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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Chairman_MAO on November 10, 2011, at 5:40:32
28 days after I started taking it, I went to bed, taking my usual 3mg Lunesta and 100mg Vistaril. Woke up three hours later. I wish I'd slept, but I'm feeling pretty good. Kinda sucks that I'm on 3mg/day of clonazepam now, because that might be blunting the effect of it. I notice substantially decreased anxiety, though (the clonazepam alone was not nearly as effective for my SP/anxiety after a few months, as is often the case).
It could also be a fluke from perhaps sleeping too much during the day, but I hvae done that before and slept soundly at night.
Interesting how these things work.
Posted by SLS on November 10, 2011, at 8:06:25
In reply to Perhaps Marplan kicked in fully today?, posted by Chairman_MAO on November 10, 2011, at 5:40:32
> 28 days after I started taking it, I went to bed, taking my usual 3mg Lunesta and 100mg Vistaril. Woke up three hours later. I wish I'd slept, but I'm feeling pretty good. Kinda sucks that I'm on 3mg/day of clonazepam now, because that might be blunting the effect of it. I notice substantially decreased anxiety, though (the clonazepam alone was not nearly as effective for my SP/anxiety after a few months, as is often the case).
>
> It could also be a fluke from perhaps sleeping too much during the day, but I hvae done that before and slept soundly at night.
>
> Interesting how these things work.
Circadian phase advance?
- Scott
Posted by Phillipa on November 10, 2011, at 11:38:38
In reply to Re: Perhaps Marplan kicked in fully today? » Chairman_MAO, posted by SLS on November 10, 2011, at 8:06:25
Scott what does that mean? Phillipa
Posted by SLS on November 10, 2011, at 12:30:17
In reply to Re: Perhaps Marplan kicked in fully today? » SLS, posted by Phillipa on November 10, 2011, at 11:38:38
> Scott what does that mean? Phillipa
It is a shift in the timing of the circadian rhythm.
Going to bed earlier and waking up earlier.
Sleep deprivation is a form of phase-advance. Some people experience an improvement in their depression after one night of total sleep deprivation. This improvement can be extended a few days by consecutive phase advances.
http://ajp.psychiatryonline.org/article.aspx?articleID=172377
- Scott
Posted by Phillipa on November 10, 2011, at 21:08:51
In reply to Re: Perhaps Marplan kicked in fully today? » Phillipa, posted by SLS on November 10, 2011, at 12:30:17
Can't go without sleep not even in high school. Thanks for explaining and the link. Phillipa
Posted by SLS on November 10, 2011, at 21:41:14
In reply to Re: Perhaps Marplan kicked in fully today? » SLS, posted by Phillipa on November 10, 2011, at 21:08:51
One can approximate the antidepressant effect of total sleep deprivation by going to bed at the usual time and waking up three hours later. Again, this has the effect of phase-advance the circadian rhythm.
- Scott
Posted by Chairman_MAO on November 11, 2011, at 7:51:07
In reply to Re: Perhaps Marplan kicked in fully today? » Chairman_MAO, posted by SLS on November 10, 2011, at 8:06:25
> > 28 days after I started taking it, I went to bed, taking my usual 3mg Lunesta and 100mg Vistaril. Woke up three hours later. I wish I'd slept, but I'm feeling pretty good. Kinda sucks that I'm on 3mg/day of clonazepam now, because that might be blunting the effect of it. I notice substantially decreased anxiety, though (the clonazepam alone was not nearly as effective for my SP/anxiety after a few months, as is often the case).
> >
> > It could also be a fluke from perhaps sleeping too much during the day, but I hvae done that before and slept soundly at night.
> >
> > Interesting how these things work.
>
>
> Circadian phase advance?
>Oh, no, I meant that the difficulty sleeping could also at least in part be due to my sleeping during the day, but that is food for thought.
This stuff is definitely working now. If I were taking it just for depression, I don't think I'd have to raise the dose because it's still not where Nardil was for the SP, although there is less anxiety now. I'll see what pdoc has to say.
