![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by g_g_g_unit on June 4, 2012, at 8:04:01
I'm really sorry to keep posting. Just having a hard time at the moment. I'm still taking 50mg Parnate -- it's been 8 days.
I notice I'm getting a lot of angry, obsessive, dysphoric thoughts throughout the day. I can't focus; my mind is constantly active and feels like a burden. My focus felt best on 30mg -- my OCD and anxiety were really bad, but I could concentrate on tasks and structure my thoughts.
I hadn't noticed any alterations in blood pressure, or change in mood at 30mg, so decided to move up. Now I feel physically weak, and my blood pressure's dropped. The teary, agitated thing is always how I react to excessive NE, but I thought there would be more SE activity at higher doses to offset the side-effects. I don't mind waiting it out at 50mg, but I don't feel great, and wonder if I'd do better on a lower or in fact a higher dose.
I moved my klonopin dose from 0.5mg to 1mg so I could sleep, so I don't know if that's contributing. If taken at bedtime, at what point would it be expected to wear off during the day? I don't take a daytime dose ...
Thanks for any help.
Posted by novelagent on June 4, 2012, at 8:48:25
In reply to not sure what to do, posted by g_g_g_unit on June 4, 2012, at 8:04:01
read my post about the klonopin under the inositol post...
you may find benefit in taking .5mg twice, once at morning, once at bed. I highly advise going to purebulk.com like I did, and for $30, you can get 500g of Inositol. Take a gram of that twice a day. That changed my life two weeks ago-- I had insomnia for weeks before that, and it was awful. It's not sedating. it just normalizes your sleep cycle... like melatonin, only more sophisticated.
> I'm really sorry to keep posting. Just having a hard time at the moment. I'm still taking 50mg Parnate -- it's been 8 days.
>
> I notice I'm getting a lot of angry, obsessive, dysphoric thoughts throughout the day. I can't focus; my mind is constantly active and feels like a burden. My focus felt best on 30mg -- my OCD and anxiety were really bad, but I could concentrate on tasks and structure my thoughts.
>
> I hadn't noticed any alterations in blood pressure, or change in mood at 30mg, so decided to move up. Now I feel physically weak, and my blood pressure's dropped. The teary, agitated thing is always how I react to excessive NE, but I thought there would be more SE activity at higher doses to offset the side-effects. I don't mind waiting it out at 50mg, but I don't feel great, and wonder if I'd do better on a lower or in fact a higher dose.
>
> I moved my klonopin dose from 0.5mg to 1mg so I could sleep, so I don't know if that's contributing. If taken at bedtime, at what point would it be expected to wear off during the day? I don't take a daytime dose ...
>
> Thanks for any help.
>
>
Posted by gadchik on June 4, 2012, at 9:50:33
In reply to not sure what to do, posted by g_g_g_unit on June 4, 2012, at 8:04:01
I only take .5mg klonopin at night,and have never felt it wear off during the day,unlike ativan. but I take brand,not generic,maybe that's why,or im a slow metabolizer?
Posted by Phillipa on June 4, 2012, at 10:21:04
In reply to Re: not sure what to do » g_g_g_unit, posted by gadchik on June 4, 2012, at 9:50:33
I take my meds at night also. Although I still am anxious I feel better the longer without them. I was told a long time ago by a previous poster via private email that he found the name brand far superior to generic and his doc did also. P
Posted by Willful on June 4, 2012, at 10:44:35
In reply to Re: not sure what to do » g_g_g_unit, posted by novelagent on June 4, 2012, at 8:48:25
What does your pdoc say?
I had various reactions to parnate, at lower doses, one of which was to feel incredibly tired. This was the reaction my pdoc focussed on, and for that he raised the dose. Parnate causes a lot of sleep disturbances and in my case this got pretty extreme although the tiredness somewhat resolved (not entirely but enough for me to function) at higher doses.
I had continuous, strange, highly repetitive dreams which responded to a higher dose but that over time was eclipsed by a state of blunted emotion. Over time, I felt disconnected from emotions and while I could reason well, my conclusions never felt as clear as they normally would. Maybe it was more an underlying exhaustion from the years of not sleeping, and the emotional drain of the particular dream I was having. So I have mixed feelings about parnate, which lean toward the negative. But still, a lot of people get help from it.
All in all, I would consult with your pdoc about whether higher doses of parnate might help, but I would be cautious about going too high. People say they do 120mg and such, but imo that's an awful lot. I was at 100mg and while I never had any food issues (I was quite vigilant, but occasionally ate something without thinking), the dose probably caused the mental issues. Emsam does causes agitation, although a different one from parnate, but that also has been mitigated over time. I would stick with the parnate for a while longer, but I guess after two and a half weeks or three weeks, I would be discouraged.I don't have OCD though, and I"m sure that complicates your treatment. I'm much more reluctant than many here to attribute my reactions on any day to a drug per se-- because it's really impossible to know without a doubt how you would react. Unless you're never angry, characterologially, I wouldn't necessarily attribute the angry thoughts to the drug. But you should also trust your own instincts-- while also taking account of your pdoc's recommendations-- in making a decision about how long to test out the potential that parnate might have.
