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Dr. Bob is Robert Hsiung, MD,
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Posted by okydoky on May 30, 2008, at 16:16:57
In reply to Re: BP lowered already, posted by Justherself54 on May 30, 2008, at 13:26:20
> I took my BP this morning. It's already lowered..I have an appointment with my GP on Tuesday to discuss...if Parnate keeps my BP on the low side, would I have to go on BP meds?
If your BP is just low but within normal range there would be no reason to adjust it. If the hypotension, which is different from low bp is bad it sounds like your doc is willing to add something for it. I took Ritalin sr for the hypotension and had low bp the entire time. I don't know what he has in mind. Parnate can increase bp and you could still have hypotension. So you really have to be careful. Stay away from stimulants (Boost) and the foods youre supposed to avoid. I was on it for several years before it started to poop out. And then I went form Marplan to parnate every 6 months then 4... Also ended up adding other stuff to potentate it. But everyone is different. Sounds like it does you a lot of good. I am glad. I am sure you and your doctor will find the right dose and if needed take something for the hypotension.
I wish you luck and I'm quite jealous,
Oky
Posted by Zeba on May 30, 2008, at 23:46:38
In reply to Re: Restarting Parnate tomorrow, posted by okydoky on May 30, 2008, at 10:10:28
I take Cozaar for hypertension, but I also have sleep apnea and use a CPAP machine. It was a pulmonary fellow who suggested if the new machine doesn't work well for me, then maybe I will be prescribed Provigil. I did not know it was contraindicated with Parnate. I took it once before but I don't remember what AD I was on at the time.
Yes, Parnate used to make me really alert when I took it for around 4 years many years ago. It also helped me lose weight. I loved that about it. Now, with the sleep apnea, I think it might be the sleep apnea making me sleepy midday. I did a sleep study, though, and I am getting enough pressure.
I suppose I could take 20 mg. in the a.m. and 20 mg. at noon, and then maybe I would not be so sleepy around 2 p.m. I used to have trouble with sleeping on Parnate when I took the doses like two or three times in the day, like taking the last one at dinner time. That's why I take all 40 mg. in the morning. I then don't have trouble sleeping at night. I just need to be sure to take it all by noon. I don't think my bp meds are making me sleepy in the day time as I take my bp meds at dinner time or later. Thanks for the thoughts and about Provigil.
Posted by okydoky on May 31, 2008, at 12:19:46
In reply to Re: Restarting Parnate tomorrow » Zeba, posted by Justherself54 on May 30, 2008, at 0:10:30
Justherself54,
How much Parnate did you take before? Did you feel as though it was enough to relieve your depression? I ask because you stated that you could not take 30mg because of hypotension. If you feel like 30mg or more would do you better than the 20mg but the hypotension is bad again it sounds like your gp is willing to address that. I would be interested in knowing what he has in mind? If you felt better within a week as I always did than maybe 20mg is enough. You could also add other meds to potentiate the Parnate or address other problems perhaps. At different times I added Depakote, Remeron, Lithium, Ritalin sr, I cannot remember them all. I do remember Depakote was used the most for me. At the time I had an exceptional psychopharmacologist on my case. He treated me with Parnate because of my prior use of cocaine. Said chemically it was what would work and he was right. I am interested in how you do. I had asked my doc to prescribe Parnate again to try but have been putting it off. I don't hold out much hope for me because it has not worked for about 13 years. But I have not retried it for about 5 years . Thing is I get a lot of side effects from it. But in the end I can honestly say it is the only AD that ever REALLY worked. It was quite the learning experience. Within three days my entire life would change each time I went on it. Like taking the dark glasses off and seeing things, hearing, smelling in an entirely different way. Someone here had a suggestion for what to take with it if I cannot sleep I need to find that post. If you find it let me know. Keep us updated,
oky
Posted by okydoky on May 31, 2008, at 12:34:52
In reply to Re: Restarting Parnate tomorrow » okydoky, posted by Zeba on May 30, 2008, at 23:46:38
I remember now that I used to make sure and take it all by 4pm. If I took it all together I would be very alert and then get very tired like you describe. I always had problems sleeping but if I took it by 4pm it was better. I don't know for sure if Provigil is contraindicated or not. I just thought it might be.
