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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 Gretchen on August 3, 1999, at 19:10:35
Hi,
I was wondering if anyone has taken Parnate (or another MAOI) with Lamictal ??I am currently taking Parnate 4omg, Lamictal 25mg (5 days now), a generic thyroid med .05mg (also just 5 days), and klonipin about 2mg a day.
From what I have read about Lamictal and from the "Notes" part of this site, I should be having very few side effects. (Mainly becoming concerned only if I happen to develop a rash.)
Instead I am having many side-effects: diffuse, strong, pressure headaches, dizziness to the point of falling over backwards plus general increase in hypo-tensive problems and a "new" dizzy feeling of spinning that is intermittent though strongest when I lay down.
Motion sickness type nausea, an inability to remember the next word I was going to say, muscle and joint pain, muscle cramps esp. in my legs.
And other never before felt symptoms: sudden disorientations in space (both "like I don't know where I am but I do and should" and while driving not knowing if it was the "right road" although I have been on it many times -- nothing "looked right". (I am not driving for a while.) Also difficulty telling what lane a car was in, but not really double vision.
Generally feeling just incredibly sick.
It would help to know if anyone else has had these many side-effects and for how long they lasted.
BTW, I have chronic major unipolar depression, my doctor is just very convinced that mood-stabilizers are where it's at. Combinations of Parnate plus Lithium, Neurontin and Depakote have caused either incredible dizziness (broke collar bone in two places)or **severely increased suicidal feelings**.
Since so far with Lamictal, there are physical symptoms I feel guilty about calling and complaining.
Maybe it will last just a few more days??
I kind of need to be able to drive.
Thanks for reading all of this. G.
Posted by Erin on August 3, 1999, at 20:01:49
In reply to Parnate and Lamictal, posted by Gretchen on August 3, 1999, at 19:10:35
Gretchen,
It sounds like you -may- be having a hypertensive reaction to the MAOI Parnate- I am not, repeat not, an expert on this but I'm almost positive that pressure headaches are one of the first symptoms of a hypertensive episode. I could be wrong but I wanted to write you back immediately because this can be a very serious condition from what I understand. I would contact your doctor immediately just to be sure (better to be on the safe side). To quote from the book, Instant Psychopharmacology (by Ronald Diamond, 1998), "the symptoms of a hypertensive crisis include a severe headache, heart palpitations, nausea and vomiting, unexplained nose bleed, and chest pain. MAOIs can also cause orthostatic hypotension (drop in blood pressure when the patient stands up quickly). This can cause temporary dizziness or even fainting." In further reading, some of the side effects listed of Lamictal include "cluminess, dizziness, drowsiness, headaches, and nausea." So, there's my 2 cents worth- I'm sure others will have more input for you-
Hope you are feeling better soon,
Erin
Posted by Ruth on August 3, 1999, at 20:18:45
In reply to Parnate and Lamictal, posted by Gretchen on August 3, 1999, at 19:10:35
I too have a unipolar depression and was on parnate and lamictal for a number of months. It proved an effective combination for a while and then seemed to become less helpful. In addition I walked around feeling sleepy much of the time. The dizziness is most likely orthostatic hypotension (meaning you get dizzy when going from sitting to standing or lying to sitting) from the parnate. :You can help this by making the shifts slowly. Also be sure you are well hydrated.
The clumsiness may be a symptom of lamictal toxicity. I had that problem along with an episode of double vision which was easily corrected by reducing the dosage.
I would be concerned about all of the side effects that you are having and by all means you need to talk to your doctor about them. It may make sense to stop one of the meds to try to isolatle which med is causing the side effect.
Let me know if you have other questions and I'll be glad to try to answer them.
> Hi,
> I was wondering if anyone has taken Parnate (or another MAOI) with Lamictal ??
>
> I am currently taking Parnate 4omg, Lamictal 25mg (5 days now), a generic thyroid med .05mg (also just 5 days), and klonipin about 2mg a day.
>
> From what I have read about Lamictal and from the "Notes" part of this site, I should be having very few side effects. (Mainly becoming concerned only if I happen to develop a rash.)
>
> Instead I am having many side-effects: diffuse, strong, pressure headaches, dizziness to the point of falling over backwards plus general increase in hypo-tensive problems and a "new" dizzy feeling of spinning that is intermittent though strongest when I lay down.
>
> Motion sickness type nausea, an inability to remember the next word I was going to say, muscle and joint pain, muscle cramps esp. in my legs.
>
> And other never before felt symptoms: sudden disorientations in space (both "like I don't know where I am but I do and should" and while driving not knowing if it was the "right road" although I have been on it many times -- nothing "looked right". (I am not driving for a while.) Also difficulty telling what lane a car was in, but not really double vision.
>
> Generally feeling just incredibly sick.
>
> It would help to know if anyone else has had these many side-effects and for how long they lasted.
>
> BTW, I have chronic major unipolar depression, my doctor is just very convinced that mood-stabilizers are where it's at. Combinations of Parnate plus Lithium, Neurontin and Depakote have caused either incredible dizziness (broke collar bone in two places)or **severely increased suicidal feelings**.
>
> Since so far with Lamictal, there are physical symptoms I feel guilty about calling and complaining.
>
> Maybe it will last just a few more days??
>
> I kind of need to be able to drive.
>
> Thanks for reading all of this. G.
Posted by Elizabeth on August 3, 1999, at 21:30:32
In reply to Parnate and Lamictal, posted by Gretchen on August 3, 1999, at 19:10:35
Hi Gretchen.
I took Lamictal (500mg - yes, that's 500) with Nardil for a few months, then kept taking the Lamictal by itself after the Nardil pooped out.
I noticed no side effects, nor any other effects, from the Lamictal.
