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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Crazy Horse on May 27, 2006, at 11:11:38
Due to severe and increasing side effects i am going off Parnate. My pdoc and i have even experimented with lower dose..going down to 60 mgs for a while, but the side effects remained. So Parnate was great for my depression, but severe insomnia and terrible daytime fatigue were making me a CrAzY Man!! With a wife, 2 children, and a Home i can't spend all day in bed, with Parnate most of the last month has been so bad that i spent a great deal of time in bed..ugh!
So i'll be off Parnate on June 2, and the plan is to try EMSAM. Please answer the questions below, i'd would appreciate it very much.
1) How long must i be off Parnate before starting EMSAM?
2) Where do most people wear the patch..hip, upper arm?
3) Can you wear it in water..shower, swimming?
4) What are the most common side effects?
5) Is it true no diet is needed at 6 mgs? Same diet as other maoi's above 6 mgs?
6) Does it begin to work relatively fast for some people? Parnate began to make a difference for me on day 10.
Anything (positive please) you would like to add..i would appreciate it very much. Thank you all.
Monte
Posted by SLS on May 27, 2006, at 12:04:47
In reply to Going off Parnate..Info about EMSAM Please, posted by Crazy Horse on May 27, 2006, at 11:11:38
I'm so sorry that Parnate did not work out for you. I wish you better luck with Emsam.
The only thing that ever worked for me was a combination of Parnate + desipramine. The most troublesome side effect was total insomnia. My doctor felt that the insomnia should be treated aggressively because the potential benefits of antidepressant treatment were so great. I ended up taking a combination of Halcion + Ativan. It worked very well. I went on to respond wonderfully for 6 months before mania began to creep in.
Regarding the waiting period, I guess the traditional conservative approach would be to wait 14 days. I suspect 10 days would be enough. Anything less is a gamble, especially since Emsam is so new to the treatment of depression. There is probably no data available on making such a switch of medications. I have been following the 14 day waiting period when switching.
- Scott
Posted by Jakeman on May 27, 2006, at 12:59:57
In reply to Going off Parnate..Info about EMSAM Please, posted by Crazy Horse on May 27, 2006, at 11:11:38
Monte,
You may want to take a look at the prescribing information guide at www.emsam.com It recommends a one week wash-out period after stopping another MAOI. The patch is worn anywhere below the neck and above the waist. It is a very thin, translucent piece of plastic, sticky on one side. Hardly noticable. They say no special diet is needed at the low dose, 6mg. I noticed positive effects within 3 days such as better mood. Some people have reported side effects like disrupted sleep or agitation.
good luck, Jake
> Due to severe and increasing side effects i am going off Parnate. My pdoc and i have even experimented with lower dose..going down to 60 mgs for a while, but the side effects remained. So Parnate was great for my depression, but severe insomnia and terrible daytime fatigue were making me a CrAzY Man!! With a wife, 2 children, and a Home i can't spend all day in bed, with Parnate most of the last month has been so bad that i spent a great deal of time in bed..ugh!
>
> So i'll be off Parnate on June 2, and the plan is to try EMSAM. Please answer the questions below, i'd would appreciate it very much.
>
> 1) How long must i be off Parnate before starting EMSAM?
>
> 2) Where do most people wear the patch..hip, upper arm?
>
> 3) Can you wear it in water..shower, swimming?
>
> 4) What are the most common side effects?
>
> 5) Is it true no diet is needed at 6 mgs? Same diet as other maoi's above 6 mgs?
>
> 6) Does it begin to work relatively fast for some people? Parnate began to make a difference for me on day 10.
>
> Anything (positive please) you would like to add..i would appreciate it very much. Thank you all.
>
> Monte
Posted by Phillipa on May 27, 2006, at 15:13:46
In reply to Re: Going off Parnate..Info about EMSAM Please, posted by Jakeman on May 27, 2006, at 12:59:57
Jakeman three days? Love Phillipa
Posted by Jakeman on May 27, 2006, at 16:23:07
In reply to Re: Going off Parnate..Info about EMSAM Please » Jakeman, posted by Phillipa on May 27, 2006, at 15:13:46
> Jakeman three days? Love Phillipa
Maybe placebo effect? But yes, my mood has improved :-) and sleep has gotten lighter :-(
warm regards, Jake
Posted by Phillipa on May 27, 2006, at 19:25:48
In reply to Re: Going off Parnate..Info about EMSAM Please » Jakeman, posted by Phillipa on May 27, 2006, at 15:13:46
Jake I didn't think it had been that long. But I thought you had insomnia? Love Phillipa
Posted by Jakeman on May 27, 2006, at 21:21:15
In reply to Re: Going off Parnate..Info about EMSAM Please » Phillipa, posted by Phillipa on May 27, 2006, at 19:25:48
I started with the patch Thursday morning. Yes I've been grappling with insomnia for some time, and had it somewhat under control with medication. Now I may have to adjust insomnia meds again if I stay with Emsam.