Here is an article or two:
http://www.modafinil.com/modafinil-tranylcypromine.html
http://www.drugstore.com/pharmacy/ayp/questions.asp?label=1169
Looks like the combination has been fairly untested. It would be interesting though.oky
Posted by Zeba on May 31, 2008, at 14:05:05
In reply to Re: Restarting Parnate tomorrow » Justherself54, posted by okydoky on May 31, 2008, at 12:19:46
So maybe it would be wise to divide the dose. Then maybe the tiredness would not surface around 2 p.m. I could take 20 mg. in the a.m. and 20 mg. at noon. Hum.
Also, I wonder if 30 mg. in the a.m. and 10 mg. in the p.m. would work. I really don't want to take Provigil. I think my pdoc would prefer no Provigil. It was my pulmonary doctor talked about Provigil. I also remember that I got sort of weird on Provigil and walked around like a zombie, shuffling along. Really weird reaction. I had a different pdoc then. Pdoc now is opposed to Provigil, and I know he would be okay with splitting the dosage.
Around 15 years ago I took Parnate, 30 mg. I can't remember if I split the dosage. But it worked really well for me--got me out of a profound depression. I did well on it for around five years when I was weaned off of it and was on no medications until more recently when I crashed into depression again. I have had ECT too (and don't recommend that at all) and quit it early and went back to Parnate and got a new pdoc and am doing much better now partly because I also see my pdoc for therapy three times per week too. He's an analyst (psychiatrist) and can prescribe the med's too.
Posted by okydoky on May 31, 2008, at 15:03:25
In reply to Re: Restarting Parnate tomorrow » okydoky, posted by Zeba on May 31, 2008, at 14:05:05
I think it would be advantagous to try splitting the dosage. You could try both ways you suggested and see which is better. I would have crashed every day if I had not split them. If that worked it would be better than adding anohter medication. Especially as you already have bp problems.
Of course this is only my humble opinion.oky
Posted by Justherself54 on May 31, 2008, at 21:41:29
In reply to Re: Restarting Parnate tomorrow » Justherself54, posted by okydoky on May 31, 2008, at 12:19:46
Hi Okeydoky
>
> How much Parnate did you take before?
I took 20 mg. It was working but I felt that to feel 100% I needed to increase to 30 mg.
Did you feel as though it was enough to relieve your depression? I ask because you stated that you could not take 30mg because of hypotension.Yes, 20 mg. relieved my depression within a week.
If you feel like 30mg or more would do you better than the 20mg but the hypotension is bad again it sounds like your gp is willing to address that. I would be interested in knowing what he has in mind?
He told me the drug name but for the life of me I can't remember it. I'm monitoring my BP and will let him know the results. So far just a little bit of lighheadedness. I'll stay at 20 mg. for now as it's early days...I'll pay closer attention to the drug name next time and let you know...
If you felt better within a week as I always did than maybe 20mg is enough. You could also add other meds to potentiate the Parnate or address other problems perhaps. At different times I added Depakote, Remeron, Lithium, Ritalin sr, I cannot remember them all. I do remember Depakote was used the most for me. At the time I had an exceptional psychopharmacologist on my case. He treated me with Parnate because of my prior use of cocaine. Said chemically it was what would work and he was right. I am interested in how you do. I had asked my doc to prescribe Parnate again to try but have been putting it off. I don't hold out much hope for me because it has not worked for about 13 years. But I have not retried it for about 5 years . Thing is I get a lot of side effects from it. But in the end I can honestly say it is the only AD that ever REALLY worked. It was quite the learning experience. Within three days my entire life would change each time I went on it. Like taking the dark glasses off and seeing things, hearing, smelling in an entirely different way.I've already noticed an ability to stay focused and on task so it's a good sign I think. If you've been off it for 5 years, maybe it'll work for you again...I sure hope so.
