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Dr. Bob is Robert Hsiung, MD,
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Posted by bulldog2 on February 15, 2010, at 8:19:14
In reply to Parnate Update- Help!, posted by ColoradoSnowflake on February 14, 2010, at 20:37:36
> Hi Everybody:
>
> I've been quiet for awhile. I've been stalled out at 30mg/day Parnate. I was hoping that 30mg. might be enough to keep the Black Monster at bay and that my rheumatoid arthritis flareup (which Parnate really fired up) would calm down.
>
> Well, that hasn't happened. 30mg.Parnate is not enough. I'm getting more and more depressed and feel myself sliding down into the slimy black pit. And 30mg keeps my RA too painful and debilitating.
>
> I'm going to have to go off the Parnate completely and back to Wellbutrin i guess. Welbutrin is the only AD I have been able to tolerate. What a terrible disappointment that is. Parnate helped me more than any other AD ever has and is kind of the last house on the block for me. But the severity of the autoimmune/rheumatoid arthritis it triggered is/was horrible. This disease of depression sucks. I feel like the stress of being depressed is what caused my RA in the first place. But that's another thread.
>
> I am really afraid. Each time I have decreased the Parnate (from high of 80mg/day) I get terrible, terrible withdrawal symptoms lasting several weeks. Now that I'm significantly depressed to boot, and will be more so as I taper down more, and will have the 14 day washout period with no antidepressant on board, I'm getting really worried that I wont be able to handle it!
>
> Those of you who have had bad withdrawal from Parnate like I do, HOW DID YOU DO IT???
>
> I would be so grateful to hear any ideas or suggestions you guys might have!!
>
> Thank you so much!!
>
> Gayle
>Have you thought about three other maois..The emsam patch, marplan and nardil. ? They shouldn't be hard on your arthritis.
I'm stopping the parnate also...It is a good ad but the cold feeling in my joints is to painful in the cold of the winter.
Posted by willey on February 15, 2010, at 15:39:51
In reply to Parnate Update- Help!, posted by ColoradoSnowflake on February 14, 2010, at 20:37:36
Im with bulldog,i stay on parnate simply cause it is the only med that let me see remision ever and yess it gives out and stauls,at these points i suffer of course,then i turn to 2 simple strategys,
1, quick raise in dose till i feel ok again then titrate back down,
2.Aumentation and or potentiaion with another med.
Being on a maoi i hope doesent make it harder for you to find other clases less ufeful now,but id start looking to see what out of them remaining sounds like you would want to go on.
If none of the parnate recomdations work,and you cant simply raise parnate which most cant,thanks docs,then like bulldog said there is a group that takes nardil and tons of experieanced users over there on that speicific drug.
I will say for myself,when i swithed to nardil,it was because on the fly i could not take it anymore and went back to a old stash of parnate and back on parnate immediatly with only a day wash out.
Also published data where the two maois are used in pre treatment of the other again showing not everyone feeels a wash is needed between a maoi and a moai.
That sound,i would get the basics,a benzo,klonopin as it seems to be more for general anxiety not panic attacks,a stimulant like modfanil to keep u lifted,and ive been touting a med named campral which balacnes both glutamate and gaba thus greating a calm sense of being along with a lack of sedation.
Keep us informed,good luck
Posted by kirbyw on February 15, 2010, at 19:06:39
In reply to Parnate Update- Help!, posted by ColoradoSnowflake on February 14, 2010, at 20:37:36
Try sending an e-mail to Dr. Ivan Goldberg at the following e-mail address. He knows more about Parnate than anyone around, He is in his 70's a retired Columbia U. Psychiatry Professor. I went to see him 3 months ago when I was in New York and he was very helpful.
Be sure to mention the arthritis flare up and at least try asking him if he knows anything about this interaction and could make any suggestions,to improve this condition so that you could stay on Parnate.. Because of his age, I think most of his years of Practice was from the early 60's when Parnate was much more common and I have the impression he had worked with hundreds and hundreds of people on Parnate, and may no something about this interaction. His e-mail is as follows
Hope this helps
Rick in Costa Rica
Posted by Phillipa on February 15, 2010, at 19:36:16
In reply to Re: Parnate Update- Help!, posted by kirbyw on February 15, 2010, at 19:06:39
Colorado how's it going now did you e-mail the doc? Love Phillipa
Posted by Maxime on February 15, 2010, at 20:34:17
In reply to Parnate Update- Help!, posted by ColoradoSnowflake on February 14, 2010, at 20:37:36
(((( Snowflake ))))
Posted by floatingbridge on February 15, 2010, at 20:59:10
In reply to Parnate Update- Help!, posted by ColoradoSnowflake on February 14, 2010, at 20:37:36
Gayle, I think there's some good advice here--
e-mail that doctor in NY--what the heck, right?
