.
HMMMM ... I wonder why it was not increased at the time I was having trouble and slipping into depression? What I was given was some olanzapine which I found VERY sedating even at very low doses and could not continue to take.
Oh well. I hope some of that makes sense as I feel I am starting to ramble a bit and I am coming up with new thoughts as I write so it might seem that the topic is shifting and the questions are not closely related.
Don
Posted by Don_Bristol on May 11, 2006, at 9:01:13
In reply to Re: Will Parnate *prevent* a major depression?, posted by JaclinHyde on May 10, 2006, at 18:23:06
> I think it all depends on what the major depression
> is from. Obviously no drug will keep us on an even
> keel if heaven forbid we suffer a loss or any
> other major life issue comes up. There are other
> chemical factors too for instance as a woman I was
> thrown for a loop when I began going through
> menopause, MAOI and all.I kind of know what you mean. See my reply just now to Willyee for lots more details which I shoul dnot try to repeat here.
> An addition of neurontin at the time did the
> trick for me.Are you saying you added neurotonin to the MAOI? Was the MAOI Parnate?
Is neurotonin related to the atypical neuroleptics like Olanzapine, Quetiapine, Risperidone, etc?
What s neurotinin usually used for?I have seen it used for nerve pain blocking but that is probably an unconventional use of neurotonin as many other meds an unconvential effect of also blocking nerve pain too.
I tried Nardil but that was not for me at all.
I want to stay with my Parnate as it gives me energy without edginess or anxiety.
Don
Posted by JaclinHyde on May 11, 2006, at 12:05:53
In reply to Re: Will Parnate *prevent* a major depression? » JaclinHyde, posted by Don_Bristol on May 11, 2006, at 9:01:13
Neurontin is one of those drugs that seems to be given out like candy for any old problem. Mostly though it is used as a anti-seizure and/or headache med. It has some real great potential when it comes to boosting the positive effects of other drugs such as AD's. Marplan has always been my MAOI of choice because Nardil put me in a permanent state of sleep and I abused parnate (bipolar II here, howdy :-) for it's energizing effects. Marplan is sort of the middle guy of the bunch and always my fall-back med. Another option instead of adding in neurontin is topomax which has the unique distinction of helping with weightloss (but then again if we are talking parnate weight GAIN is probably not a problem.)
JH
Posted by Don_Bristol on May 11, 2006, at 14:19:52
In reply to Re: Will Parnate *prevent* a major depression?, posted by JaclinHyde on May 11, 2006, at 12:05:53
> Neurontin is one of those drugs that seems to be
> given out like candy for any old problem. Mostly
> though it is used as a anti-seizur and/or headache
> med. It has some real great potential when it
> comes to boosting the positive effects of other
> drugs such as AD's.
>
> Marplan has always been my MAOI of choice because
> Nardil put me in a permanent state of sleep and
> I abused parnate (bipolar II here, howdy :-) for
> it's energizing effects. Marplan is sort of the
> middle guy of the bunch and always my fall-back med.
Hi JaclinHydeISTR that Marplan is not available in the US any more. I believe it is available here in the UK.
What you say about abusing Parnate rings a bell with me. One theory is that I may have a some bipolar in me. Cab you tell me what you got up to to abuse Parnate? Were you taking extra high doses on those occassions you wanted to get high/manic?
> Another option instead of adding in neurontin
> is topomax which has the unique distinction of
> helping with weightloss (but then again if
> we are talking parnate weight GAIN is probably
> not a problem.)
>
> JH
I have heard all the stories about no weight gain on parnate but I have gained weigth and a lot too. Now that may not be due to the Parnate. The weight gain may be due to untreated dysthymia from too low a dose of Parnate.I am glad you mentioned weight gain because I will mention it as a possible indication that my MAOI is not powerful enough at 50mg. I get no side effects whatso ever so 50mg is hardly pushing things to the limit.
best wishes
Don
Posted by willyee on May 11, 2006, at 14:28:54
In reply to Re: Will Parnate *prevent* a major depression?, posted by JaclinHyde on May 11, 2006, at 12:05:53
Nuerontion is definatly an option,of most of the augmenting mood stablizers,its probuably one of the easiest ones to take,i.e depakote and watching the liver.....Topamax and all the side effects.
