Psycho-Babble Medication Thread 15880

Shown: posts 1 to 9 of 9. This is the beginning of the thread.

 

Parnate dose 100mg+?!

Posted by S. Suggs on November 28, 1999, at 14:46:35

My doc recently put me on Parnate. Have already noticed a very positive response such as: Increased energy, less anxiety, better sleep etc... He told me to basically dose myself as needed. I know that the textbook range is 30 - 60 mg per day in divided doses. I really do not need to change the dose now since it is working well, but should I need to, what might the max dose be. I have read in several places that it can go as high as 100+. I know that there will be varied input on this question. I am currently taking 50 mg and love it!! This is a great drug. All responses are welcome.

Blessings,

S. Suggs

 

Re: Parnate dose 100mg+?!

Posted by saint james on November 28, 1999, at 15:34:45

In reply to Parnate dose 100mg+?!, posted by S. Suggs on November 28, 1999, at 14:46:35

> My doc recently put me on Parnate. Have already noticed a very positive response such as: Increased energy, less anxiety, better sleep etc... He told me to basically dose myself as needed. I know that the textbook range is 30 - 60 mg per day in divided doses

James here....

I would say if you are really feeling great then you are at the correct dose. Increasing the dose beyond what works is not going to effect mood more. With the MAOI's you have to watch the aged products reaction, so it makes sence to keep the dose at the least amount as the aged food rection is dose related.

However, if you start feeling less than well, that is a good time to consider taking more. Call your doc to OK taking a dose more than the guide lines he/she gave you.

j

 

Re: Parnate dose 100mg+?!

Posted by Mark on November 29, 1999, at 0:58:10

In reply to Re: Parnate dose 100mg+?!, posted by saint james on November 28, 1999, at 15:34:45

Did Parnate work for your social anxiety, ifyou have it? And was it more effective than Nardil, Marplan, or Moclobemide, if you have tried them?

 

Re: Parnate dose 100mg+?!

Posted by S. Suggs on November 29, 1999, at 8:22:42

In reply to Re: Parnate dose 100mg+?!, posted by Mark on November 29, 1999, at 0:58:10

> Did Parnate work for your social anxiety, ifyou have it? And was it more effective than Nardil, Marplan, or Moclobemide, if you have tried them?

I have not been officially diagnosed with social anxiety, but I do notice a difference with a reduction of stress in social situations (more at ease etc...). Have not tried any of the other MAOI's, so I cannot be a judge of them. I am under the impression that the MAOI's are as effective or more effective than other SSRI's for social anxiety (based on what I have read on this forum). Probably due to liability issues.

 

My Parnate experience at 90 mg/day

Posted by jb on November 29, 1999, at 12:23:30

In reply to Parnate dose 100mg+?!, posted by S. Suggs on November 28, 1999, at 14:46:35

hi, i tried parnate for social phobia, then went back to nardil, and then switched back to parnate, etc. parnate didn't provide the level of efficacy of nardil, but did have more tolerable side effects. i had hoped 90 mg/day of parnate would have been as effective as Nardil. Didn't find this to be the case, though I did not stay on it at this dose for over a month. So, my doc didn't find 90mg/day to be a problem - FOR ME. However, i am very surprised at your doc's suggestion of self-dosing. i would switch docs, if i were you. find someone experienced in psychopharmacology. best place i've found is university-based anxiety disorders clinic

jb

hope this helps, somewhat.

 

Re: My Parnate experience at 90 mg/day

Posted by S. Suggs on November 29, 1999, at 19:30:19

In reply to My Parnate experience at 90 mg/day, posted by jb on November 29, 1999, at 12:23:30

jb, thanks for the input. I have no plans to increase beyond 50 mg of parnate, provided all is well, as it is now. My doc and I have been discussing parnate for some time. He told me that of all his patients, he trust me with this drug (I'm all the time taking him internet references and educating him on augmentation strategies with ssri's etc...). The bottom line is that he trust me to work with him within reason. If for example, I went to him and told him that I was taking above the FDA labled max of 60, he would have kittens. I'll keep him for now, since I have worked so long to build this working relationship, based on trust and knowledge. Again, thanks for the info on your experience with 90 mg. I'm sure that there are a lot of others out there.

Blessing,

S. Suggs

 

would you believe 250mg?

Posted by george o on December 1, 1999, at 1:22:55

In reply to Parnate dose 100mg+?!, posted by S. Suggs on November 28, 1999, at 14:46:35

> My doc recently put me on Parnate. Have already noticed a very positive response such as: Increased energy, less anxiety, better sleep etc... He told me to basically dose myself as needed. I know that the textbook range is 30 - 60 mg per day in divided doses. I really do not need to change the dose now since it is working well, but should I need to, what might the max dose be. I have read in several places that it can go as high as 100+. I know that there will be varied input on this question. I am currently taking 50 mg and love it!! This is a great drug. All responses are welcome.
>
> Blessings,
>
> S. Suggs

i developed rapid tolerance to parnate and had to have it increarsed every week or two until we got over 200mg, my doctor did this after consulting with an expert at his school (he was a resident). the horrible thing was that there seemed to be a rebound effect, where not only did my depression return as i developed tolerance but i became twice as depressed as i had been to start.

 

Re: would you believe 250mg?

Posted by Elizabeth on December 4, 1999, at 9:14:43

In reply to would you believe 250mg?, posted by george o on December 1, 1999, at 1:22:55

> i developed rapid tolerance to parnate and had to have it increarsed every week or two until we got over 200mg, my doctor did this after consulting with an expert at his school (he was a resident). the horrible thing was that there seemed to be a rebound effect, where not only did my depression return as i developed tolerance but i became twice as depressed as i had been to start.

This happened to me with Nardil. Increasing the dose didn't seem to help much but I wasn't as aggressive about it as you seem to have been.

There's a handful of cases reported in the literature of Parnate "addiction;" I wonder if many or most of these weren't actually just plain old tolerance, as you describe.

 

Re: would you believe 250mg?

Posted by Scott L. Schofield on December 5, 1999, at 12:14:24

In reply to would you believe 250mg?, posted by george o on December 1, 1999, at 1:22:55


> i developed rapid tolerance to parnate and had to have it increased every week or two until we got over 200mg, my doctor did this after consulting with an expert at his school (he was a resident). the horrible thing was that there seemed to be a rebound effect, where not only did my depression return as i developed tolerance but i became twice as depressed as i had been to start.

I've had similar experiences with Parnate, but it never made my depression worse. Perhaps you experience some sort of dopamine burn-out due to the effects of amphetamine metabolites of Parnate.

At 40mg/day for two weeks, I would get the beginnings of a response, only to lose it within a few days. My doctor titrated me up to 150mg/day. I found that it helped slightly with anergia and dementia, but did nothing for anhedonia and depressed mood.

As an aside, the only treatment that produced a robust antidepressant response that lasted for more than a couple of weeks was a combination of Parnate 60mg/day and desipramine 150mg/day. You may want to consider looking into using a similar combination. I have found imipramine (Tofranil) to be a better antidepressant than desipramine (Norpramin), although the side-effects of desipramine are of a lesser magnitude. I believe there is a consensus that you want to either start them together or add the MAOI while the tricyclic is already on board. This is supposed to lessen the risk of having a severe reaction (high blood-pressure among others). I'm not sure what this consensus is based on. I have added a tricyclic to an ongoing MAOI trial on multiple occasions and have not experienced any adverse events.

You might also want to explore adding thyroid or possibly low-dose lithium (300-600mg/day).

I hope this helps.


- Scott


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