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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by Crazy Horse on January 25, 2007, at 18:16:03
I've been on Parnate in the past and as far as working as an AD it is the best i have ever taken, by far! BUT, the side effects are the problem..for me it was severe insomnia (and i tried every sleep med there is..nothing worked) and afternoon fatigue. My question is, do some people respond well to Parnate without these side effects..do the side effects ever go away with time? Also, last time i was on a very high dose- 160 mgs. This time (if i try it) i plan to stay between 60 and 80 mgs. at the highest, (as i always need high doses of meds) maybe at 60mgs. i could actually be depression free and without severe insomnia and the debilitating afternoon fatigue? I wonder if it's possible as i have never read many success stories about Parnate working well without the unbearable side effects.
Any feedback about this subject will be greatly appreciated. I value ALL of your opinions very much. Thank you.
-Monte
Posted by Quintal on January 25, 2007, at 18:51:52
In reply to Can anyone have a 'Normal' life on Parnate?, posted by Crazy Horse on January 25, 2007, at 18:16:03
I took between 80-120mg Parnate with 4mg klonopin and found that taking an exra 10-20mg of Parnate in the afternoon avoided the debilitating fatigue you describe. The Klonopin took over at night and helped me sleep - had no problem with insomnia while taking Parnate.
Q
Posted by Phillipa on January 25, 2007, at 19:41:17
In reply to Re: Can anyone have a 'Normal' life on Parnate? » Crazy Horse, posted by Quintal on January 25, 2007, at 18:51:52
Monte thinking of trying it again? Love Phillipa
Posted by corafree on January 25, 2007, at 21:29:10
In reply to Can anyone have a 'Normal' life on Parnate?, posted by Crazy Horse on January 25, 2007, at 18:16:03
I'm tryin' understand Nardil and Parnate.
Found this thread from few years back.
http://www.dr-bob.org/babble/20050326/msgs/477285.html
Is the Nardil 'good again' Crazy Horse?
cf
ps: Why am I thinking one of them is ENSAM?
Posted by Crazy Horse on January 25, 2007, at 21:47:23
In reply to Re: Can anyone have a 'Normal' life on Parnate? » Crazy Horse, posted by corafree on January 25, 2007, at 21:29:10
> I'm tryin' understand Nardil and Parnate.
>
> Found this thread from few years back.
>
> http://www.dr-bob.org/babble/20050326/msgs/477285.html
>
> Is the Nardil 'good again' Crazy Horse?
>
> cf
>
> ps: Why am I thinking one of them is ENSAM?I really don't know much at all about Nardil. I know it works well for Ace. EMSAM is new, i tried it and it didn't help me..it is very mild compared to Parnate and Nardil. Parnate works great for me, but has 'hard to live with' side effects.
-Monte
Posted by willyee on January 25, 2007, at 22:23:14
In reply to Can anyone have a 'Normal' life on Parnate?, posted by Crazy Horse on January 25, 2007, at 18:16:03
I think we disagree here,to me the most important thing is a anti depressant effect.
We have so many means that help in regard to its side effects,HOWEVER we are SHORT to say the least in having available many successful anti depressants.
If you can get this drug to produce a decline in depression,i say go for it,PERIOD.
Side effects if one is up and mobile can be dealt with,depression is just so damn painful i dont think id trade it off with much other than being paralized or blind.
There are tons and tons of sleep options to explore,and the day time fatiqgue is also somthing u can attack,but again for me nothing overrides the soothing preciousness of a remissive state of depression.Its worth pure gold to me.
Good luck in what you choose.
P.s since you responded to lyrcia so well,perhaps after starting the parnate you can then add lyrcia,knowing it so well,in perhaps a different dosage to aid in some side effects such insomnia etc.As you know lyrcia is quite dose deprendent on what it will do for you.
Posted by Declan on January 25, 2007, at 22:27:12
In reply to Re: Can anyone have a 'Normal' life on Parnate? » corafree, posted by Crazy Horse on January 25, 2007, at 21:47:23
What are you taking now, Monte?
The reason I ask is that if you are not taking some effective AD, I wonder why you want to go to such a high dose of parnate so quickly?
Admittedly there are some people who say insomnia is a problem on ANY dose of Parnate.