> Jake I didn't think it had been that long. But I thought you had insomnia? Love Phillipa
Posted by willyee on May 28, 2006, at 9:28:53
In reply to Going off Parnate..Info about EMSAM Please, posted by Crazy Horse on May 27, 2006, at 11:11:38
Call me crazy.CRAZY haha,but i just dont see the worry in switching maois,especialy when nardil which is a umm hydrazine or whatever isnt in the picture.
Your not combininb them,so i would never think a washout of weeks would be neccassry ,,just me.
Also of all the maois,parnate is the shortest lived one,or one of them,honestly my personal opinion,and just mine is just let a 2 day period maybe,but of course im not a doc,i just play one on the internet,took my info for what its worth.
as a side note,ive taken maois in combo,parnate,deprenyl,moclimie,nardil,not all those lol but a mixture from one time or anotehr.
Dont only thing i wont mix parnate with is an ssri ever ever ever ever,plus i hate them,also parnate needs a really good washout from imiprimine,ewww nasty.
I also dident like the parnate/ritalin combo,even though i see its used,it was a nightmare for me,totaly maniac,anyway im sure u will be fine,best of luck!
Posted by Crazy Horse on May 28, 2006, at 10:05:25
In reply to Re: Going off Parnate..Info about EMSAM Please » Phillipa, posted by Jakeman on May 27, 2006, at 21:21:15
Posted by ed_uk on May 28, 2006, at 12:39:20
In reply to Going off Parnate..Info about EMSAM Please, posted by Crazy Horse on May 27, 2006, at 11:11:38
Hi Crazy
>My pdoc and i have even experimented with lower dose..going down to 60 mgs for a while, but the side effects remained.
60mg is still quite a lot. I know lower doses didn't work for you when you first started Parnate but they might work for you now. Worth a try? I think so :) If it doesn't work out you could still taper off and try Emsam.
Regards
Ed
Posted by Donna Louise on May 30, 2006, at 8:18:25
In reply to Going off Parnate..Info about EMSAM Please, posted by Crazy Horse on May 27, 2006, at 11:11:38
> Due to severe and increasing side effects i am going off Parnate. My pdoc and i have even experimented with lower dose..going down to 60 mgs for a while, but the side effects remained. So Parnate was great for my depression, but severe insomnia and terrible daytime fatigue were making me a CrAzY Man!! With a wife, 2 children, and a Home i can't spend all day in bed, with Parnate most of the last month has been so bad that i spent a great deal of time in bed..ugh!
>
> So i'll be off Parnate on June 2, and the plan is to try EMSAM. Please answer the questions below, i'd would appreciate it very much.
>
> 1) How long must i be off Parnate before starting EMSAM?
>
> 2) Where do most people wear the patch..hip, upper arm?
>
> 3) Can you wear it in water..shower, swimming?
>
> 4) What are the most common side effects?
>
> 5) Is it true no diet is needed at 6 mgs? Same diet as other maoi's above 6 mgs?
>
> 6) Does it begin to work relatively fast for some people? Parnate began to make a difference for me on day 10.
>
> Anything (positive please) you would like to add..i would appreciate it very much. Thank you all.
>
> MonteI may be mistaken but I thought the literature said 2 week washout from another MAOI. I did a 10 day washout from effexor, the literature said 7 days was sufficient, my pdoc wanted 2 weeks so I compromised.
I move it around, mostly though I put it on my middle chest and hips, thighs, that is where I found it would stick. It also sticks best for me after a shower. I had trouble at first but that was mostly me being fumble fingered. Put it where the skin doesn't bend too much and there isn't much hair. Mine sticks great in the water and shower, it isn't coming off unless I pull it off and I live Fla. where I sweat alot too. My pdoc says above the knees and elbows but I like it on my trunk.
