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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by g_g_g_unit on January 31, 2012, at 2:39:05
1. Did you notice any significant difference in effect once you passed a certain threshold, i.e. 60mg? Last time I was prescribed the drug, my psychiatrist wouldn't raise the dose above 40mg, though I've read of several people who found a significant improvement in anxiety etc. only once they reached 60mg.
2. Does the drug have any positive/neutral effects on cognition? How would you compare it to SSRIs? Does the initial stimulant effect fade, and if so, were there any benefits on focus etc. thereon? Would be particularly interested in hearing from those with ADHD ..
3. Did sleep improve at higher doses, i.e. 50-60mg?
Posted by SLS on January 31, 2012, at 4:59:55
In reply to q's for those who are, or have been, on Parnate, posted by g_g_g_unit on January 31, 2012, at 2:39:05
> 1. Did you notice any significant difference in effect once you passed a certain threshold, i.e. 60mg? Last time I was prescribed the drug, my psychiatrist wouldn't raise the dose above 40mg, though I've read of several people who found a significant improvement in anxiety etc. only once they reached 60mg.
Having had much experience with Parnate and working with several doctors, I can say with confidence that true therapeutic dosage range for Parnate is 40-80 mg/day.
> 2. Does the drug have any positive/neutral effects on cognition?
I find that it is neutral. However, cognition will improve as depression improves. If you do experience "brain-fog" or "spaciness" in the beginning, these things should pass.
> Does the initial stimulant effect fade,
I'm not sure what you mean by "stimulant effect". How would you describe it?
> 3. Did sleep improve at higher doses, i.e. 50-60mg?That has not been my experience with Parnate. Where did you get this idea from?
- Scott
Posted by g_g_g_unit on January 31, 2012, at 5:19:23
In reply to Re: q's for those who are, or have been, on Parnate » g_g_g_unit, posted by SLS on January 31, 2012, at 4:59:55
> > 1. Did you notice any significant difference in effect once you passed a certain threshold, i.e. 60mg? Last time I was prescribed the drug, my psychiatrist wouldn't raise the dose above 40mg, though I've read of several people who found a significant improvement in anxiety etc. only once they reached 60mg.
>
> Having had much experience with Parnate and working with several doctors, I can say with confidence that true therapeutic dosage range for Parnate is 40-80 mg/day.Did you ever experience an initial exacerbation of depression, especially on lower doses?
If there wasn't any improvement gleaned at 40mg (though I only stayed on the dose for 2 weeks, before discontinuing), do you see any logic in returning to Parnate at 60mg? The reason I ask is because my living situation is becoming so dire that I'm not sure I can afford to waste any more time on pointless drug trials. Right now, the only thing I can think about is dying. I mention that only to give a general idea of my mindset and how bad things are for me - I know it's the depression at work, but I feel like I need some kind of miracle.
>
> > 2. Does the drug have any positive/neutral effects on cognition?
>
> I find that it is neutral. However, cognition will improve as depression improves. If you do experience "brain-fog" or "spaciness" in the beginning, these things should pass.Yes, spaciness was definitely an issue last time, though I experience so much brain-fog and spaciness in my current depressed state that I was hoping Parnate might improve those things.
>
> > Does the initial stimulant effect fade,
>
> I'm not sure what you mean by "stimulant effect". How would you describe it?Hmm. Well, I recall lower doses feeling very much akin to Dexedrine - i.e. mild euphoria, improved concentration, energy, motivation etc. At higher doses, i.e. 30mg, the effect turned nastier and increased anxiety and irritability. Dr Gillman informed me that Parnate doesn't metabolize to amphetamine (though there does seem to be a circulating myth along those lines). But regardless, I often read about people reporting an initial stimulant-like effect, which fades with time. I was wondering if likewise any improvements in attention, motivation and anhedonia might fade too.
>
> > 3. Did sleep improve at higher doses, i.e. 50-60mg?
>
> That has not been my experience with Parnate. Where did you get this idea from?
>Again, I believe I've read accounts from e.g. bulldog2, maybe JadeKelly, who mentioned that the insomnia eased up a bit at higher doses. Here's a quote from bulldog2:
"I finally reached 60 mg and stayed there 2 weeks ...The insomnia went away and I slept okay."
Posted by g_g_g_unit on January 31, 2012, at 5:21:56
In reply to Re: q's for those who are, or have been, on Parnate » SLS, posted by g_g_g_unit on January 31, 2012, at 5:19:23
Oh, I should add that the reason I discontinued was because, after 8 weeks total spent on the drug (2 at 40mg), I was feeling depressed, spacey, irritable and unable to sleep.
The fact that you suggest the spaciness might pass though does give me some hope.
