Psycho-Babble Medication Thread 254616

Shown: posts 1 to 20 of 20. This is the beginning of the thread.

 

Klonopin for Parnate Insomnia

Posted by Budgie on August 27, 2003, at 2:33:07

Hi,

Parnate is doing wonders for my depression after only 3 weeks, and I've even caught glimpses of a real "high" now and then- as in unbounded happiness, free from mental illness.

But I have GOT to get to sleep! My schedule is completely out of whack. I've heard Klonopin is an option:

1. If you only take a dose at night, does it still leave you groggy the next day?

2. If you take it a dose at night and one in the day, will you lose the stimulating effects (which I'm really digging) of the Parnate?

I'm interested in Klonopin, because I still have pretty strong SA. Basically, if I use it just as a sleep med, will I also gain a bit of relief during the day from the SA? I'm looking for the best of both worlds here.

Many thanks in advance.
Budgie

 

Re: Klonopin for Parnate Insomnia

Posted by btnd on August 27, 2003, at 5:50:15

In reply to Klonopin for Parnate Insomnia, posted by Budgie on August 27, 2003, at 2:33:07

I'd rather suggest Ambien (zolpidem) for sleep problems or Xyrem (GHB) if you can acquire it.

If you have social anxiety/phobia then I'd rather use Klonopin during the day (in the morning).

 

Re: Klonopin for Parnate Insomnia » Budgie

Posted by cubbybear on August 28, 2003, at 2:12:48

In reply to Klonopin for Parnate Insomnia, posted by Budgie on August 27, 2003, at 2:33:07

>>
> But I have GOT to get to sleep! My schedule is completely out of whack. I've heard Klonopin is an option:
>
> 1. If you only take a dose at night, does it still leave you groggy the next day?

I've been on this very same drug combo, except that I started Klonopin first (for insomnia during depression), then went on to Parnate. (My problem has been major depression w/anxiety or panic) I've always taken the Klonopin at bedtime and was quite groggy when I woke up during the first couple of weeks, but that side-effect disappeared.
>
> 2. If you take it a dose at night and one in the day, will you lose the stimulating effects (which I'm really digging) of the Parnate?

Can't say. . I've never tried it. You'd probably feel a bit sedated. Other people can probably help you with their own experiences.
>
>

 

Re: Klonopin for Parnate Insomnia » Budgie

Posted by mattdds on August 28, 2003, at 9:07:28

In reply to Klonopin for Parnate Insomnia, posted by Budgie on August 27, 2003, at 2:33:07

Hi Budgie,

I was recently put on Parnate as well. I'm up to 30 mg. I've had negative experiences with all other AD's but I want to see what this one does. Kind of my little experiment. My pdoc is kind of an old timer, and likes to use older drugs like the tricyclics, MAOI's and he's a big fan of Klonopin and Xanax.

I also take Klonopin 1.0 mg daily, and Ambien 10mg.

Initially, Klonopin is a good sleep inducer, but tolerance to that effect builds rather quickly, but I still do get the "soothing" antianxiety effects from it.

On the other hand, I have used Ambien for over a year and have not gone above 10mg. My experience has been that it does *NOT* form any sort of dependence. I've gone off after months of continuous use with no problem. It's a wonderful sleep agent, especially for *inducing* sleep, but not so much for maintaining it (unless you get up and take another).

Parnate is not helping my sleep, as seems to be the problem for you. My problem seems to be more getting throught the night, rather than initiating sleep. This is where Klonopin might be more effective. As I said, it is not very good at initiating sleep. But recently, I have been taking Ambien 10mg, and Klonopin 0.5 mg right before bed, and it seems to help a lot!

Bottom line for sleep meds:

1. Ambien - great for inducing sleep, no withdrawal, not so great for maintaining sleep
2. Benzos - good initially, but tolerance builds
quickly to this effect. They still help me maintain sleep though.
3. Trazodone - many people swear by this, but I don't like the antihistamine-type effect. Definitely worth a try.

Best,

Matt

P.s. Let's keep each other informed about the Parnate trial! So far for me it's very tolerable compared to SSRI's, TCA's.