Posted by novelagent on June 4, 2012, at 14:24:30
In reply to Re: not sure what to do, posted by Willful on June 4, 2012, at 10:44:35
not sure why that last post was posted as if I posted it, and not the original poster... I've never taken Parnate
> What does your pdoc say?
>
> I had various reactions to parnate, at lower doses, one of which was to feel incredibly tired. This was the reaction my pdoc focussed on, and for that he raised the dose. Parnate causes a lot of sleep disturbances and in my case this got pretty extreme although the tiredness somewhat resolved (not entirely but enough for me to function) at higher doses.
>
> I had continuous, strange, highly repetitive dreams which responded to a higher dose but that over time was eclipsed by a state of blunted emotion. Over time, I felt disconnected from emotions and while I could reason well, my conclusions never felt as clear as they normally would. Maybe it was more an underlying exhaustion from the years of not sleeping, and the emotional drain of the particular dream I was having. So I have mixed feelings about parnate, which lean toward the negative. But still, a lot of people get help from it.
>
>
> All in all, I would consult with your pdoc about whether higher doses of parnate might help, but I would be cautious about going too high. People say they do 120mg and such, but imo that's an awful lot. I was at 100mg and while I never had any food issues (I was quite vigilant, but occasionally ate something without thinking), the dose probably caused the mental issues. Emsam does causes agitation, although a different one from parnate, but that also has been mitigated over time. I would stick with the parnate for a while longer, but I guess after two and a half weeks or three weeks, I would be discouraged.
>
> I don't have OCD though, and I"m sure that complicates your treatment. I'm much more reluctant than many here to attribute my reactions on any day to a drug per se-- because it's really impossible to know without a doubt how you would react. Unless you're never angry, characterologially, I wouldn't necessarily attribute the angry thoughts to the drug. But you should also trust your own instincts-- while also taking account of your pdoc's recommendations-- in making a decision about how long to test out the potential that parnate might have.
>
>
Posted by novelagent on June 4, 2012, at 14:25:37
In reply to Re: not sure what to do, posted by novelagent on June 4, 2012, at 14:24:30
oops, someone else posted that after all, and not me... okay, that makes more sense....> not sure why that last post was posted as if I posted it, and not the original poster... I've never taken Parnate
>
>
> > What does your pdoc say?
> >
> > I had various reactions to parnate, at lower doses, one of which was to feel incredibly tired. This was the reaction my pdoc focussed on, and for that he raised the dose. Parnate causes a lot of sleep disturbances and in my case this got pretty extreme although the tiredness somewhat resolved (not entirely but enough for me to function) at higher doses.
> >
> > I had continuous, strange, highly repetitive dreams which responded to a higher dose but that over time was eclipsed by a state of blunted emotion. Over time, I felt disconnected from emotions and while I could reason well, my conclusions never felt as clear as they normally would. Maybe it was more an underlying exhaustion from the years of not sleeping, and the emotional drain of the particular dream I was having. So I have mixed feelings about parnate, which lean toward the negative. But still, a lot of people get help from it.
> >
> >
> > All in all, I would consult with your pdoc about whether higher doses of parnate might help, but I would be cautious about going too high. People say they do 120mg and such, but imo that's an awful lot. I was at 100mg and while I never had any food issues (I was quite vigilant, but occasionally ate something without thinking), the dose probably caused the mental issues. Emsam does causes agitation, although a different one from parnate, but that also has been mitigated over time. I would stick with the parnate for a while longer, but I guess after two and a half weeks or three weeks, I would be discouraged.
> >
> > I don't have OCD though, and I"m sure that complicates your treatment. I'm much more reluctant than many here to attribute my reactions on any day to a drug per se-- because it's really impossible to know without a doubt how you would react. Unless you're never angry, characterologially, I wouldn't necessarily attribute the angry thoughts to the drug. But you should also trust your own instincts-- while also taking account of your pdoc's recommendations-- in making a decision about how long to test out the potential that parnate might have.
> >
> >
>
>
Posted by Raisinb on June 4, 2012, at 17:25:23
In reply to not sure what to do, posted by g_g_g_unit on June 4, 2012, at 8:04:01
8 days is a long time to be dealing with such intense dysphoria. The rage is worrisome too. Have you called your pdoc?