I sure wish someone started me on this class of drugs in around 2003 when I first started thinking that the other drugs didn't do anything for me. After a failed trial of TCA in 03 I asked for an MAOI but doctor said absolutely not. Could have saved me a lot of time ...
Oh well, I am grateful to have what I have now--and for the community on this board which seems to have been around forever. ;-)
Posted by ed_uk2010 on November 11, 2011, at 8:00:03
In reply to Re: Perhaps Marplan kicked in fully today? » SLS, posted by Chairman_MAO on November 11, 2011, at 7:51:07
>This stuff is definitely working now. If I were taking it just for depression, I don't think I'd have to raise the dose because it's still not where Nardil was for the SP, although there is less anxiety now. I'll see what pdoc has to say.
How much Marplan are you taking?
> Oh well, I am grateful to have what I have now--and for the community on this board which seems to have been around forever. ;-)
Yes, I know what you mean :)
Posted by Chairman_MAO on November 11, 2011, at 13:08:36
In reply to Re: Perhaps Marplan kicked in fully today? » Chairman_MAO, posted by ed_uk2010 on November 11, 2011, at 8:00:03
> How much Marplan are you taking?
40mg/day now. I'm going to ask to go to 60, especially since the plan is for me to come off of clonazepam. It seems to be OK with the marplan, but it was losing effectiveness on its own. It is also impairing my concentration. Once the dose of this is stabilized, then the plan is to get back on Dexedrine and titrate that back up to 60mg/day, which is going to take a while (I'm lucky to have a doctor that will even do this at all).
I required at least 90mg/day of Nardil and ended up at 120mg/day of Parnate and 120mg/day of Nardil, so the dose of this needs to be higher. I am not getting the full effect, I don't think, but it is encouraging. I'd be able to tell better what it was doing if I weren't on the benzo. Oh well.
Thanks for your interest and support.
>
> > Oh well, I am grateful to have what I have now--and for the community on this board which seems to have been around forever. ;-)
>
> Yes, I know what you mean :)I don't post about this stuff anywhere else, really. It's a great comfort to be able to see the core group of people here that stick around.
Posted by ed_uk2010 on November 15, 2011, at 13:59:59
In reply to Re: Perhaps Marplan kicked in fully today? » ed_uk2010, posted by Chairman_MAO on November 11, 2011, at 13:08:36
>40mg/day now. I'm going to ask to go to 60, especially since the plan is for me to come off of clonazepam. It seems to be OK with the marplan, but it was losing effectiveness on its own. It is also impairing my concentration.
For many people, memory is impaired on benzodiazepines. I expect you might notice an improvement in memory as well as concentration.
Are you going to go to 50mg next?
Posted by Chairman_MAO on November 17, 2011, at 6:46:54
In reply to Re: Perhaps Marplan kicked in fully today? » Chairman_MAO, posted by ed_uk2010 on November 15, 2011, at 13:59:59
> >40mg/day now. I'm going to ask to go to 60, especially since the plan is for me to come off of clonazepam. It seems to be OK with the marplan, but it was losing effectiveness on its own. It is also impairing my concentration.
>
> For many people, memory is impaired on benzodiazepines. I expect you might notice an improvement in memory as well as concentration.
>
Yeah, I know mine is; I have poor concentration as it is. Sometimes, it's a double-edged sword because if I'm _really_ anxious, there can be a net improvement because I'm not so scattered and calmer. Overall, though, it's a loss.> Are you going to go to 50mg next?
>
>I just went up to 60. I used to take 120mg/day of Nardil and 120mg/day+ of Parnate, and I conveyed to him that 40 wasn't doing very much. I asked about 80, and he said that the max is usually 60 and that we'll cross that bridge should we need to go there.
After a few days at 60mg, I'm sleeping less and getting up is easier. Anxiety is decreasing. Let's see how long this "energized" feeling lasts; my experience with other MAOIs is that it fades after a few months.
