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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by vanvog on March 8, 2013, at 21:56:01
I'm on Parnate 80 mg/day for 7 weeks now for atypical depression and social anxiety. Parnate works really well for my SA and so-so for my depression. Overall it's the best med I tried so far.
(1 week x 20 mg, 2 weeks x 40 mg, 3 weeks x 60 mg, 1 week x 80 mg)
Currently I'm taking 80 mg in the morning right after I get up, this knocks me out 1-1,5 hours later and I need a nap for at least 1 hour. It starts with a buzz then extreme fatigue and sleepiness sets in.
I tried multiple doses a day but nothing seems to work:
1) single dose in the morning knocks me out and requires a naptime (which interferes with my employability)
2) divided doses, I tried two, three, four doses a day, all it does is making me sleepy and physically week all day not able to do anything
3) single dose before sleep makes me wake up in the middle of the night after just a few hours, and really messes with me sleep leaving me unrested and more fatigued the next day
I understand that for the medication to work correctly it is important to take it divided doses but in my experience taking parnate in 3-4 doses had the worst effect on me in terms of fatigue and physical weakness.
Parnate is not activating for me in general, it made me slightly more fatigued.
I would like to hear some opinions and first hand experiences of taking Parnate in one single dose and many divided doses. It shouldn't really make any difference for Parnate has more of a "biological" (MAO inhibition) effect which is delayed compared to SSRI reuptake inhibition?
Posted by bleauberry on March 9, 2013, at 9:14:48
In reply to Parnate single vs. devided doses, nothing works!, posted by vanvog on March 8, 2013, at 21:56:01
I think maybe your dose size is too aggressive this early into treatment with Parnate? Maybe it would be ok with someone else, but it is obviously not with you. Actually, for most people, I believe a dose of that size, even after being on it a while, would be problematic no matter who.
I only had to take 5mg max of parnate. That was my best dose. Higher was not as good, lower not as good. You have to find YOUR best dose, which could be anywhere on the map. Don't go by predetermined target guesses, especially if it was someone else who determined those target doses for you.
The benefit I got from parnate was similar to you. I found it amazing for being comfortable in a crowd, feeling like I was a part of it, whatever it was. Depression wasn't helped too much, just a little.
Posted by vanvog on March 9, 2013, at 10:31:05
In reply to Re: Parnate single vs. devided doses, nothing works!, posted by bleauberry on March 9, 2013, at 9:14:48
I was severely depressed with atypical symptoms and suicidal ideation, had to actually go inpatient. I'm somewhat treatment resistant because I had almost no remission on very high doses of Effexor and Wellbutrin.
Now the thing is, no matter how high the dose of Parnate was, it had always the same effect of basically knocking me out, it was the same with 20mg as it is now with 80mg. I felt better on 60mg, even better on 80mg now. I feel very stable at this dose and have no side effects other than described above.
Posted by brklyn233342 on March 9, 2013, at 12:50:26
In reply to Re: Parnate single vs. devided doses, nothing works!, posted by vanvog on March 9, 2013, at 10:31:05
Ive had success breaking a high dose into two settings,a am dose around 9 am and pm around 5 pm.As i stated however only when i began to augment it with a potentiator did the cocktails seem to work,i have used meds such as modfanil to ghb to do this.Good luck with your succiess.
Posted by vanvog on March 10, 2013, at 10:59:57
In reply to Re: Parnate single vs. devided doses, nothing works!, posted by brklyn233342 on March 9, 2013, at 12:50:26
Does the daytime fatigue get better after some time?
Posted by brklyn233342 on March 10, 2013, at 17:10:48
In reply to PARNATE fatigue, posted by vanvog on March 10, 2013, at 10:59:57
It dident for me,i used simple caffiene tabs that actualy had a synergy,at first that worked great but qucikly built up a tolerance,then i tried the mild stimulant MODFANIL which worked actualy less then simple caffeine BUT the cost was unbelevable.The only thing that truly worked was the adhd stimulant VYVANSE which worked 100 percent i was up and doing stuff,and it never stopped,HOWEVER i obtained it from my girl who was able to spare some for her CFS but now cant,i tried to get it to no avail,no doc will allow the use of a stimualnt with parnate,i read how some peoples doc do,so if yours is willing go for it,it might be a sure thing,however mine wont even phantom the idea.
Posted by vanvog on March 10, 2013, at 18:04:48
In reply to Re: PARNATE fatigue, posted by brklyn233342 on March 10, 2013, at 17:10:48
Unfortunately my Pdoc is strictly against any kind of stimulants and won't even prescribe me Modafinil. I can't afford to go doctor shopping at this point.
It appears the sedating side effect of Parnate is not at all that rare. I found a study where 10% of the patients experienced hypersomnolence and excessive fatigue in the late afternoon.
Most people report that their initial fatigue from Parnate disappeared within 2-3 weeks, well mine didn't get a bit better and I've been taking Parnate for 7 weeks now. Some say their fatigue got better at higher doses, I'm on 80 mg/day now and feel no different than on 20 mg/day.
Posted by brklyn233342 on March 13, 2013, at 16:49:16
In reply to Re: PARNATE fatigue, posted by vanvog on March 10, 2013, at 18:04:48
Your right about the fatique,funny thing is i notice it becomes more stimulating if you wanna call it that at around 11 pm.
Im not surprised a doc wont give you a stimulant,ive used tons and none have interacted but that was with a certain doc,the average doc wont hear of it
Posted by alchemy on March 17, 2013, at 13:19:40
In reply to PARNATE fatigue, posted by vanvog on March 10, 2013, at 10:59:57
Parnate didnt work out for me for mood, but it did seem like the fluctuations with fatigue and activation started to level out.
Posted by vnessg90 on March 24, 2013, at 2:15:38
In reply to Re: Parnate single vs. devided doses, nothing works!, posted by brklyn233342 on March 9, 2013, at 12:50:26
I used to pass out from fatigue 10 hrs after taking single dose of parnate. The best solution was to take a divided dose every 12 hrs, 5 am then nap for 2 hrs, later 5pm for the other half veg out for an hr thn go about my evening.
Posted by Kim on April 3, 2013, at 9:34:36
In reply to Re: PARNATE fatigue » vanvog, posted by alchemy on March 17, 2013, at 13:19:40
PDocs have prescribed PARNATE + Dexedrine off and on for 20+ years (OMG, can't believe depression that bad for so long) due to treatment-resistant depression. I suggest PDoc shopping. Have had to several times insurance change, moves, etc. Most will tell you over the phone if they will consider it. Never had PDoc charge me for initial visit when they've been shocked at my cocktail. (Also add clonazepam and lamotrogine to the mix.) Literature suggests interaction is theoretical, but good luck telling a PDoc you've researched your own meds. And be prepared for pharmacist to have a stroke (haha) and delay filling your RX until personally discussed "danger" with PDoc and with you. Also may have problems getting 90-day instead of 30-day supply. Dextroamphetamine requires new written RX for each refill; a hassle someone who is depressed does NOT need.
This is the end of the thread.
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