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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Shaner on June 27, 2007, at 20:34:38
I started Parnate 3 weeks ago after stopping effexor due to extreme fatigue and increased anxiety. It seemed to be working really well at 10 and 20mg but I kept increasing to 40mg. Every time I've tried something new in the past-ssri's, effexor, modafinil, I think it's working in the beginning but as I increase the dose I just go downhill and can't stop obsessing about other medication or dose decisions. Now at 40mg Parnate I am back to extremely tired and somewhat agitated. I know these may be side effects that may go away but can anybody suggest whether I should drop the dose back down or just wait it out? I've been at 40mg for 5 days.
Posted by steel on June 27, 2007, at 20:39:40
In reply to Parnate dose issue, posted by Shaner on June 27, 2007, at 20:34:38
> I started Parnate 3 weeks ago after stopping effexor due to extreme fatigue and increased anxiety. It seemed to be working really well at 10 and 20mg but I kept increasing to 40mg. Every time I've tried something new in the past-ssri's, effexor, modafinil, I think it's working in the beginning but as I increase the dose I just go downhill and can't stop obsessing about other medication or dose decisions. Now at 40mg Parnate I am back to extremely tired and somewhat agitated. I know these may be side effects that may go away but can anybody suggest whether I should drop the dose back down or just wait it out? I've been at 40mg for 5 days.
I wouldent recomend parnate without using a benzo,usualy klonopin,at the start where you are a small pieace such as .25 would prob work great,cant say why,perhaps it evens it out a bit as ive heard parnate can actualy DECREASE gaba which might result in agitation and so on.
Id take .25 daily,of course you want to follow up more than just my comment.
Posted by Sigismund on June 27, 2007, at 20:54:15
In reply to Parnate dose issue, posted by Shaner on June 27, 2007, at 20:34:38
If I were you I would reduce the dose to where it worked best.
Maybe 20mg?
The less you take the better.
You can always increase later.
Posted by OzLand on June 27, 2007, at 23:33:24
In reply to Parnate dose issue, posted by Shaner on June 27, 2007, at 20:34:38
I am taking 40 mg. as well, and I was taking 20 mg. in the a.m. and 20 mg. at noon. I could barely make it through the p.m. without being so tired I could hardly stand it. So, my pdoc said to try different times of day. This week I tried 20 mg. in the a.m., 10 mg. at noon, and 10 mg. at dinner. This is better, but I still feel tired. This is very strange to me as I used to get the amphetamine like kick from it years ago. Not now. My pdoc also suggested taking it all at night. I am not sure I want to do this, but I will play around with maybe 20 mg. in the a.m. and 20 mg. at dinner. At bedtime I take 600 mg. of Neurontin and could increase it to 900 mg. but I would rather not if I don't need to. What does your doctor say??? I have been on Parnate now for around 6 weeks I think. I started out with 20, then 20-30 on alternating days, then 30-40 on alternating days, and now 40.
Posted by Jedi on June 28, 2007, at 2:44:09
In reply to Re: Parnate dose issue » Shaner, posted by OzLand on June 27, 2007, at 23:33:24
Hi,
I had to quit Parnate because of a rare auto-hypertensive reaction. Before this occurred I was on 80mg of Parnate. It took eight weeks for the afternoon somnolence side effect to go away.
Give it some time.
Jedi
Posted by sophia04 on June 28, 2007, at 3:09:48
In reply to Re: Parnate dose issue, posted by Jedi on June 28, 2007, at 2:44:09
Shaner,
I ramped up to 60 mg of parnate for 12 weeks and felt fundamentally poisoned the entire time + had to contend with completely treatment-resistant insomnia. Because of the daytime fatigue, my doc suggested taking 30mg at 6pm and 30mg at bedtime. Before I finally cracked I went almost an entire week with essentially no sleep - despite the fact that I was cycling through many sleep aids and experiencing all their side effects. I finally had enough and decided to titrate off parnate. I started taking the entire dose first thing in the morning and am now down to 30mg and am tolerating it beautifully! No insomnia, fainting spells, daytime fatigue, and my appetite is better. My doc and I decided that I would hover here for a while and see what happens. I do believe I'm starting to finally experience some anti-depressant effects. I have historically needed higher than normal doses of meds, but Parnate may be an exception. Anyway, I'm happy to feel more sane and rested and curious to see if my mood will continue to lift. Good luck! I would talk to your doc about taking your whole dose when you wake up. It has done wonders for me. Let me know how it goes.
Sophia
Posted by Shaner on June 28, 2007, at 18:40:52
In reply to Re: Parnate dose issue, posted by steel on June 27, 2007, at 20:39:40
Will adding klonopin make me more tired and would this be long term or short term advice? Also I sometimes take modafinil 100mg. How do you think they would react with klonopin? If it makes me more relaxed and social without increasing tiredness that would be ideal.
Posted by steel on June 28, 2007, at 22:06:43
In reply to Re: Parnate dose issue, posted by Shaner on June 28, 2007, at 18:40:52
> Will adding klonopin make me more tired and would this be long term or short term advice? Also I sometimes take modafinil 100mg. How do you think they would react with klonopin? If it makes me more relaxed and social without increasing tiredness that would be ideal.
Believe it or not like dopamine,gaba is actualy both stimulatory as well as inhibitory.
Ever notice the small jitters that come along with a benzo?I believe its gaba A but im not sure.
Anyhow there is a point i notice with parnate where any additional stimulants such as caffiene worsen the fatigue,where as a very very small pieace of klonopin pops me right up.
Posted by OzLand on June 28, 2007, at 23:11:57
In reply to Re: Parnate dose issue Shaner, posted by sophia04 on June 28, 2007, at 3:09:48
That's what I used to do years ago--take 30 mg. all in the morning, and I did great that way. I am thinking of trying that again or at least 30 mg. in the a.m. and then maybe 10 mg at 6 p.m. If I crash, I am going to do the same; go back to 30 mg. all at once in the morning.
Posted by OzLand on June 28, 2007, at 23:14:03
In reply to Re: Parnate dose issue, posted by steel on June 28, 2007, at 22:06:43
Interesting as I drink probably 3 diet pepsi's during the day trying to wake up.
Posted by Shaner on June 29, 2007, at 12:47:59
In reply to Re: Parnate dose issue » steel, posted by OzLand on June 28, 2007, at 23:14:03
Thanks for the info. It's very frustrating because there seems to be so many saying that much higher doses takes on a whole new feeling but if it's going to make me very tired it's not worth trying. Have any of you had success augmenting modafinil with parnate, and do you take it every day or does it wear off or cause agitation.? I've taken a few times and works better sometimes that others.
Posted by steel on June 29, 2007, at 13:51:50
In reply to Re: Parnate dose issue » steel, posted by OzLand on June 28, 2007, at 23:14:03
> Interesting as I drink probably 3 diet pepsi's during the day trying to wake up.
Yess very odd the brain,if you wanna learn more in depth simply do a seach keyword GABA AS EXCITATORY but spelled right lol.
In fact small doses of .5 are sometimes used in CFS.
But of course benzo are sedating drugs,so no more than the recomended .25 should be used unless sedation is the desired affect
This is the end of the thread.
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