 

Re: Klonopin for Parnate Insomnia » mattdds

Posted by cubbybear on August 28, 2003, at 21:51:02

In reply to Re: Klonopin for Parnate Insomnia » Budgie, posted by mattdds on August 28, 2003, at 9:07:28

>. My pdoc is kind of an old timer, and likes to use older drugs like the tricyclics, MAOI's and he's a big fan of Klonopin and Xanax.
>
Hello Matt,
Just curious--by any chance are you situated in the L.A. area, and if so, who is your doctor? A lot of us would appreciate the chance to have an "old timer" pdoc like that.

 

Re: Klonopin for Parnate Insomnia » mattdds

Posted by Budgie on August 29, 2003, at 0:32:28

In reply to Re: Klonopin for Parnate Insomnia » Budgie, posted by mattdds on August 28, 2003, at 9:07:28

Hi Matt,

Thanks so much for the feedback; I'll talk about all of that with my doc when I see him next week.

How long has your trial been? Have you noticed much success yet? I've been on 30mg for just over 3 weeks now. I am truly amazed with the AD effects and improved cognition. I realize now how dumb everything else I've tried made me at the time (especially Zyprexa)!

Do I understand correctly that you were on Klonopin first, before the Parnate? If that were the case, have you noticed an increase in energy from the P? I'm really back and forth on this issue- whether to try a benzo or not. I've never tried one before, but my SA is a problem that just won't go away. It's not intolerable- I encounter maybe 1-2 brief situations a day where it rears its ugly head. But sometimes those small encounters are enough to drain and deflate me for the rest of the day. So I'd like (ideally of course) to find something that doesn't make me too tired or blunt during the day, but just gives me a tiny bit of mellowness when I need it. Which is why I was wondering if just using it at night to combat the insomnia might have some residual benefits the next day?

What (if you don't mind me asking) are your other side-effects, and what are you doing for them? My only SEs, fortunately, are some minor physical problems: Weight loss (I used to be a rail and I don't want an amphetamine to turn me back into one)- if I increase the dosage to 45, do you think I'd continue to lose weight? Also, having a few problems *ahem* in bed. The libido's kind of low, and the blood isn't quite flowing to my dude like usual. Low blood pressure?

Finally, what are your symptoms, and what other treatments have you tried/ are trying? I just started some CBT work for the SA, on the recommendation from some others on the board here, but I'm probably not taking it seriously enough yet.

Hope to hear back from you.

Best,
Budgie

 

Re: Klonopin for Parnate Insomnia » mattdds » cubbybear

Posted by mattdds on August 29, 2003, at 9:15:40

In reply to Re: Klonopin for Parnate Insomnia » mattdds, posted by cubbybear on August 28, 2003, at 21:51:02

Hi there,

Actually no, I'm located on the other side (NYC). But I'm quite sure you could find a similar pdoc out west coast.

As a matter of fact, I consider myself extremely lucky. I'm not sure if you're aware, but only in New York State do they require triplicate prescriptions for benzodiazepines. And even if you're lucky enough to get a prescription, you *must* have a diagnosis of panic disorder to get any refills! This is extremely unfortunate, because now doctors are writing for drugs like Miltown (meprobamate) and barbiturates to avoid the hassle! This, to me is absolute nonsense!

Good luck, I imagine it will actually be easier in the way of benzos in LA. I just happened to be very fortunate.

Best,

Matt

 

Parnate trial, etc. » Budgie

Posted by mattdds on August 29, 2003, at 10:17:31

In reply to Re: Klonopin for Parnate Insomnia » mattdds, posted by Budgie on August 29, 2003, at 0:32:28

Hi Budgie,

>>Thanks so much for the feedback; I'll talk about all of that with my doc when I see him next week.

No problem, hope some of it helps.

I'm about 2.5 weeks into the Parnate trial, the first week of which was only 20 mg. I just got to 40mg yesterday. I really want to see what this stuff can do, and may go up to 60 mg eventually. My doc was afraid to go any higher than 20 because of my extremely bad luck with other AD's (SSRI's, TCA's). So, far, other than the small amount of orthostatic hypotension, I don't really have any SE's. Amazing, this drug is so easy to take, and the diet is not too big a deal.

>>Do I understand correctly that you were on Klonopin first, before the Parnate?

Yes, I was on Klonopin first, and I have primarily anxiety problems (Panic Disorder, SA, GAD).

>>If that were the case, have you noticed an increase in energy from the P?

