![[dr. bob]](/dr-bob-sm.gif)
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 deuce224 on May 13, 2006, at 19:32:33
I tried parnate for 3 and a half weeks and I got myself up to 30 mgs. I felt stimulated but very groggy, hard time concentrating. So I switched over to Nardil which I hated, way more dazed and no stimulation. So from what I have been reading I really didn't give parnate a fair shot. Some people say they felt dazed for a long time before that side effect left them feeling good. I read someone else's thread who said they didnt get any good therapeutic effect on parnate until they got to 40 mgs for a few weeks. I am just so scared because I have been in a major depression for 8 months this time and I am supposed to start graduate school in 3 months. I feel like maybe my best bet is to stick with the parnate for atleast 2 months to give it a fair trial. Any thoughts, advice, please?
Posted by JaclinHyde on May 13, 2006, at 20:14:08
In reply to PARNATE-how long and how much., posted by deuce224 on May 13, 2006, at 19:32:33
Nope, 3 and 1/2 weeks at only 30mg is not a good enough trial. Imho you would need at least 60mg for maybe 4-5 weeks to really give it a fair shake. The other option is Marplan which IS still available here in the US (I take it.) It seems to fall right in the middle of the "Nardil is too tiring/Parnate too activating" feeling with fewer side effects on the whole.
YMMV of course :-)
JH
Posted by deuce224 on May 13, 2006, at 20:36:11
In reply to Re: PARNATE-how long and how much., posted by JaclinHyde on May 13, 2006, at 20:14:08
does the dazed feeling go away? How long does it take to normal out a bit?
Posted by willyee on May 13, 2006, at 21:42:16
In reply to Re: PARNATE-how long and how much., posted by deuce224 on May 13, 2006, at 20:36:11
Ahh i have to respectuflly disagree,the fact it took so long for u to titrate to 30 mg shows ur doc is being very very cautious which is fine.
First data sheet of parnate was 10 mg,raised to 30 mg max.
Second was 30 mg as even a tehrputic dose,max 60 mg.
Pubmed has studies ranging even further well into the 100 mg.
Even at the start of parnate,when it worked wonders for me,i was on a 40 mg dose.
Your trial lentgh was sufficent,just the dose i personaly believe was not even at a theputic window.
Posted by Declan on May 14, 2006, at 1:47:48
In reply to PARNATE-how long and how much., posted by deuce224 on May 13, 2006, at 19:32:33
You must be wondering (as I am) if 30mg/d makes you feel stimulated and groggy (hard time concentrating), whether higher doses will make you feel worse, rather than better.
So much depends on how bad you feel. And you want to start grad school in 3 months. It feels like a worry.
Even though people who have responded well to Parnate often profit from higher doses, I wonder if lower doses may be helpful.
Another way of saying this may be to say that I am sceptical of the concept of remission, more or less, if you get my drift.
Declan
Posted by Caedmon on May 14, 2006, at 14:14:40
In reply to Re: PARNATE-how long and how much., posted by JaclinHyde on May 13, 2006, at 20:14:08
I think your doctor is smart in being slow and steady about doses. Of course one may need more than 30mg, but it's not unreasonable to go slow.
I'm in the same situation. I'm starting out on Parnate. I want it desperately to work, because I have grad school in 3 months as well. I know I'll never make it through 2 years of intense classes, group work, clinic hours, and a thesis if I'm feeling the way I feel now! I've gotten a sort of sleepiness from Parnate, I can only call it a type of narcolepsy, which hopefully will go away with time or a different dose. If not, then I may augment with modafinil which I found useful in the past for my depression anyway.
But - I'm at 40mg of Parnate and it IS finally making a real impact. I feel less anxious, more sociable, less apathetic, and more motivated. It isn't consistent throughout the day, and it's been a slow "warming up" rather than a "BOOM! I'M ALL BETTER!" type of sensation. On the Goldberg Depression Scale I still rank in the "mild-moderate depression" bracket. So, perhaps after a while I may need a higher dose. But I am evaluating the doses in 2-3 week steps per my doctor's orders to really give the dose a decent chance rather than get ahead of myself.
On the one hand, a common reason for not responding to an MAOI is insufficient dose. On the other hand, after all the things I've read about tranylcypromine and withdrawal and potential for addiction, I think it's prudent to work closely with one's doctor and determine the right dose in a conservative manner. Please note the following letters in J Psychiatry Neurosci. 1994 November; 19(5): 382–384:
http://www.pubmedcentral.gov/pagerender.fcgi?artid=1188630&pageindex=1#page
http://www.pubmedcentral.gov/pagerender.fcgi?artid=1188631&pageindex=1#pageBest of luck!
- Chris
Posted by JaclinHyde on May 15, 2006, at 8:08:01
In reply to Re: PARNATE-how long and how much., posted by Caedmon on May 14, 2006, at 14:14:40
I just had to stop Parnate cold turkey (100mg for over 4 months) because of a sudden hospital stay and the worst withdrawal symptom I had was extreme tiredness. I was put back on my old MAOI standby, Marplan which tends to make a person tired at the beginning of treatment anyway so the combination really knocked me out. Other than that I haven't felt any other withdrawal effects but I know I am one of the lucky ones.
JH
> Please note the following letters in J Psychiatry Neurosci. 1994 November; 19(5): 382–384:
> http://www.pubmedcentral.gov/pagerender.fcgi?artid=1188630&pageindex=1#page
> http://www.pubmedcentral.gov/pagerender.fcgi?artid=1188631&pageindex=1#page
>
> Best of luck!
>
> - Chris
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.