Someone here had a suggestion for what to take with it if I cannot sleep I need to find that post.I take .05 clonazapam, 25 mg seroquel and 7.5 zopiclone and have been sleeping very well.
I don't have near the side effects that I did on Nardil. I had to double my sleep meds when I was on it...Parnate just seems easier of my system.
If you find it let me know. Keep us updated,
>
> okyI will Oky..take care
Posted by Zeba on May 31, 2008, at 23:44:46
In reply to Re: Restarting Parnate tomorrow » Zeba, posted by okydoky on May 31, 2008, at 15:03:25
I agree; I think this is what I will do. Tomorrow I will take 30 mg. in the a.m. and 10 mg. at noon and do this for a week. Next week I will try a 20/20 split for a week and see which is best.
Posted by okydoky on June 1, 2008, at 0:45:57
In reply to Re: Restarting Parnate tomorrow » Zeba, posted by okydoky on May 31, 2008, at 15:03:25
I looked up your bp medication. Do you have diabetes or kidney problems or an enlarged heart? Are you taking it exclusively for high bp? Not trying to scare you. I just thought depending on why you take this particular drug you might be able to do something natural. Especially if the Parnate lowers your bp.
You implied you are already taking other medications too. Obviously I am not averse to taking medication but if there is a safer effective alternative, which can sometimes include lifestyle changes I personally would try that first. I dont know your history. Perhaps you have tried other medications and/or natural alternatives? Also you couldbe like me in that I am too depressed to change much but my diet.
I read this is a strong medication and one usually not taken until others have failed and/or indicated for other reasons also.
I just thought with Parnate messing with everyones bp this might be something to start thinking about. If Parnate is lowering your bp do you need the cozarr also? Or perhaps something else instead.
I am just speculating. I am not very knowledgeable and certainly am not a doctor. Perhaps you should run it by your doctor that you want to change how you take the Parnate.
It might work again for me but I wanted to be able to address my rapidly declining cognitive skills and memory and will not be able to do that as far as I know while on Parnate.
Good luck keep us updated,
oky
Posted by okydoky on June 1, 2008, at 13:43:15
In reply to Re: Restarting Parnate tomorrow » okydoky, posted by Zeba on May 31, 2008, at 23:44:46
I apologize for being so invasive yesterday in my post. I'm sure some of it was none of my business.
Was about me.oky
Posted by Justherself54 on June 1, 2008, at 23:42:00
In reply to Re: Restarting Parnate tomorrow » Zeba, posted by okydoky on June 1, 2008, at 13:43:15
Today blood pressure dropped quite low and felt a little light headed a couple of times. Also very tired and a little flat and scatter-brained but I overdid it painting my kitchen yesterday, so it could be fibromyalgia related. I hope it's just a temporary bump and I'll continue to feel better.
Posted by Phillipa on June 2, 2008, at 18:54:27
In reply to Re: Restarting Parnate, posted by Justherself54 on June 1, 2008, at 23:42:00
Wow that's a lot of work. No wonder you're tired. And you should be proud of yourself. Sounds like things are on the up for you. Congrats. Phillipa
Posted by Zeba on June 2, 2008, at 22:42:31
In reply to Re: Restarting Parnate tomorrow » Zeba, posted by okydoky on June 1, 2008, at 13:43:15
No problem. You were not being intrusive. I was out of town for the weekend to a sister-in-law. Her oldest son has three children, and the oldest just graduated high school. I can't believe it sometimes. My nephew was already four years old when my husband and I got married, but still!!!
Re the problems, I don't have kidney problems or heart problems or diabetes. Just asthma, sleep apnea, and GERD which all seem to go together. I have had hypertension for around 15 years now. My bp is around normal now and sometimes a little high and sometimes a little low. When I go to the doctor, it is high (white coat...).
Parnate worked really well for me years ago and is working for me now too. I have now tried 30 mg. in the a.m. and 10 mg. in the p.m., and this is working much better. I will talk to my pdoc about it tomorrow morning.