Oh yeah! You see, at first I was really worried about the Parnate being too activating. But to my surprise, The "stimulating" effects from Parnate, for me, have been extremely pleasant and tolerable. The only downside has been sort of a "crash" at about midday, when I feel sleepy for about an hour. This is not necessarily bad. I could never take naps before, now I am loving them. It's a really pleasant, soothing sleep!

>>I've never tried one before, but my SA is a problem that just won't go away. It's not intolerable- I encounter maybe 1-2 brief situations a day where it rears its ugly head. But sometimes those small encounters are enough to drain and deflate me for the rest of the day. So I'd like (ideally of course) to find something that doesn't make me too tired or blunt during the day, but just gives me a tiny bit of mellowness when I need it. Which is why I was wondering if just using it at night to combat the insomnia might have some residual benefits the next day?

I can relate to the "draining" social encounters. Klonopin is a very poor sedative, but a very potent anxiolytic. This is of course after a short period of becoming accustomed to the drug. You may have some initial startup effects like drowsiness, but that only lasts a week or so. In your case, perhaps *daytime* Klonopin in low-dose would give you *more* energy, because for me it reduces anxious fatigue, from events similar to what you describe (stressful social situations). So if you reduce the anxiety, you may have more energy. But, like I say, it's a poor sedative after a week, so not good for sleep long term.

So go with the Ambien for insomnia. IMHO, the efficacy and SE profile of Ambien are absolutely amazing! Gets you to sleep, with absolutely no trace of a hangover, and there is zero withdrawal (at least for me). I've taken it for months straight, and stopped cold turkey before. I had maybe 1 mildly rough night, but this was probably just a return of my poor sleeping habits.

Klonopin is different, you will need a slow taper to discontinue, like you would with Paxil or Effexor.

Other than the soothing antianxiety effect of Klonopin, I have absolutely *no* sedation (or any other SE's for that matter).

>>Also, having a few problems *ahem* in bed. The libido's kind of low, and the blood isn't quite flowing to my dude like usual. Low blood pressure?

Really? Parnate is supposed to be much better in that regard. But everyone is different. Have you noticed anorgasmia? Delayed orgasm? On SSRI's I thought I would have a stroke before....well, finishing. Not so on Parnate. I even feel *more* of an interest in sex now, whereas the SSRI's zombified me!

But I think you're talking about "getting up". Right? This could very likely be related to the low blood pressure, IMO.

I have noticed that my diastolic runs low - around 65-70, and my systolic hasn't changed much, around 120-125.

I've heard that the BP side effects resolve themselves later into it, especially if the dose is low. So perhaps the "bed" problems will resolve for you too, I hope.

>>Finally, what are your symptoms, and what other treatments have you tried/ are trying? I just started some CBT work for the SA, on the recommendation from some others on the board here, but I'm probably not taking it seriously enough yet.

I have primarily Panic Disorder, and get attacks in social situations. This leads to GAD and depressive episodes.

I would *strongly* encourage CBT. CBT resolved 80% of my social anxiety, especially all the anticipatory anxiety, and the Klonopin killed the rest of it. CBT is very synergistic with meds, for me too. Think of it this way, there are NO side effects to CBT, and you have absolutely nothing to lose from trying, so work hard with your therapist! It WILL pay off!

I still have some residual depersonalization / derealization from all the previous panic attacks (even though panic is totally controlled), but the Parnate seems to be mopping that up pretty nicely. It really sharpens your thinking, in my (short) experience.

I'm pretty excited about Parnate, it is by far the most tolerable AD I've ever taken. I do admit I'm starting to feel more confident and positive lately. This coming from a big sceptic about AD efficacy. I think Parnate has some "other" effects, like sharpened thinking, and frankly, euphoric effects.

One last thing. I kinda wanted to try Nardil, initially, with all the people on this board liking it so much for it's antianxiety effects. So at first I was kind of bummed that my pdoc wrote out for Parnate. Now, I'm glad I got Parnate. I figure with the Parnate-plus-Klonopin, I get the best of both worlds; fewer sexual and weight gain side effects and (from what I gather) side effects in general. Plus, the mild motivating, and sharpening effects it seems to have. CBT and Klonopin take care of any residual anxiety / tension. Ambien for sleep rules.