For me though, I'd rather try to take only so much Parnate as I could while getting a decent nights sleep.Which for me might end up 10 or 20mg/d plus 7.5mg Remeron at night.
Anyway, I'm just curious as to how you are thinking about this.
Posted by Crazy Horse on January 26, 2007, at 7:01:06
In reply to Re: Can anyone have a 'Normal' life on Parnate? » Crazy Horse, posted by Declan on January 25, 2007, at 22:27:12
I'm currently on:
450mgs. Wellbutrin
250mgs. Zoloft
300mgs. Lyrica b.i.d.
3 mgs. Klonopin t.i.d.Actually, if i go back to Parnate i will take the lowest effective dose possible to hopefully reduce the severity of side effects.
-Monte
Posted by Crazy Horse on January 26, 2007, at 7:15:46
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by willyee on January 25, 2007, at 22:23:14
> I think we disagree here,to me the most important thing is a anti depressant effect.
>
> We have so many means that help in regard to its side effects,HOWEVER we are SHORT to say the least in having available many successful anti depressants.
I hear you, the most important thing is definitely the antidepressant effect. Unfortunately, my pdoc does not treat the side effects as aggressively as i wish he would. I live in a relatively small area so finding a better/different pdoc is impossible. Certainly living with the side effects vs. the misery of horrible depression is a no brainer. Thanks for your imput.-Monte
Posted by halcyondaze on January 26, 2007, at 11:53:31
In reply to Re: Can anyone have a 'Normal' life on Parnate? » willyee, posted by Crazy Horse on January 26, 2007, at 7:15:46
For me, the insomnia is just as bad at high doses (90 mg/day) as it was at low doses (40 to 60 mg/day).
Posted by halcyondaze on January 26, 2007, at 11:55:23
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by willyee on January 25, 2007, at 22:23:14
Willyee, can you answer my Parnate questions in a few threads above? You're the one here who has had the longest experience on high dose Parnate, and the experience most similar to mine. Thank you!
> I think we disagree here,to me the most important thing is a anti depressant effect.
>
> We have so many means that help in regard to its side effects,HOWEVER we are SHORT to say the least in having available many successful anti depressants.
>
> If you can get this drug to produce a decline in depression,i say go for it,PERIOD.
>
> Side effects if one is up and mobile can be dealt with,depression is just so damn painful i dont think id trade it off with much other than being paralized or blind.
>
> There are tons and tons of sleep options to explore,and the day time fatiqgue is also somthing u can attack,but again for me nothing overrides the soothing preciousness of a remissive state of depression.Its worth pure gold to me.
>
>
> Good luck in what you choose.
>
>
> P.s since you responded to lyrcia so well,perhaps after starting the parnate you can then add lyrcia,knowing it so well,in perhaps a different dosage to aid in some side effects such insomnia etc.
>
> As you know lyrcia is quite dose deprendent on what it will do for you.
>
>
Posted by corafree on January 26, 2007, at 12:49:17
In reply to Can anyone have a 'Normal' life on Parnate?, posted by Crazy Horse on January 25, 2007, at 18:16:03
I don't know why typing in the address doesn't work here, so just copied it.
http://www.biopsychiatry.com/dopamine.htm
Antidepressants and the dopamine connection
Measurement of D2-like binding by receptor autoradiography, using the ligand [3H]YM-09151-2, revealed that both fluoxetine and desipramine increased D2-like binding in the nucleus accumbens shell; fluoxetine had a similar effect in the nucleus accumbens core. Tranylcypromine, however, had no effect on D2-like binding in the nucleus accumbens but decreased binding in the striatum. In micro-dialysis experiments, our data showed that levels of extracellular dopamine in the nucleus accumbens were not altered in rats treated with either fluoxetine or desipramine, but increased by tranylcypromine.
What does this say??? :(
tks, cf
Posted by corafree on January 26, 2007, at 12:56:31
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by corafree on January 26, 2007, at 12:49:17
Okay it does work.
Butt, still, it's not really layman terminology, and I'm a laygirl. (haha) Must I sacrifice sex for soothing my anxiety?