(Short, short course of benzos if nessesary?)
Another maoi? Really. Maybe you could tolerate it just fine. And the washout may not be even as long, esp. if you share the intensity of your distress with your doc. They can speed it up maybe.
How well does wellbutrin work for you, on that (annoying) scale of 1-10 for depression?
super-hugs!
fb
I'm so glad you posted--good luck!
Posted by ColoradoSnowflake on February 16, 2010, at 0:36:08
In reply to Re: Parnate Update- Help!, posted by willey on February 15, 2010, at 15:39:51
Hi Everyone!
Thanks so very much to all of you for the good ideas and the support!!
Tomorrow I'm going to write to Dr. Ivan Goldberg. I'd love to find out if anyone but me has gotten crippling RA from Parnate use. Maybe he'll even answer! Thanks Rick for the address.
I see my pdoc on Wed. and will ask about the washout between maoi's. I would try Marplan and maybe even Nardil if I didn't have to go through horrible washouts every time. My pdoc is good with maois. He had me on Nortrip with the Parnate which was a good thing for me. So clearly he's not afraid of maois. I'll also see about some Xanax (no klonipin for me..it lays me low with depression) or maybe some percodan if I have trouble again lowering my dose of parnate. I'd rather be knocked out than go through what I did from 80mg to 60mg of Parnate!! I don't ever use those drugs so I'm sure he would give them to me if he thought they would help me more than hurt me.
He did let me go high on the Parnate but didn't like it when my RA was so bad I was falling all the time. It was killing me too.I do take Modafinal every day now and it's very helpful. I plan to continue it.
Wellbutrin helps me about 5 or 6 on a scale of 10. I don't cry constantly, but it doesn't take away the thoughts of suicide like Parnate did. It's better than nothing! It's about the only drug I've been able to take without severe reactions. Maybe I can supplement Wellbutrin with enough other stuff that it could work for me.
I'm going to ask him about the Campral. I see it is for alcoholics. I'm a recovering one for quite a few years now, so maybe that would be a good drug for me??
Thanks so much!! I feel like I have some more things to try and to think about now, and that helps me LOTS.
Hugs to you all!!
Gayle
Posted by bulldog2 on February 16, 2010, at 16:37:25
In reply to Re: Parnate Update- Help!, posted by ColoradoSnowflake on February 16, 2010, at 0:36:08
> Hi Everyone!
>
> Thanks so very much to all of you for the good ideas and the support!!
>
> Tomorrow I'm going to write to Dr. Ivan Goldberg. I'd love to find out if anyone but me has gotten crippling RA from Parnate use. Maybe he'll even answer! Thanks Rick for the address.
>
> I see my pdoc on Wed. and will ask about the washout between maoi's. I would try Marplan and maybe even Nardil if I didn't have to go through horrible washouts every time. My pdoc is good with maois. He had me on Nortrip with the Parnate which was a good thing for me. So clearly he's not afraid of maois. I'll also see about some Xanax (no klonipin for me..it lays me low with depression) or maybe some percodan if I have trouble again lowering my dose of parnate. I'd rather be knocked out than go through what I did from 80mg to 60mg of Parnate!! I don't ever use those drugs so I'm sure he would give them to me if he thought they would help me more than hurt me.
> He did let me go high on the Parnate but didn't like it when my RA was so bad I was falling all the time. It was killing me too.
>
> I do take Modafinal every day now and it's very helpful. I plan to continue it.
>
> Wellbutrin helps me about 5 or 6 on a scale of 10. I don't cry constantly, but it doesn't take away the thoughts of suicide like Parnate did. It's better than nothing! It's about the only drug I've been able to take without severe reactions. Maybe I can supplement Wellbutrin with enough other stuff that it could work for me.
>
> I'm going to ask him about the Campral. I see it is for alcoholics. I'm a recovering one for quite a few years now, so maybe that would be a good drug for me??
>
> Thanks so much!! I feel like I have some more things to try and to think about now, and that helps me LOTS.