It does sound like what you are experiencing is hypotension or orthostatic hypotension. The perceptual weirdness might be the Lamictal. I'd wonder about the role of the thyroid supplement (is it T3 or T4?) as well. Can you identify a point when the symptoms started that correlates with starting or raising the dose of one of your meds?
I think you really should bug your doctor about this (page him/her if necessary). It sounds serious.
Also, just curious: which mood stabilizer(s) caused increased suicidal thoughts? (I have a guess and want to see if I'm right. :->)
Posted by anita on August 4, 1999, at 1:00:49
In reply to Parnate and Lamictal, posted by Gretchen on August 3, 1999, at 19:10:35
Hi G,
I was on Nardil + Lamictal, and Parnate + Lamictal. The headaches may be caused by Lamictal -- I had
them at first, but they were helped by ibuprofen. Lamictal may raise the levels of Parnate, so perhaps
some of the other side effects are due to the resultant increase in blood levels of Parnate. You should
definitely report these problems to your doc.good luck,
anita
Posted by Gretchen on August 6, 1999, at 12:35:20
In reply to Re: Parnate and Lamictal, posted by anita on August 4, 1999, at 1:00:49
Hi everyone,
Thanks for answering so quickly. When I try to post, I haven't been able to get a connection back for the last two days.
I just wanted to let you know that because I was able to read your responses the first day and I felt/feel very gratelful for your concern.
I did talk to my doctor regarding my symptoms (as _everyone_ suggested) and she still feels I should continue with the meds. She had never heard of anyone having so many side-effects, but since it wasn't making me more suicidal; it has officially worked the "best" so far.
Sorry I can't look back at who said what because that has been making my browser shut down, but I think this is to Elizabeth:
The mood-stabilizers that I had the extreme worsening of depression were: Neurontin (by itself) and Depakote + Parnate. Lithium just made me have what I thought of as seizures (falling down, body shaking, waking up not knowing where I was.) The doc at that time suggested "support hose." After four days and two fractures to my collar bone, I stopped seeing her (that was a few years back.)
The visual distortions at least have been getting better and the nausea is more intermittent. The only thing that has been getting worse is the insomnia (great time to be having internet problems -huh?)
The call to the doc was at least worth it because she suggested that my falling over backwards "sounded like sunstroke."
I live in Seattle, WA. Not a place where that dx is given much! :)
Thank you again for your help and sorry it took so long to get back to you.
G.
Posted by Chris A. on August 6, 1999, at 23:41:08
In reply to Re: Parnate and Lamictal, posted by Gretchen on August 6, 1999, at 12:35:20
Gretchen,
I hope this finds you feeling better. The Parnate/Lamictal combo was a bit too activating for me. Otherwise there were no side effects. One question - do you or your physician monitor your blood pressure at all when taking an MAOI such as Parante? When I first took an MAOI over twenty years ago my pDoc monitored my BP himself every visit. I never had another doc do that since and I haven't been up front enough to confront them about it. My current doc admonishes me to monitor my own. When I'm hypotensive I add water and salt and sometimes have to avoid driving. When on an MAOI and experiencing a headache checking blood pressure should be a number one priority to rule out hypertension as the cause. Please take care of yourself!
Posted by andrewb on August 8, 1999, at 0:06:56
In reply to Parnate and Lamictal, posted by Gretchen on August 3, 1999, at 19:10:35
Have you done a search on the tips page under the keyword lamictal. If you check out the side efects page and the interactions page you will see psychiatrists describe patients who have experienced many of the side effects you have while taking lamictal.
Posted by Sarah on August 9, 1999, at 20:20:40
In reply to Re: Parnate and Lamictal, posted by andrewb on August 8, 1999, at 0:06:56
> Have you done a search on the tips page under the keyword lamictal. If you check out the side efects page and the interactions page you will see psychiatrists describe patients who have experienced many of the side effects you have while taking lamictal.
Where is the tips page, and side effects and interaction pages you're referring to?
Posted by andrewb on August 10, 1999, at 1:49:01
In reply to Re: Parnate and Lamictal, posted by Sarah on August 9, 1999, at 20:20:40
> > Have you done a search on the tips page under the keyword lamictal. If you check out the side efects page and the interactions page you will see psychiatrists describe patients who have experienced many of the side effects you have while taking lamictal.
>
> Where is the tips page, and side effects and interaction pages you're referring toGlad you asked,
at the top of this page you will see the word 'tips', click on it and you will be taken to the tips page.
The tips page is devided into a left and right hand side.
Scroll down the right hand side until you see little blank box. In this box you can type in your search term, for example 'lamictal'. Press the search button on the page or the return key on your computer and you will be taken to the lamictal search reasults. The search results will show up on the left hand side. Amoungst the results you will see the words 'side effects' and 'interactions', click on those word and you will be taken to those respective pages.
See you there!
Posted by Gretchen on August 10, 1999, at 15:45:59
In reply to Re: Parnate and Lamictal, posted by andrewb on August 10, 1999, at 1:49:01
> > > Have you done a search on the tips page under the keyword lamictal. If you check out the side efects page and the interactions page you will see psychiatrists describe patients who have experienced many of the side effects you have while taking lamictal.
Hi,
Yes, I did read both the Notes and Tips pages and that was the reason I decided to post with the subject of "Parnate and Lamictal" and not just "Lamictal."
It seemed that in a couple of instances (in the Notes) where many side-effects occurred in the same person, that person was also taking Nardil.
I thought perhaps people taking MAOI's might have a tendency to have an increased number of side-effects to the med for some reason. Although, based on the posts I received, this is not true.
Sorry, I didn't mean to complain about obvious side-effects.
This is the end of the thread.
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