I need choose one of following:
Paxil
Celexa
Lexapro
Parnatewaytks, cf
Posted by corafree on January 26, 2007, at 12:58:37
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by halcyondaze on January 26, 2007, at 11:53:31
Serax? re insomnia?
cf
Posted by naughtypuppy on January 26, 2007, at 13:16:48
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by corafree on January 26, 2007, at 12:58:37
> Serax? re insomnia?
>
> cf
I had to take that along with trazadone to get to sleep. Worked ok, but I still had the afternoon sleepies.
Posted by psychobot5000 on January 26, 2007, at 13:45:35
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by corafree on January 26, 2007, at 12:49:17
I've puzzled over that, too. I think that what it says is that desipramine and fluoxetine both 'sensitize' D2 receptors in those areas of the brain, meaning I suppose that they somehow indirectly get the brain to be more sensitive to dopamine at those receptors.
Tranylcypromine, however, does something different (though it would act on the same systems). It directly increases dopamine concentrations. This isn't surprising, since Tranylcypromine seems to have several mechanisms that (stimulant-like) increase dopamine directly. Because of the extra dopamine bouncing around, some of the receptors (according to the study) actually downregulate in response to the Parnate (those in the striatum).
That's how I read it.
> http://www.biopsychiatry.com/dopamine.htm
>
> Antidepressants and the dopamine connection
>
> Measurement of D2-like binding by receptor autoradiography, using the ligand [3H]YM-09151-2, revealed that both fluoxetine and desipramine increased D2-like binding in the nucleus accumbens shell; fluoxetine had a similar effect in the nucleus accumbens core. Tranylcypromine, however, had no effect on D2-like binding in the nucleus accumbens but decreased binding in the striatum. In micro-dialysis experiments, our data showed that levels of extracellular dopamine in the nucleus accumbens were not altered in rats treated with either fluoxetine or desipramine, but increased by tranylcypromine.
>
> What does this say??? :(
>
> tks, cf
Posted by bulldog2 on January 26, 2007, at 18:06:50
In reply to Re: Can anyone have a 'Normal' life on Parnate? » corafree, posted by psychobot5000 on January 26, 2007, at 13:45:35
I think the insomnia issue is very important.Chronic insomnia can lead to decreased quality if life in the long run. Sleep is when the body repairs itself and your body is restored. It sounds like parnate is a very potent ad but you have to find some med to allow you at least 5-6 hours of quality sleep.
Posted by halcyondaze on January 26, 2007, at 18:59:59
In reply to Can anyone have a 'Normal' life on Parnate?, posted by Crazy Horse on January 25, 2007, at 18:16:03
> I've been on Parnate in the past and as far as working as an AD it is the best i have ever taken, by far! BUT, the side effects are the problem..for me it was severe insomnia (and i tried every sleep med there is..nothing worked) and afternoon fatigue. My question is, do some people respond well to Parnate without these side effects..do the side effects ever go away with time? Also, last time i was on a very high dose- 160 mgs. This time (if i try it) i plan to stay between 60 and 80 mgs. at the highest, (as i always need high doses of meds) maybe at 60mgs. i could actually be depression free and without severe insomnia and the debilitating afternoon fatigue? I wonder if it's possible as i have never read many success stories about Parnate working well without the unbearable side effects.
>
> Any feedback about this subject will be greatly appreciated. I value ALL of your opinions very much. Thank you.
>
> -Monte
I'm on Parnate and I lead a normal life. I take 80 mg/day. I don't experience afternoon fatigue but do have insomnia, for which I take 100 to 200 mg Seroquel and 10 mg Sonata.I've heard that those with daytime fatigue find taking some of the medication at night can reduce this. Have you tried that?
Posted by Crazy Horse on January 26, 2007, at 19:02:28
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by bulldog2 on January 26, 2007, at 18:06:50
> I think the insomnia issue is very important.Chronic insomnia can lead to decreased quality if life in the long run. Sleep is when the body repairs itself and your body is restored. It sounds like parnate is a very potent ad but you have to find some med to allow you at least 5-6 hours of quality sleep.
>
Yes, i totally agree. Without the dietary restrictions (which really are not that big of a deal for me) and the insomnia, Parnate is the perfect AD for me!-Monte
Posted by Crazy Horse on January 26, 2007, at 19:22:41
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by halcyondaze on January 26, 2007, at 18:59:59
> I've heard that those with daytime fatigue find taking some of the medication at night can reduce this. Have you tried that?