>
> Hugs to you all!!
> Gayle
>
>
>
>Can You use wellbutrin with low dose parnate? The wellbutrin would as a substitute for the modafanil.
Posted by ColoradoSnowflake on February 16, 2010, at 21:48:24
In reply to Re: Parnate Update- Help!, posted by bulldog2 on February 16, 2010, at 16:37:25
Bulldog:
I wish I could! He said NO! I have to have the Parnate out of my system for 14 days before I can take Wellbutrin.
I know some people take the two together but, after the bad experiences I've been having just coming down on parnate, I think I'll follow his instructions!
Posted by Phillipa on February 16, 2010, at 22:04:13
In reply to Re: Parnate Update- Help!, posted by ColoradoSnowflake on February 16, 2010, at 0:36:08
Gayle campral is also good for anxiety. Don't forget to ask and please keep posting. Love Phillipa
Posted by willey on February 17, 2010, at 22:26:45
In reply to Re: Parnate Update- Help! » bulldog2, posted by ColoradoSnowflake on February 16, 2010, at 21:48:24
Bull dog,i hope you want to come off parnate,and that youre not doing so simply because ur doc wont allow any augments.
Parnate is not a miracle,it has periods where it needs to be tweaked all the time,but although the combo mentioned,wellbutrin/parnate is one for example,is actualy not a great one,but point is u have so many many options left,if u ever go on again and want some augment tips contact me,hate to see u leave a med that will allow u some kind of remission to none,so either way wish ya luck
Posted by bulldog2 on February 19, 2010, at 18:50:33
In reply to Re: Parnate Update- Help!, posted by willey on February 17, 2010, at 22:26:45
> Bull dog,i hope you want to come off parnate,and that youre not doing so simply because ur doc wont allow any augments.
>
> Parnate is not a miracle,it has periods where it needs to be tweaked all the time,but although the combo mentioned,wellbutrin/parnate is one for example,is actualy not a great one,but point is u have so many many options left,if u ever go on again and want some augment tips contact me,hate to see u leave a med that will allow u some kind of remission to none,so either way wish ya luckYou're right that parnate is a good med. Going up very slowly and only on 15 mg right now. doing 5 mg at a time. Seems like I get a lot of different moods on parnate. Depends on what I eat or what med I am on. Today I took a percocet for pain and when the percocet wore off I felt dysphoric. later took 800 mg neurontin and ate dinner and got a good clear headed stim feeling which felt good. You can really tweek this med with other meds.
Posted by willey on February 19, 2010, at 19:15:30
In reply to Re: Parnate Update- Help! » willey, posted by bulldog2 on February 19, 2010, at 18:50:33
Yess my view,and only mine of course is there 2 points on parnate,able to use higher dose range,and must augment it or potentiate it.
Alone it begins to feel dry and nast to me.
I only mention this cause reading ur posts u seem to be a good place knowledge wise,but remeber above all dont loose respect for it,do everything slow and careful,and if u believe anything i say read into pharmcology of CAMPRAL,a gaba/glutamte modulator,no drug interactions,creats calm without sedation,pay no mind to its on label use,its been great for social enhancment.
GOOD LUCK TO US ALL.
Posted by floatingbridge on February 19, 2010, at 21:12:15
In reply to Re: Parnate Update- Help!, posted by willey on February 19, 2010, at 19:15:30
Colorado Snowflake,
Any updates? Thinking of you.
Hugs!
fb
Posted by Phillipa on February 19, 2010, at 21:22:35
In reply to Snowflake: parnate, maoi update?, posted by floatingbridge on February 19, 2010, at 21:12:15
Ditto!!!! Phillipa
Posted by ColoradoSnowflake on February 19, 2010, at 22:42:26
In reply to Snowflake: parnate, maoi update?, posted by floatingbridge on February 19, 2010, at 21:12:15
Hi Everybody:
Thanks for asking!
I came down to 20mg/day Parnate on Monday (my RA was still too much for me on 30mg). Immediately I wasn't so chilled/frozen. I went to bed for the first time in 10 months without having deep chills , wearing sweats,woolsocks,woolhat and having frozen feet until 5 am. I wore regular nightwear, no socks, and was fine! That's BIG. But I am still itching, dizzy and in RA pain.. and now also have something like fibro in my arms and shoulders to boot.