Best of luck, and keep me informed! I'm going to see how long I can go without pizza on this stuff!

Take care,

Matt

P.s. I don't know what makes me so incapable of writing a short post on the internet, sorry!

 

Re: Parnate trial, etc. » mattdds

Posted by zeugma on August 29, 2003, at 13:19:07

In reply to Parnate trial, etc. » Budgie, posted by mattdds on August 29, 2003, at 10:17:31

mattdds, you wrote:

Think of it this way, there are NO side effects to CBT":


Why should 'side effects' be limited to those caiused by a drug. People on placebos regularly get side effects and these are not CAUSED by the drug. CBT CAN have side effects because it increases awareness of why social situations produce anxiety, and this in turn can cause the anxious response to heighten. I am not saying this is necessarily a bad thing: I take it that effective treatments tend to have side effects,in fact the therapeutic effect is a kind of 'side effect.'


Again, not disputing the value of CBT: I am beginning to acquire some faith in it finally despite the fact that I have had a very rough couple of weeks on it. I wish you luck with Parnate!

 

Re: Parnate trial, etc. » zeugma

Posted by mattdds on August 29, 2003, at 14:50:38

In reply to Re: Parnate trial, etc. » mattdds, posted by zeugma on August 29, 2003, at 13:19:07

Zeugma,

I think you're absolutely right.

I probably could have phrased that better. It's true, there are some uncomfortable "side-effects" of CBT, like when you are forced to enter situations that are uncomfortable. This definitely causes increased anxiety, at least temporarily.

I hadn't thought of it this way. I guess what I meant was actual pharmalogical effects (e.g. hypertensive crisis, anorgasmia, dry mouth, altered EKG readings, etc.). But it's true that even non-somatic treatments (like CBT) can have SE's, as you pointed out. Good points!

I used to jokingly say on psychological babble that the only side effect was a "pain in the rear". But it is more honest to include such things as temporarily increased anxiety, etc.

I think a lot of people sensationalize treatments that have worked for them. I am pretty enthusiastic about my CBT results, so I guess I fell into this trap of over-hyping it. CBT is definitely not a cure-all. However, I'm still convinced that, overall, the risks are so small and the potential benefits are so great, that everyone should at least give it a fair trial!

Best,

Matt

 

Re: Parnate trial, etc. » mattdds

Posted by Budgie on August 29, 2003, at 19:28:11

In reply to Parnate trial, etc. » Budgie, posted by mattdds on August 29, 2003, at 10:17:31

Hi Matt,

What positive news. It's so nice to find someone who shares similar problems and is having some success in treating them. It makes me feel like I'm on the right track med-wise and therapy wise. Maybe we can have a more specific discussion over on psychological babble about CBT.
>
> my extremely bad luck with other AD's (SSRI's, TCA's).
I, too have had zero to only moderate luck (sometimes god-awful) with Zoloft, Welbutrin and Effexor. Would you call your depression Atypical or TR? Or do you say it's just a response to the anxiety?

So, far, other than the small amount of orthostatic hypotension, I don't really have any SE's. Amazing, this drug is so easy to take, and the diet is not too big a deal.

Wow, you're lucky. I had quite a few problems at the beginning with the diet. It took me a while to figure out that ham and marinated meats are very bad.
>
>

>
In your case, perhaps *daytime* Klonopin in low-dose would give you *more* energy, because for me it reduces anxious fatigue, from events similar to what you describe (stressful social situations). So if you reduce the anxiety, you may have more energy.

Wow, that's exactly what I dream of.
>
Have you noticed anorgasmia? Delayed orgasm? On SSRI's I thought I would have a stroke before....well, finishing. Not so on Parnate. I even feel *more* of an interest in sex now, whereas the SSRI's zombified me!

No problems with the O. SSRIs are the worst, I agree. Thank God we're not on them anymore.
>
> But I think you're talking about "getting up". Right? This could very likely be related to the low blood pressure, IMO.

That's what I hope. I'm eating a big juicy steak right now, with extra salt on it.

> I still have some residual depersonalization / derealization from all the previous panic attacks (even though panic is totally controlled), but the Parnate seems to be mopping that up pretty nicely. It really sharpens your thinking, in my (short) experience.