Thanks for your concern, and I am sorry if you thought you offended me. You did not. I just wasn't around to respond.
Posted by Zeba on June 2, 2008, at 22:46:38
In reply to Re: Restarting Parnate, posted by Justherself54 on June 1, 2008, at 23:42:00
Did you let your doctor know your bp fell quite low. This is nothing to mess around with. Sounds like it would be best to stay at 20 mg. for awhile.
When I started on Parnate, I started at 10 mg. for a few days before going to 20 mg. for a week before going to 30 mg. for a week and then 40 mg.
I think I would have been dizzy, etc. if I had started out on 20 mg. rather than a gradual increase. Maybe that would not make any difference for you??
Take care and keep taking your bp at multiple times during the day, okay???
Posted by undopaminergic on June 5, 2008, at 13:54:34
In reply to Re: Restarting Parnate » Justherself54, posted by Zeba on June 2, 2008, at 22:46:38
I recommend taking Parnate in divided doses, not only to maintain alertness throughout the day, but also in order to avoid complications.
Tranylcypromine (Parnate), in addition to its MAO-inhbiting properties, has acute amphetamine-like effects that are closely dependent upon the concentration of the drug in tissues, unlike the MAO inhibition, which persists for weeks even after cessation of the drug. This has a couple of implications:
Taking a high dose of Parnate, all at once, may provoke a so-called spontaneous hypertensive reaction, and dividing the daily dose into two or more smaller doses helps avoid this complication, which has frightened a number of people into quitting the drug prematurely. This reaction only occurs with Parnate, and not with Nardil or Marplan, because these other MAOIs lack Parnate's amphetamine-like actions. Amphetaminergic complications may occur with selegiline as well, but not with rasagiline.
The other implication of Parnate's amphetamine-like action is for the time of administration. The doses should be taken at suitable times of the day in order to maintain alertness, and to avoid worsening the insomnia that is a frequent side-effect of all MAOIs, regardless of when they are taken.
Posted by Justherself54 on June 5, 2008, at 14:36:14
In reply to Re: Restarting Parnate, posted by undopaminergic on June 5, 2008, at 13:54:34
Thanks for the info. I'm still at 20 mg..I take first dose in the morning and second mid afternoon..I will try to increase to 30 shortly as 20 has helped a lot but I still would like to feel a bit better.. That dosage is where the hypotension really becomes a problem. When I tried 30 mg before, I set my alarm so I could take the first dose really early and still get the rest in by early afternoon.
I'm going to do the increase after the weekend as I'm going to see my grandkids and if the hypotension hits, I don't want to scare the little ones if I have to drop to my hands and knees...
Wish me luck..
Posted by Zeba on June 5, 2008, at 21:15:09
In reply to Re: Restarting Parnate, posted by undopaminergic on June 5, 2008, at 13:54:34
I am doing better with the 30 mg. in the a.m. and 10 mg. around noon or 1 p.m. I am going to try a 2/20 split. If I take Parnate any later than around 3 p.m., then it affects my sleep. Otherwise, I have had no problems with insomnia. Was at the neuologist's today and bp was 140/97. I was uptight,though, and so later it went down. Taking the 40 mg. in the a.m. never caused me to develop hypertensive reaction. In fact my bp was lower. If I split the dose, I may need to take my bp med's earlier in the day rather than at bedtime. I did 40 mg. in a.m. for around a year, but I am also very careful about what I eat and drink, and only once did I develop hypertensive crisis, and that was many years ago in the 80's when I tried to kill myself on Parnate by taking a handful of Contac slow release capsules. I ended up on the Cardiac intensive Care unit of the hospital. It was horrible; I thought my head would explode. I never thought that I could make my heart explode too. Never again. I am extra careful now that I am older.