Posted by SLS on January 31, 2012, at 7:26:10
In reply to Re: q's for those who are, or have been, on Parnate » g_g_g_unit, posted by g_g_g_unit on January 31, 2012, at 5:21:56
> Oh, I should add that the reason I discontinued was because, after 8 weeks total spent on the drug (2 at 40mg), I was feeling depressed, spacey, irritable and unable to sleep.
>
> The fact that you suggest the spaciness might pass though does give me some hope.My knee-jerk reaction is that Parnate may not be the right drug for you. 8 weeks is a long time. However, you have not really tested this drug to its potential, and knee-jerk reactions are far from being scientific.
I respond to Parnate at 80 mg, but not 60 mg.
I can believe that sleep can get better at higher dosages for some people. Just not me.
You are facing a difficult decision. I wish I could help more to make it easier.
- Scott
Posted by emmanuel98 on January 31, 2012, at 19:00:40
In reply to Re: q's for those who are, or have been, on Parnate » g_g_g_unit, posted by SLS on January 31, 2012, at 7:26:10
Parnate pulled me out of a vegetative depression that I had been in for almost two months. It worked within a few days. So I think 8 weeks is a pretty fair trial. I know some people on this list use pretty high doses, but my p-doc won't go above 40mg. I've been semi-OK on 30mg. NO more lying in bed all day, but I have had severe agitated depressions. I didn't find parnate speedy at all, though it did affect my sleep and still does.
As an aside, parnate gives me terrible dry mouth I teach for a living and have to sip water continually to talk. I went to the dentist yesterday and the hygenist told me that the lack of saliva means bacteria aren't washed out of the mouth and off the teeth and that my teeth were in fairly bad condition, so much so that they want me to do cleanings every 3 months. I am thinking of stopping the parnate because of this. I have felt pretty well for several months now.
Posted by g_g_g_unit on February 1, 2012, at 3:50:10
In reply to Re: q's for those who are, or have been, on Parnate » g_g_g_unit, posted by SLS on January 31, 2012, at 7:26:10
> My knee-jerk reaction is that Parnate may not be the right drug for you. 8 weeks is a long time. However, you have not really tested this drug to its potential, and knee-jerk reactions are far from being scientific.
Yeah, that is sad to hear and I am prone to taking stuff I hear/read at face-value, so your comment does have me feeling hesitant .. I suppose because, on a gut level, I likewise feel that it's not the right choice. But then again, Dr Gillman did recommend hanging around on a *therapeutic dose* for 8 weeks before deciding.
>
> I respond to Parnate at 80 mg, but not 60 mg.
>
> I can believe that sleep can get better at higher dosages for some people. Just not me.
>> You are facing a difficult decision. I wish I could help more to make it easier.
No, that's okay. But you're right, it is an extremely difficult decision .. mostly because I just don't feel like I have the wherewithal or hope or energy to last too many trials.
Posted by SLS on February 1, 2012, at 7:08:48
In reply to Re: q's for those who are, or have been, on Parnate » SLS, posted by g_g_g_unit on February 1, 2012, at 3:50:10
> > You are facing a difficult decision. I wish I could help more to make it easier.
> No, that's okay. But you're right, it is an extremely difficult decision .. mostly because I just don't feel like I have the wherewithal or hope or energy to last too many trials.I understand.
What prevents you from remaining on Parnate until you get to 60 mg?
Remember, if you decide to abort your Parnate trial, you will need to discontinue the drug using a taper and then wait two weeks before starting another drug. That could take a month. You could, instead, add nortriptyine, Abilify, Wellbutrin, or lithium as adjuncts to Parnate. A doctor would probably be more comfortable adding lithium. With lithium, a two week trial is plenty. Some people respond to it within three days. I wouldn't try any of these adjuncts until you are at 60 mg of Parnate for 2-3 weeks.
I'm still waiting for my crystal ball to arrive from Amazon.
- Scott
Posted by g_g_g_unit on February 1, 2012, at 17:01:08
In reply to Re: q's for those who are, or have been, on Parnate » g_g_g_unit, posted by SLS on February 1, 2012, at 7:08:48
> I understand.
>
> What prevents you from remaining on Parnate until you get to 60 mg?Oh, well nothing really - I was just wondering if my last trial indicated it might be a waste of time, and, like I say, I respect your opinion a lot, so your expression of doubt left me more unsure ..
>
> Remember, if you decide to abort your Parnate trial, you will need to discontinue the drug using a taper and then wait two weeks before starting another drug. That could take a month. You could, instead, add nortriptyine, Abilify, Wellbutrin, or lithium as adjuncts to Parnate. A doctor would probably be more comfortable adding lithium. With lithium, a two week trial is plenty. Some people respond to it within three days. I wouldn't try any of these adjuncts until you are at 60 mg of Parnate for 2-3 weeks.Thanks. I see my psychiatrist tomorrow. I'll see how/if he's willing to augment.
>
> I'm still waiting for my crystal ball to arrive from Amazon.Heh.
This is the end of the thread.
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