Exactly. I've experienced depersonalization in the past to the point where, in retrospect, I wonder if I was borderline psychotic (not a pleasant thought). Now I walk around actually feeling like I'm "engaged" in the world. I've been feeling so good, so positive lately, I just want to talk with everyone and raise my hand every two minutes in class. Which is really good, but sometimes I find myself committed into a social situation before I realize it, and then the typical anxiety response happens. So that stinks. But I know it'll pay off if I can get the anxiety under control. Parnate's been great for the problem of avoidance.

I'm very happy to hear that things are going well for you, too. Let's keep each other informed about our progress and changes. And if you want we can talk about CBT and other things on the other board.

>
> P.s. I don't know what makes me so incapable of writing a short post on the internet, sorry!

Don't apologize at all! Long posts are good, just like long emails. It bothers me when people can't sit down and just communicate- it's much better than the fractured bits and blurbs of info that usually flies at us these days! I enjoy talking to you.

Budgie (aka Chris)

 

Re: Parnate trial, etc.

Posted by matthhhh on August 30, 2003, at 14:03:55

In reply to Re: Parnate trial, etc. » mattdds, posted by zeugma on August 29, 2003, at 13:19:07

Ive tried all ssris all make me soooo tired. Several people here have indicated that parnate is a more stimulating med with effects on serotonin. Has parnate worked for anyone who tried ssris and couldnt stand the fatigue from them?
Seems that parnate could be a good alternative

 

Re: Parnate trial, etc. » Budgie

Posted by mattdds on August 30, 2003, at 15:09:16

In reply to Re: Parnate trial, etc. » mattdds, posted by Budgie on August 29, 2003, at 19:28:11

Hey Chris,

>>It's so nice to find someone who shares similar problems and is having some success in treating them. It makes me feel like I'm on the right track med-wise and therapy wise. Maybe we can have a more specific discussion over on psychological babble about CBT

Yeah, it is nice, when others have responded to treatments you are getting! I think you can't really go wrong with the CBT (definitely won't hurt, could REALLY help!), as well as with the Parnate. And yes, I'd love to discuss this over at psychological. I tried to get threads going over there in the past on CBT, but they would usually wind up fizzling out fast, as people seem to prefer more Freudian, psychoanalytic-type therapy or supportive, nondirectional therapy on that board. So I kinda had given up. But I'd love to discuss the techniques, and how it works if you're interested. Larry Hoover, Dinah, me and a few others had a really good discussion about CBT a couple months ago. It was fun, and I learned a lot. Larry is really smart with that stuff.

>>ham and marinated meats are very bad

Actually, I had a ham and eggs on a roll the other day from a Manhattan deli, and checked my BP afterwards - no rise at all. I quite sure ham is OK. Not so sure about the marinated meats (could be marinated with lots of soy sauce).

>I'm "engaged" in the world. I've been feeling so good, so positive lately, I just want to talk with everyone and raise my hand every two minutes in class

That's great! Very encouraging to hear that. I hear this type of response is pretty common with Parnate.

I have a question for you. I think you posted before that you got daytime sleepiness, but that changed later on, as you had taken the drug for longer. So, this SE subsided for you? How long did it take?

In the mornings, I'm really rolling; music sounds really good (esp. Foo Fighters), and life has a "crispness" to it. I jump out of bed early now and get going. However, I seem to "crash" a bit at around 5-6 p.m. and have urges to take a nap! Not really a problem for now, but when dental clinics start again for me, I don't want to fall asleep with a drill in someone's mouth! It does seem to be getting better.

I'm sticking with the Parnate, at least for a while. Since it's been so easy, I figure, why not? I feel like it's starting to work, at almost 3 weeks. I've noticed I startle less easily, and my overall worry levels have decreased a lot. It kind of feels like a really mild SSRI-don't-care-feeling, but without the agitation, and with some extra stimulating kick. I realize some of this may be a placebo effect, but I am sure the Parnate at least has some immediate stimulating, mind-clarifying effects.

Oh, one more thing, sometimes I forget to take my Klonopin now, and feel like I need less. I don't know what to make of this, other than perhaps my overall anxiety is lowered? Thanks for reading and responding!