Posted by okydoky on June 5, 2008, at 21:25:29
In reply to Re: Restarting Parnate » undopaminergic, posted by Zeba on June 5, 2008, at 21:15:09
Seriously you might want to discuss the possibility of havnig Procardia at hand in the off chance of a hypertensive crisis. But I don't know how it would all be with the bp meds you already take.
oky
Posted by Zeba on June 6, 2008, at 19:41:17
In reply to Re: Restarting Parnate » Zeba, posted by okydoky on June 5, 2008, at 21:25:29
I have thought about that, and I keep forgetting to ask. My bp always goes up when I Go to the doctor--white coat thing I think. Mostly my bp is low or normal. Today I took my bp med earlier. I think I will start monitoring again now that I am taking 20 mg. in the a.m. and 20 mg. at noon. My pdoc things that is a good idea and told me, too, to do 10 jumping jacks if I start to get really sleepy. Hum. He is so funny sometimes.
Posted by okydoky on June 7, 2008, at 9:13:33
In reply to Re: Restarting Parnate » Zeba, posted by okydoky on June 5, 2008, at 21:25:29
You should, sit in the same position every time you take your bp and wait a few minutes after sitting to take it. This way it will be calmed down from any activity (even walking) before you take it and you'll have a consistent measurements for comparison. Also your arm is supposed to be at heart level or something. (Memory!)
Did he tell you to get up slowly from a sitting or laying position? Rising quickly can cause a sudden change in bp which is hypotension. So even if you have it a little you can mitigate it by doing these things slowly. I always forgot when I woke up in the morning. Ended up on the floor frequently! I guess the jumping jacks gets your blood flowing quicker or better and raise your bp a bit, but only temporarily.Nothing wrong with low bp. Ive had it with or without Parnate my whole life which is probably why when I took Parnate and it lowered it even more I had some problems. I used to take my bp often mainly because I was scared of hypertensive crisis and read I could have it without the screaming headache. My usual bp with Parnate was around 90/60,so I always had to get up slow or I would pass out.
All they gave me in the ER was Procardia. I had to wait forever unless I screamed enough and then they gave me some Procardia and then I had to wait another 5 or so hours. I was so relieved I finally got the Procardia Rx and did not have to go to the ER but I had multiple spontaneous episodes. It is probably better to go to the ER. I just had too many!
It sounds like things are going well. I am so glad.Keep us updated,
oky
Posted by okydoky on June 7, 2008, at 9:38:10
In reply to Re: Restarting Parnate » okydoky, posted by okydoky on June 7, 2008, at 9:13:33
I posted somewhere my trouble with sleeping while on Parnate. I think you were the one that had a specific suggestion? I cannot find it.
Do you recall this? Was it you or do you know what it was?
Thanks,
oky
Posted by Zeba on June 8, 2008, at 17:06:45
In reply to Re: Restarting Parnate » okydoky, posted by okydoky on June 7, 2008, at 9:13:33
I tried to post on a different computer and could not send the message as I guess the password is made longer than what one puts in for a password. Anyway, Yes I will try sitting, etc. and take my bp a number of times a day. I am not getting so sleepy now that I take 20 mg. in the a.m. and 20 mg. in the p.m. I may go back to 30/10 though as I seem to feel most depressed in the morning. I just am not sure which is best. I think I did well on the 30/10. I will try 20/20 for a few days more and then go back to 30/10 if it seems better.
Yes, hypertensive crisis is nothing to laugh at.
Take care and let us know how you are doing too.
Posted by okydoky on June 8, 2008, at 18:06:41
In reply to Re: Restarting Parnate » okydoky, posted by Zeba on June 8, 2008, at 17:06:45
I'm glad you are doing what is best for you. Not what I or somebody else or a docter or a book might say.
You sound tired. Or read so I guess.
I am alive, that's about it.
Good luck,
oky
Posted by Justherself54 on June 8, 2008, at 19:20:06
In reply to Re: Restarting Parnate » Zeba, posted by okydoky on June 8, 2008, at 18:06:41
First day at 30 mg. Here's hoping the hypotension doesn't get too bad :-(
Posted by okydoky on June 8, 2008, at 20:21:42
In reply to Re: Restarting Parnate, posted by Justherself54 on June 8, 2008, at 19:20:06
How are you taking it? Did you take it in divided doses?
Good luck,
oky
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