Posted by rjlockhart04-08 on June 4, 2012, at 18:14:53
In reply to not sure what to do, posted by g_g_g_unit on June 4, 2012, at 8:04:01
The best thing is to mention to your doctor for something that will block dopamine and norephrinerine.....too much dopamine, unregulated will cause dysphoria and making you feel irrtible and little things will bother you, ask about something that will block the dopamine terminals...copazine...zyprexa...maybe also Ideral which blocks good porpotrtion of NE that causes you to have body symtoms of anxiety and too much stimulation....benzos don't do a vary good job at treating a problem that needs more direct treatment. Benzos are also classified as minor tranquelizers, major tranqulizers if they are both combined they should take away these symptoms your having.....
rj
Posted by g_g_g_unit on June 4, 2012, at 23:28:59
In reply to Re: not sure what to do » g_g_g_unit, posted by Raisinb on June 4, 2012, at 17:25:23
> 8 days is a long time to be dealing with such intense dysphoria. The rage is worrisome too. Have you called your pdoc?
I don't think I mentioned rage, did I? I've experienced rage before, but there isn't any on Parnate - just general irritability and anger (or enhanced self-righteousness, I suppose).
No, I see my psychiatrist weekly, so I'll let him know in person in a couple of days. One problem is he's rarely worked with MAOIs, so I don't just want to be taken off entirely.
Posted by g_g_g_unit on June 4, 2012, at 23:38:19
In reply to Re: not sure what to do, posted by Willful on June 4, 2012, at 10:44:35
> What does your pdoc say?
>
> I had various reactions to parnate, at lower doses, one of which was to feel incredibly tired. This was the reaction my pdoc focussed on, and for that he raised the dose. Parnate causes a lot of sleep disturbances and in my case this got pretty extreme although the tiredness somewhat resolved (not entirely but enough for me to function) at higher doses.
>
> I had continuous, strange, highly repetitive dreams which responded to a higher dose but that over time was eclipsed by a state of blunted emotion. Over time, I felt disconnected from emotions and while I could reason well, my conclusions never felt as clear as they normally would. Maybe it was more an underlying exhaustion from the years of not sleeping, and the emotional drain of the particular dream I was having. So I have mixed feelings about parnate, which lean toward the negative. But still, a lot of people get help from it.Interesting .. yeah, I find it emotionally blunting too (which is the opposite of what I was hoping for..). I don't dream though, unless I take Klonopin.
>
>
> All in all, I would consult with your pdoc about whether higher doses of parnate might help, but I would be cautious about going too high. People say they do 120mg and such, but imo that's an awful lot. I was at 100mg and while I never had any food issues (I was quite vigilant, but occasionally ate something without thinking), the dose probably caused the mental issues. Emsam does causes agitation, although a different one from parnate, but that also has been mitigated over time. I would stick with the parnate for a while longer, but I guess after two and a half weeks or three weeks, I would be discouraged.My psychiatrist wouldn't prescribe more than 60mg anyway. The maximum recommended dose here is 30mg, but I managed to convince him to follow the American guidelines, because I know a Harvard psychiatrist who regularly prescribes 60mg for OCD patients. I have read about people in Australia taking more than that, though.
I personally wonder if it isn't some kind of imbalance between MAO-inhibition and the stimulant effect .. 10/20mg caused a similar agitation, which eased up on 30mg (but didn't help mood, anxiety) .. so maybe 60/70mg will provide the right balance.
>
> I don't have OCD though, and I"m sure that complicates your treatment. I'm much more reluctant than many here to attribute my reactions on any day to a drug per se-- because it's really impossible to know without a doubt how you would react. Unless you're never angry, characterologially, I wouldn't necessarily attribute the angry thoughts to the drug. But you should also trust your own instincts-- while also taking account of your pdoc's recommendations-- in making a decision about how long to test out the potential that parnate might have.
>
>
No, you're correct. I harbor a tremendous amount of anger towards my family, and that's generally who the thoughts are directed towards. What is more strange is the thoughts' persistence (i.e. I will have angry, intrusive monologues throughout the day, ruminate obsessively over past hurts etc.). My litmus tends is when I tend to feel angry towards people I otherwise like -- like my psychiatrist -- and that's been occurring too, which makes me think it's just a general dysphoria from overstimulation. I also feel more inclined to isolate and not want to be around friends (another litmus test).
Posted by Raisinb on June 5, 2012, at 20:48:19
In reply to Re: not sure what to do » Raisinb, posted by g_g_g_unit on June 4, 2012, at 23:28:59
I guess I was using the terms interchangeably. You're right; irritability and rage are different animals. Good that your'e seeing the pdoc soon.
Posted by phidippus on June 7, 2012, at 20:35:33
In reply to not sure what to do, posted by g_g_g_unit on June 4, 2012, at 8:04:01
Parnate seems to be doing jack for your OCD. Are your thoughts racing?
Eric
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.