Best

Matt

 

Re: Parnate trial, etc. » mattdds

Posted by Budgie on August 30, 2003, at 22:05:40

In reply to Re: Parnate trial, etc. » Budgie, posted by mattdds on August 30, 2003, at 15:09:16

Hi Matt,

> I have a question for you. I think you posted before that you got daytime sleepiness, but that changed later on, as you had taken the drug for longer. So, this SE subsided for you? How long did it take?
>
It's definitely not as severe as it was in the beginning, but again, I'm wondering if that was from bad reactions with food. Right now, my sleep schedule is really weird. I'll have crazy insomnia for maybe 2 nights (that's why I've become addicted to this board recently!), and I'll be fine in the day off of 2-3 hours sleep. Then it'll hit me after a few days- for several days I'll need afternoon power naps and then still sleep like a baby for 8-9 hours at night. I'm on a cycle for sure, just not a 24 hour one!


> and life has a "crispness" to it. I jump out of bed early now and get going.

Yes, it's wonderful to feel that way again!

I don't want to fall asleep with a drill in someone's mouth!

Yeah, try hard not to do that.
>
> Oh, one more thing, sometimes I forget to take my Klonopin now, and feel like I need less. I don't know what to make of this, other than perhaps my overall anxiety is lowered? Thanks for reading and responding!
>
That's good news. Isn't it less addictive when you don't take it on a regular schedule? I hope that means that only a tiny bit will help me a lot. I'm a philosophy major, so I'm really afraid of losing any of these "mind-clarifying effects," as you say. I *need* to feel like I sound intelligent and coherent in class (but maybe this is a separate therapy issue). :)

I'll be away for a few days, but maybe after that we can share some CBT stuff. I'm sure I'll need to after visiting family.

When do you go back to dental school? Talk to you later.

Chris

P.S. I'm posting another question below, so have a peek at that, too, if you don't mind.
>
>

 

Re: Parnate trial, etc.

Posted by mattdds on August 30, 2003, at 22:23:30

In reply to Re: Parnate trial, etc., posted by matthhhh on August 30, 2003, at 14:03:55

Matt,

I think with SSRI's people are all different. For example, I had horrible insomnia on them, but sleep (relatively) easily on Parnate. Go figure!

For most people, Parnate is indeed "activating", and it is actually the drug of choice for atypical depression, where the main symptoms are sleeping too much, eating too much, and difficulty getting motivated.

I was scared stiff of the MAOI's, but really they're no big deal. The side effects are *much* milder than SSRI's (other than the hypertensive crisis, which won't happen if you adhere to the diet/drug restrictions). Up until doses of 30 mg, I had *no* noticible SE's.

Parnate may be worth a try for you.

Best of luck,

Matt

 

Re: Parnate trial, etc. » Budgie

Posted by mattdds on August 30, 2003, at 22:48:54

In reply to Re: Parnate trial, etc. » mattdds, posted by Budgie on August 30, 2003, at 22:05:40

Chris,

About the Klonopin question you had:

>>That's good news. Isn't it less addictive when you don't take it on a regular schedule? I hope that means that only a tiny bit will help me a lot. I'm a philosophy major, so I'm really afraid of losing any of these "mind-clarifying effects," as you say. I *need* to feel like I sound intelligent and coherent in class (but maybe this is a separate therapy issue). :)

I wouldn't call it "addictive", but I think I know what you mean. I'm guessing that you mean that you become dependent on it if you take it for a longer than a couple of weeks. This is absolutely right. But I think only a select few become "addicted", in the medical sense. However, you *will* need to taper your dose very slowly when you decide it's time to discontinue. The PDR cites a study that when people were tapered over 7 weeks, the withdrawal side effects tended to be very mild.

There are a couple of major advantages of taking Klonopin regularly, which I'll try to explain.

1. The benzodiazepine family (of which Klonopin is a member) tend to produce what some call "differential tolerance", that is, tolerance builds to certain effects and not to others. Conveniently, tolerance usually builds to the sedative and "slowing" effects rapidly. However, the generalized anxiolytic and certainly anti-panic effects **do not** typically create tolerance. I've taken the same dose of Klonopin for over a year with no loss of benefit for panic during social situations. Actually, I would say it's better now, because I have *zero* noticible side effects, no kidding! So what you wind up with after regular dosing is a very clean anxiolytic without sedation or "brain fog"!