Also Nuerontion works well with benzos too,seems to add a touch to them.If you do go this route,might wanna look into Pregablin which is believe although almost identical does have advantages and is actualy approved for anti-anxiety unlike Nuerotion.
Either one will work fine with Parnate.Secondary to that is Gabatril,eh like Nuerontion the biggest problems i found with these two drugs are they loose there effectivness to quickly,Nuerotion when first taking it can seem like a dream for anxiety and social problems,and then quickly seem to do nothing,this is for some people.
Personaly im looking into Geodon,as i liked the 60 mg samples,what it did was seem to make the next days parnate dosing much more effective when i took Geodon at night.Seraquel,like u said i am not a fan,personaly i believe like Thorazine this is just too powerful and is one of those that should be used only for what its intended,schiz disorder.
Just remember,if choose to go off parnate,whatever state ur in now,you will add to that a washout period of being off a med,are you ready for that?Compare that to the option of possably augmenting it first,good luck!
Posted by linkadge on May 11, 2006, at 16:33:41
In reply to Re: Will Parnate *prevent* a major depression?, posted by willyee on May 11, 2006, at 14:28:54
>He says that in some parts of the world there >are people going through mega-crises (such as >civilians in horrific war zones) and many of >those people do not need the degree of support >I seem to need and they don't go into >depression the way I did.
Some of these people don't have the option to be depressed. If it is a life or death situation some people can put off depression. If you've just been hit by a tsunami, your may not mourn lost loved ones till much after the fact. I don't think its a valid argument.
Sure, some people seem to be more immune to depression than others, but even after all these years we really can't pinpoint why.
But anyhow, its what you feel is best. You've got to know how you feel about this drug in comparison to others.
Linkadge
Posted by Jost on May 11, 2006, at 16:58:18
In reply to Will Parnate *prevent* a major depression?, posted by Don_Bristol on May 10, 2006, at 18:00:50
Another option to increase the effect of the parnate might be lithium. I tried it, although it didn't work for me.
You need a blood test after a few weeks to assess blood levels and check for certain side effects, but the dose, when used as an adjuntive, is low, so it's pretty safe after that.
Personally, I think you could try a higher dose. As has been mentioned, the therapeutic dose in the US is 30-60 mg. And people have gone higher than that. All depends on your tolerance and response.
If you like parnate a lot, and want to try to stick with it, it makes sense to me.
These drugs are not thoroughly understood, anyway. How your doctor could know that parnate would or wouldn't prevent an recurrence, under stress, is beyond me, unless he's psychic.
As for how people cope in wartime or under extreme conditions--again, it's a very complex, and highly abstract question, which might not map so easily onto how people cope under chronic stress. Or it might, who knows? It's highly speculative and not relevant, really..Jost
Posted by JaclinHyde on May 11, 2006, at 17:04:12
In reply to Re: Will Parnate *prevent* a major depression? » JaclinHyde, posted by Don_Bristol on May 11, 2006, at 14:19:52
Well considering I am in the US and just got my Marplan refilled the other day I would say that the demise of the drug here in the states is un-true :-)
Again, my favorite of the MAOI's bar none and most definitely available.
JH
Posted by fires on May 11, 2006, at 18:21:20
In reply to Will Parnate *prevent* a major depression?, posted by Don_Bristol on May 10, 2006, at 18:00:50
>>Is he correct when he says that the Parnate should have prevented the major depression I recently experienced?<<
Maybe not "should" but very well could. I was free of MDD for 14 years on Parnate. Stopped Parnate and had an episode of MDD within months.
This is the end of the thread.
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