I saw my pdoc the other day and he is looking into Campral for me. Only addiction specialists can prescribe it but I'm sure he could if he thought it would be good. (Thanks, Willy)! Pdoc says I should do what I think is best about the Parnate. He worries about my being so dizzy and falling, but leaves it up to me.
I've been totally gluten-free since January lst because of the autoimmune problems with my thyroid and guts. Maybe that's helping me be not so depressed????
I don't know, but I'm really feeling better!! I'll just stay put on meds where I am for the time being unless pdoc lets me add Campral.
I just wish I would get un-dizzy enough to resume my exercise classes. I have an appt with the Vertigo specialist doc in March, so maybe she'll shed some new light on the dizziness.
I'm trying to get someone to prescribe LowDoseNaltrexone for my RA. My Rheumatologist hadn't heard of it, thought it was another scam. My pdoc said he didn't know enough about the LowDose aspect but thought it was OK with Parnate...to ask my Internist for it. Internist said he'd never heard of it and talk to my Rheumatologist. No one will prescribe it for me.
Geesh!!!But, this whole week my depression is better..I have more energy and hope!! This is a great thing!! I hope hope hope it lasts!!
So that's my story at the moment.
Thank you so much for caring!!
xxooxx Gayle
Posted by willey on February 20, 2010, at 7:12:52
In reply to Re: Snowflake: parnate, maoi update?, posted by ColoradoSnowflake on February 19, 2010, at 22:42:26
Well glad to see the good outlook,its always a tool in itself!
I hate to say this,especialy if in ur case im wrong,but in my world docs hate using any not frontline,ive been rejected on everything since my orignal doc retired,god she knew her stuff.
Anyway there might be a good chance they simply wont give it to you.
In this case all i can say is this,look for yourself at a site called DRUGBANK,see it has no interactions rather then take a posters,any posters word,and see how its profile of gaba/glutamate balance simply fits many mood disorders,and with that,if u feel safe,
Well all i can say is i believe your allowed to order drugs that arent sheldued,this one is def not,and everywhere,and perhaps make a decision there.
Im forced into this world due to docs rejections without logic to why.
I dont plan on letting docs stop my progress or hurt me any longer.
Also campral is a fairly cheap drug.Good luck
Posted by Phillipa on February 20, 2010, at 19:29:46
In reply to Re: Snowflake: parnate, maoi update?, posted by ColoradoSnowflake on February 19, 2010, at 22:42:26
Campral are you sure an addictions docs? One poster her her pdoc prescribed it for her and it worked. Good for anxiety also Love Phillipa great that your're feeling better.
Posted by floatingbridge on February 20, 2010, at 19:54:50
In reply to Re: Snowflake: parnate, maoi update?, posted by ColoradoSnowflake on February 19, 2010, at 22:42:26
I've been wondering about the campral. Google didn't reveal any 'off-label' or therapeutic uses besides alcohol cravings
How do you see it fitting into your regime?
fb
Posted by willey on February 21, 2010, at 8:52:31
In reply to campral » ColoradoSnowflake, posted by floatingbridge on February 20, 2010, at 19:54:50
Well its pharmacology is very simple.First it modulates gaba.
Gaba as you know is a chemical that just about every single one there is,inlcuding all benzos work on just in slighty different.But again from mood stablizers,to barbitutes,to benzos,and so on ,gaba has and does play a MAJOR role in psychiatry.
What makes campral unique,is unlike meds which alter it in various ways,campral instead keeps it at a exact balance in glutamate which is the major chemical looked at in many brain disorders,onlcuding mania,anxiety,seziruea,alzhiemers,and so on.
Basicaly glutmate can over excite the brain,and this state is considered toxic as in seizures.Gaba simply inhbits the brain,such as in sleep meds,and other sedatives,which even though appear dopey,still considered nuero protection.
When drinking,or taking gaba meds,the change in either causes a never ending rebound imbalance of the chemicals.
Campral keeps this balance restored,and is touted to be non altered by any subsequent med being taken.
This med for me has increased sociability,mood,depression seems to have less power over domintaing my meds and seems to slip off more,and last of course anxiety.
I imagine campral is boosted hghly by the additions of other gaba meds such as benzos and mood stablizers.
Posted by floatingbridge on February 21, 2010, at 10:31:42
In reply to Re: campral, posted by willey on February 21, 2010, at 8:52:31
Willey, thank you for your explanation. So, is this an under-used med? Maybe many use it and I hadn't heard....