I ate tons of pop tarts last night for no reason, which is something that I don't normally do. I do not feel carb cravings like I did on Nardil, so maybe I just did because I happened to buy them. At any rate, I just was losing lots of weight after getting off of Nardil and watching my diet so I have to get back on it ...
Cheers.
Posted by ed_uk2010 on November 17, 2011, at 11:42:47
In reply to Re: Perhaps Marplan kicked in fully today? » ed_uk2010, posted by Chairman_MAO on November 17, 2011, at 6:46:54
> > >maybe I just did because I happened to buy them...
Quite possibly. I'm like that if I buy sweet stuff. Sometimes it's best not to buy it!
Best of luck on 60mg. Let us know how it goes.
Posted by Chairman_MAO on November 17, 2011, at 13:34:40
In reply to Re: Perhaps Marplan kicked in fully today? » Chairman_MAO, posted by ed_uk2010 on November 17, 2011, at 11:42:47
> > > >maybe I just did because I happened to buy them...
>
> Quite possibly. I'm like that if I buy sweet stuff. Sometimes it's best not to buy it!
>Yeah, I'm just not going to buy it anymore. I think I gained 2lbs just from last night. ;-)
I'll let you know how it goes. Right now I'm in a haze and somewhat hypotensive. All things considered, it is not too unpleasant but I'd rather have energy.
At 2mg/day of clonazepam now, decreasing by 0.25mg/wk until 0. _Then_ I get to add the Dexedrine back and titrate it up to 60mg/day, who knows how many more months that will take. Ugh, patience ...
Posted by ed_uk2010 on November 17, 2011, at 14:16:05
In reply to Re: Perhaps Marplan kicked in fully today? » ed_uk2010, posted by Chairman_MAO on November 17, 2011, at 13:34:40
>Then_ I get to add the Dexedrine back and titrate it up to 60mg/day, who knows how many more months that will take. Ugh, patience ...
Is the Dexedrine for depression, ADHD or something else? Do you find tolerance to be a problem?
Posted by Chairman_MAO on November 18, 2011, at 4:59:26
In reply to Re: Perhaps Marplan kicked in fully today? » Chairman_MAO, posted by ed_uk2010 on November 17, 2011, at 14:16:05
> Is the Dexedrine for depression, ADHD or something else? Do you find tolerance to be a problem?
>
>I guess you could say that I take it to augment the antidepressant and for inattentive ADD, but I tend not to use those labels.
There is a tolerance to the initial euphoric effect but not to the therapeutic effect [for ADD]. With an MAOI, there seems to be less tolerance to the mood lift--but that might not be less tolerance per se as much as MAO inhibition + amphetamine.
Posted by ed_uk2010 on November 18, 2011, at 12:01:01
In reply to Re: Perhaps Marplan kicked in fully today? » ed_uk2010, posted by Chairman_MAO on November 18, 2011, at 4:59:26
> > Is the Dexedrine for depression, ADHD or something else? Do you find tolerance to be a problem?
> >
> >
>
> I guess you could say that I take it to augment the antidepressant and for inattentive ADD, but I tend not to use those labels.
>
> There is a tolerance to the initial euphoric effect but not to the therapeutic effect [for ADD]. With an MAOI, there seems to be less tolerance to the mood lift--but that might not be less tolerance per se as much as MAO inhibition + amphetamine.Interesting. How does the combination affect your BP?
Posted by Chairman_MAO on November 18, 2011, at 20:56:19
In reply to Re: Perhaps Marplan kicked in fully today? » Chairman_MAO, posted by ed_uk2010 on November 18, 2011, at 12:01:01
> Interesting. How does the combination affect your BP?
>
>It's fine. The BP increase is no different than if I wasn't taking the MAOI. Also, being on the MAOI lowers my baseline BP.
One must not do this recklessly, but the risks are overblown.
This is the end of the thread.
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