I actually believe that Klonopin has *sharpened* my thinking, if anything. Anxiety is a huge intellect killer for me. It also robs me of all spontanaity in social situations.

This is why benzos, in my opinion, are poor sleep drugs, they poop out quickly.

2. There is some evidence that benzodiazepines **when taken p.r.n. - or as needed**, interfere with CBT treatment. This is not seen when benzos are taken on a regular basis. I know this seems contrary to intuition, but this is what the research shows. I think this is because, p.r.n. usage is a form of "escape behavior", which defeats the purpose of some CBT assignments. Steady dosing *do not* have this effect, for some reason or another. This is what the studies have shown. Weird, eh?

Yeah, we'll chat CBT when you get back. I go back to school on tuesday. Have a great trip.

Matt

 

Re: Parnate trial, etc. » matthhhh

Posted by cubbybear on August 31, 2003, at 8:23:00

In reply to Re: Parnate trial, etc., posted by matthhhh on August 30, 2003, at 14:03:55

> Ive tried all ssris all make me soooo tired. Several people here have indicated that parnate is a more stimulating med with effects on serotonin. Has parnate worked for anyone who tried ssris and couldnt stand the fatigue from them?
> Seems that parnate could be a good alternative

Hello Matt,
I did it the other way, i.e. I had great results with Parnate for nearly two decades. It definitely is a stimulating AD and has good anxiolytic qualities too. I'm presently living in Thailand and Parnate is not available here. So last year I decided to give Zoloft, an SSRI, a try (after Remeron pooped out), and I really couldn't stand the Zoloft for a number of reasons. Fatigue was *not* an issue, but even so, I didn't like it at all. So last March, in the depths of depression, I returned to the U.S. for a new supply of Parnate, and got back on my feet. For me, there's nothing like it.

 

Re: Parnate trial, etc. » matthhhh » cubbybear

Posted by mattdds on August 31, 2003, at 10:02:48

In reply to Re: Parnate trial, etc. » matthhhh, posted by cubbybear on August 31, 2003, at 8:23:00

Cuddybear,

You're on Parnate too?

What dose? I'm at 40 mg/d now. I think I can officially say that I woke up in a substantially better mood today. This may very well be the beginning of my FIRST AD response! I'm still sceptical, but at the same time enthusiastic.

If nothing else, it has no problematic side effects for me, and has a number of "good" effects, which seem separate from the primary AD effect. Is this your experience? It certainly seems like a unique AD.

2 decades of luck with Parnate! That's amazing!

Good luck!

Matt

 

Re: Parnate trial, etc. » mattdds

Posted by cubbybear on September 1, 2003, at 0:59:33

In reply to Re: Parnate trial, etc. » matthhhh » cubbybear, posted by mattdds on August 31, 2003, at 10:02:48

> Cuddybear,
>
> You're on Parnate too?
>
> What dose? I'm at 40 mg/d now. I think I can officially say that I woke up in a substantially better mood today. This may very well be the beginning of my FIRST AD response! I'm still sceptical, but at the same time enthusiastic.

My usual starting dose has always been 40 mg., then after I'm stabilized, I decrease to 30 mg for the maintenance dose. I wish you the best of luck with it. By the way, are you located outside of the U.S.? I ask this because you use the letter "c" in sceptical, rather than the U.S. spelling "skeptical."
>
> If nothing else, it has no problematic side effects for me, and has a number of "good" effects, which seem separate from the primary AD effect. Is this your experience? It certainly seems like a unique AD.

My experience with side effects has always been low blood pressure (hypotension) for the first couple of weeks, then it disappears. I get a craving for sweets and carbohydrates, which enables me to gain back the weight I've lost while I'm depressed. (apparently, this is opposite the experience of most people, who lose weight while on Parnate.)
>

 

Re: Parnate trial, etc. » mattdds

Posted by Ima on September 4, 2003, at 9:08:24

In reply to Re: Parnate trial, etc. » matthhhh » cubbybear, posted by mattdds on August 31, 2003, at 10:02:48

Hey All,

I referenced this thread looking up parnate.
Very good thread, helpful.

Can I interject a question?

Do any of you have experience with Parnate helping Bi polarII?

I know the ssri route is not for me.
Ive tried and they make me more manic.
I also suffer from insomnia and GAD.
Thanx
Ima


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