Sounds good. Thanks Willey--glad it works for you--and good luck to you and Snowflake!
fb
Posted by sigismund on February 22, 2010, at 22:34:29
In reply to Re: campral, posted by willey on February 21, 2010, at 8:52:31
>This med for me has increased sociability,mood,depression seems to have less power over domintaing my meds and seems to slip off more,and last of course anxiety.
Sounds good. Any downside or side effects?
Posted by willey on February 23, 2010, at 9:52:27
In reply to Re: campral » willey, posted by sigismund on February 22, 2010, at 22:34:29
Two both posts above,underused i would not say,its used extenisvly in its on label use,the reason why i personaly,and some info here,there,see it as potential more,is even u guys if u look at its profile,
Id we listen and believe what weve been told,gaba is crucial to anxiety relieaf and mood,campral modualtes this,so it doesent decrease,also more recently we,depression/mood disorders have been talking a lot about gutamate,well it balances both gaba and glutamte evenly,this is said to be its only profile,no hidden other effects,so woulld u agree if it does this,and also has no known drug interactions,should be used even if as a small augmen to perhaps benzos?
I personaly gey a pro social effect from it,i also noticed im more able to keep depression at the thin line and not crossing over.Other then a study for mood,its not mentioned for it except in small wording at the end of POSSABLE USES,it even as most meds,esepcialy mood stablizers have,is a risk of depression,so i cant say being the only speaking voice that its gonna work for everyone etc,i just thought reading it that like me people should at least know about it as an option,that is what will help us move on,not relying on docs for all info,but everywhere inlcuding and importantly here where we can share unconvetional methods to this group who for most has been through the convential machine too much.
I have used it 4 weeks now.
Posted by stargazer2 on February 26, 2010, at 22:24:55
In reply to Parnate Update- Help!, posted by ColoradoSnowflake on February 14, 2010, at 20:37:36
Hi Gayle,
I'm on Nardil 30 and Wellbutrin XL 150, only after much research and bringing information to my pdoc for him to read, before he reluctantly prescribed Wellbutrin with Nardil.
If I was going to have a reaction it would have occurred in the first week and I've been on it now for almost a year, if I can remember.
I can't say if that is what has helped me the most but Nardil alone was just so-so, so I went to an endocrinologist to be worked up to see if my thyroid was out of whack and I was prescribed Synthroid for a marginal thyroid level.
After awhile on the Nardil-Synthroid combo, I came up with trying Wellbutrin, since my pdoc had already told me he would not prescribe a stimulant as I had a reaction on one while taking Nardil. I believe my depression is closely related to ADD, the chicken and egg theory.
But, not every doc will add "countraindicated" meds, like Wellbutrin, to Nardil and that is the problem, but understandably with the risk of a reaction being so great, the docs have to be very cautious, and in most cases will not go down that road.
I even told my doc I owuld sign a waiver so that it anything happened to me I would not hold him accountable. He kind of laughted at that suggestion but did agree to ordering Wellbutrin.
I was just lucky he did because I was reaching a critical point in my depression treatment.
All I can tell you is it is working for me but again, the doc has to do what he is comfortable with and that is totally out of our hands.
I feel for you. Life is so unfair when you have sicknesses that are not easily treated. But there are so many drugs that didn't exist when I was first diagnosed. Almost too many though, so it is more difficult to find the magic bullet(s).
Posted by ColoradoSnowflake on February 27, 2010, at 17:22:25
In reply to Re: Parnate Update- Help!, posted by stargazer2 on February 26, 2010, at 22:24:55
Hi Stargazer:
Thanks so much for your supportive post! It really is hard for some of us to find something that works!!
I'm happy that your Nardil plus Wellbutrin is working for you!! It gives me hope that I might find something too!
My pdoc is pretty good with trying things with me. I did take a TCA with Parnate. And I do take a stimulant with Parnate, Provigil. But he says absolutely no on taking Wellbutrin unless I go totally off Parnate and washout for two weeks! I've gone to him a long time so I do trust him with my personal reaction to drugs.
He asked me if I was interested in trying another MAOI like Ensam, Nardil or Marplan. After such a reaction to Parnate, which seems to have the fewest side effects generally, I'm not very enthusiastic about trying another one.
I may try some Ritalin with the Parnate I'm on, but Ritalin makes me so depressed I'm not holding my breath!
And on and on it goes.
Thanks again, Stargazer, and good luck to you!!
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