I have had no problems with food restrictions at 6mg and have just read on another thread that there were none on the 12mg patch (40mg of selegiline) on the 2500 people in the study. But there are food restrictions on the info monograph or whatever you want to call it anyway, may not be necessary. I am not worried about them if I have to go higher.
I have had no side effects whatsoever, maybe just not enough antidepressant effect for me at 6mg. I also take klonopin and I know that helps with what others report as some anxiety type properties. But I have anxiety anyway so I wouldn't know the difference there. Mine is certainly no worse.
I had more energy and motivation immediately, but it has taken over 4 weeks of using the patch and being off effexor for it all to shake down. I may need a little something more for depression, maybe not. Today is a good day.
I think I answered your questions listed...that is my experience with it anyway.Donna
Posted by Crazy Horse on May 30, 2006, at 8:50:58
In reply to Re: Going off Parnate..Info about EMSAM Please, posted by Donna Louise on May 30, 2006, at 8:18:25
> > Due to severe and increasing side effects i am going off Parnate. My pdoc and i have even experimented with lower dose..going down to 60 mgs for a while, but the side effects remained. So Parnate was great for my depression, but severe insomnia and terrible daytime fatigue were making me a CrAzY Man!! With a wife, 2 children, and a Home i can't spend all day in bed, with Parnate most of the last month has been so bad that i spent a great deal of time in bed..ugh!
> >
> > So i'll be off Parnate on June 2, and the plan is to try EMSAM. Please answer the questions below, i'd would appreciate it very much.
> >
> > 1) How long must i be off Parnate before starting EMSAM?
> >
> > 2) Where do most people wear the patch..hip, upper arm?
> >
> > 3) Can you wear it in water..shower, swimming?
> >
> > 4) What are the most common side effects?
> >
> > 5) Is it true no diet is needed at 6 mgs? Same diet as other maoi's above 6 mgs?
> >
> > 6) Does it begin to work relatively fast for some people? Parnate began to make a difference for me on day 10.
> >
> > Anything (positive please) you would like to add..i would appreciate it very much. Thank you all.
> >
> > Monte
>
> I may be mistaken but I thought the literature said 2 week washout from another MAOI. I did a 10 day washout from effexor, the literature said 7 days was sufficient, my pdoc wanted 2 weeks so I compromised.
> I move it around, mostly though I put it on my middle chest and hips, thighs, that is where I found it would stick. It also sticks best for me after a shower. I had trouble at first but that was mostly me being fumble fingered. Put it where the skin doesn't bend too much and there isn't much hair. Mine sticks great in the water and shower, it isn't coming off unless I pull it off and I live Fla. where I sweat alot too. My pdoc says above the knees and elbows but I like it on my trunk.
> I have had no problems with food restrictions at 6mg and have just read on another thread that there were none on the 12mg patch (40mg of selegiline) on the 2500 people in the study. But there are food restrictions on the info monograph or whatever you want to call it anyway, may not be necessary. I am not worried about them if I have to go higher.
> I have had no side effects whatsoever, maybe just not enough antidepressant effect for me at 6mg. I also take klonopin and I know that helps with what others report as some anxiety type properties. But I have anxiety anyway so I wouldn't know the difference there. Mine is certainly no worse.
> I had more energy and motivation immediately, but it has taken over 4 weeks of using the patch and being off effexor for it all to shake down. I may need a little something more for depression, maybe not. Today is a good day.
> I think I answered your questions listed...that is my experience with it anyway.
>
> Donna
>
>Thank you Donna, you answered my questions and i appreciate you taking the time to help me out. :)
Monte
Posted by mworkman on May 30, 2006, at 17:51:24
In reply to Re: Going off Parnate..Info about EMSAM Please » Donna Louise, posted by Crazy Horse on May 30, 2006, at 8:50:58
I went on a one day washout from 45 mg of nardil to 6mg of emsam. I think that nardil works mostly on SE and GABA, though, while emsam works on DA and NE mostly. So I didn't think there would be much of a chance of reaction. Parnate and emsam work mostly on DA and NE, so there is probably a higher chance of a reaction. Plus, parnate is amphetamine like and emsam has amphetamine metabolites, so that might cause problems. So a full washout might be better.
Posted by Donna Louise on May 31, 2006, at 7:05:17
In reply to Re: Going off Parnate..Info about EMSAM Please » Donna Louise, posted by Crazy Horse on May 30, 2006, at 8:50:58
This is the end of the thread.
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