>Seems like this would exasperate the insomnia problem?? Thank you for your imput, i'll take all the advice i can get.
-Monte
Posted by bulldog2 on January 26, 2007, at 21:24:26
In reply to Re: Can anyone have a 'Normal' life on Parnate? » halcyondaze, posted by Crazy Horse on January 26, 2007, at 19:22:41
I'm theorizing the daytime fatigue is caused by the chronic lack of sleep. Seems like one's body gets out of sync on this med..Without sleep at night eventually the body get's fatigued during the day. Sounds similar to an amphetemine crash.I'm wondering if this causes parnate poop out. Without the restorative properties of sleep your brain just can't make the amines the med needs to do it's work.
Posted by Crazy Horse on January 26, 2007, at 21:53:55
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by bulldog2 on January 26, 2007, at 21:24:26
> I'm theorizing the daytime fatigue is caused by the chronic lack of sleep. Seems like one's body gets out of sync on this med..Without sleep at night eventually the body get's fatigued during the day. Sounds similar to an amphetemine crash.I'm wondering if this causes parnate poop out. Without the restorative properties of sleep your brain just can't make the amines the med needs to do it's work.
I think you are right on. So the question should not be how do i prevent/cope with the afternoon fatigue, it should rather be, what do i need to do to get 6-8 hrs. of sleep each night?
Literally, what should one do? I'd say be on an effective sleep aid, follow good sleep hygiene recommendations, limit the amount of caffiene you take in, get plenty of exercise, eat well, try to go to bed at the same time every night, etc.Please, everyone add any comments/suggestions concerning Parnate and coping with insomnia and other side effects.
-Monte
Posted by Quintal on January 26, 2007, at 22:11:49
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by bulldog2 on January 26, 2007, at 21:24:26
I had no trouble sleeping while on Parnate but still suffered afternoon fatigue - the classic 'Parnate slump' until I started taking another 10-20mg at 5:00PM. Taking Parnate in tandem with 4mg Klonopin seemed to help me with sleep and anxiety/jitters.
Q
Posted by psychobot5000 on January 26, 2007, at 22:23:21
In reply to Re: Can anyone have a 'Normal' life on Parnate?, posted by Crazy Horse on January 26, 2007, at 21:53:55
> > I'm theorizing the daytime fatigue is caused by the chronic lack of sleep.
I experienced the daytime fatigue the -first- day I was on Parnate, in other words, before I had a chance for it to damage sleep. While I assume Parnate does make people tired by damaging sleep, I believe there is an independent mechanism going on there, too. I'm a chronice insomniac, always tired, and this was something different. I find (in a limited trial) that on tranylcypromine/Parnate, at some point in the afternoon (or points?), I get a strong feeling of drowsiness, that passes off in an hour or so. It's not tiredness all day--indeed, because it's so energizing, Parnate sometimes seems to reduce the need for sleep--which is not necessarily a good thing...In any case, I do agree that possibly the best thing you can do about the problem is to make sure you are as well-rested as possible, so as to function well during the day. One thing I don't recall hearing mentioned is Xyrem. Tranylcypromine seems such a disruptive drug that it frequently overpowers sleep medications, but I think this less likely with Xyrem, which just knocks you out. ...Otherwise, all commonly used sleep medications damage sleep architecture by reducing stage 3 and 4 sleep (this includes Ambien, Ambien CR, and Lunesta). Researchers believe these are the most important for restorative sleep. One drug that I've heard claimed as avoiding this is trimipramine (a tricyclic similar to doxepin). ...In any case, Xyrem contrasts with other sleep aids by actually increasing deep sleep (3 and 4). It's disadvantages are that it is usually used only for narcolepsy, (regular or MAOi-induced insomnia is thus off-label), and that it is highly controlled.
However, the MAOi expert (and Harvard researcher) Dr. J A Bodkin recommends Xyrem for MAOi-induced insomnia.
Posted by Declan on January 26, 2007, at 23:42:26
In reply to Re: Can anyone have a 'Normal' life on Parnate? » bulldog2, posted by Quintal on January 26, 2007, at 22:11:49
Remeron with Parnate seems not recommended but possible?
Remeron lasts way too long, but has a good effect on the amount of deep sleep (I think).
Combination possible?
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