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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by bluebird on October 10, 2004, at 18:21:43
Hey Todd, How's the Parnate at 40mg a day working for you? How are you splitting up your doses? My doc says 1 in the morning, 1 in the afternoon and 2 in the evening. I am also taking 2mg of Cloneazepam and hydroxyzine in the evenings. I have been sleeping a lot better and also I am able to stay awake most of the day. Tiredness hits around 2 to 4 in the afternoon. I take a nap get up take my meds and by 9 to 10 I am in bed and seem to sleep all night. The depression and other problems haven't gone away yet but I know it will take time. I am only on my 3rd week. Went to the doc last Tuesday and she raised dose to 40mg for 4 weeks. Haven't had really bad SE's but I feel I am still having some withdrawal symptoms from the Paxil. All and all everyone say my personality still seems to be coming back and that I am likeable again. Paxil gave the the I don't care about anything or anyone attitude, which I can now see. I am starting to care about things again, which is kind of nice and the sexual SE's seem to be going away also. Just wondering if you are doing well and how your SE's in comparison to Nardil are doing? Are you beginning to feel the Parnate in a positive way? I do get a little impatient waiting on it to work. I did have a reaction to some pickle relish which was in fresh chicken salad. I don't plan to eat pickle relish again. It was a very small amount. Other than that I have had no problem with the diet and I have lost some weight which is a positive. I plan to stay on Parnate for a good while because they say it can take a while to work. I look forward to hearing from you. Thanks and Blessings, bluebird
Posted by King Vultan on October 10, 2004, at 20:13:27
In reply to King Vultanothers/Parnate at 40 how's it working?, posted by bluebird on October 10, 2004, at 18:21:43
I posted some information to Kara in a thread up above a ways on some other aspects of how I'm doing. I'm actually on my 7th day of 50 mg/day. I was only on 40 mg/day for two and a half weeks, but it was obvious that it was just not going to be enough. I now seem to be getting into the range where there is a significant antidepressant effect, and I want to take a month or two to see what the full effects of the dosage wind up being, as I may not have to go much higher, if at all. I take 1 pill at 7 AM, 11 AM, 2 PM, 5 PM, and 8 PM.
Another thing that caused me to ask to increase the dosage is that I've read that there is a dose to weight relationship for Parnate just as there is for Nardil. Well, at least some practicioners subscribe to this school of thought, anyway. For Parnate, it is supposedly 0.7 mg/day per kg of body weight. For me at roughly 70 kg (154 lbs/2.2), this figures out to 49 mg or 5 pills a day. Since the dose to weight formula for Nardil (1.0 mg/kg of body weight--for me, about 70 mg or 5 x 15 mg/day) did provide a therapeutic dose, it seemed reasonable to do the same kind of thing with Parnate.
Parnate seems to have much less severe side effects than Nardil. It has lowered my BP and heart rate, but not as much as Nardil did, and I really haven't noticed any problems from it. About the only thing I can say is that the insomnia does seem worse on Parnate. I am alternating back and forth between 0.25 mg Halcion/triazolam one night and 2 x 25 mg of the Unisom tablets (doxylamine succinate) the next. The dosage of the Unisom is twice what the package recommends, but I have a reference from a site in Australia that says 25-50 mg is okay. I only needed about half this amount of each sleep aid on Nardil. The 2 x 25 mg Benadryl that worked fairly well on Nardil is really not adequate on Parnate.
Todd
Posted by ron1953 on October 11, 2004, at 1:12:11
In reply to King Vultanothers/Parnate at 40 how's it working?, posted by bluebird on October 10, 2004, at 18:21:43
I discontinued Parnate, 40mg/day yesterday. Although it seemed to help the depression quite a bit, I was experiencing extreme tiredness/lethargy more and more. At first, it was episodic and happened in the afternoon. Yesterday, it was so bad I felt like a zombie from the moment I woke up. Also, the Parnate didn't help with my other symptoms of irritability and frustration. So the decision has been made. I'm having no symptoms from stopping cold turkey. What's next? Your guess is as good as mine.
Posted by Chairman_MAO on October 13, 2004, at 10:48:05
In reply to King Vultanothers/Parnate at 40 how's it working?, posted by bluebird on October 10, 2004, at 18:21:43
Greetings, all! After a several-month hiatus from med-centered consciousness (I'm sure at least some people here know what I mean by that), I simply could not resist posting here any longer. :)
And I'm pleased to report that, despite untreated dysthymia and ADD, I managed to enroll myself at Rutgers University in New Jersey, serendipidously receiving far more financial aid than I ever could have dreamed of. Then, during the last week of August, as I was preparing to gleefully vacate my parents' house, I presented for treatment at the local medical school's mental health clinic. Unlike my previous state-funded psychiatrist in my parents' home county, the resident I saw here seemed interested in me as a person and intent on helping me. After a brief discussion with her supervising doctor, she agreed to let me try Parnate, given my lengthy history of failures with everything else.
From day one it's been nothing but improvement! I titrated up to 80mg/day in less than a month so that I'd have maximum effectiveness for the school year. It would take hours of writing and revision to adequately convey the manifold improvements I enjoy, but it suffices to say that, on most days I experience at worst euthymia and at best hours of unfettered positivity. The robust, sustained mood lift is superior to and completely unlike any other drug I've tried, including the ones that get you "high". Sometimes when, as Bob Marley wrote, the "sun is shining and weather is sweet", I'll be waiting for the campus bus in the morning and be thinking "wow, it's great to be alive!" I used to trudge around, head angled toward the ground, feeling as if I were a member of the "untouchable" social caste, unable to look others in the eye for too long without feeling profound psychic discomfort. Now I walk with a self-assured stride, looking strangers in the eye and smile! My excessive rumination, anxiety, social phobia, and depression have all been decreased by well over 50%. I fully intend to take this drug for as long as it remains even 25% as effective as it is now.
My doctor told me that I am the singular MAOI patient at that facility--among hundreds of patients. I replied to this regrettably unsurprising news with muted lamentation. Why deny so many suffering people such effective drugs? These are the only side effects I have: delayed orgasm--though when the Parnate is in my system the orgasms are way more intense than they are by default--and insomnia. The insomnia was SEVERE at the beginning of treatment, but seems to be improving; I managed to sleep last night with only marijuana instead of downers. Also, there was some hypotension, pretty bad impotence, weakness, and afternoon drowsiness during the first 2-3 weeks that have all but disappeared.
The fuss made over the diet is, IMHO, laughable. I've been safe simply avoiding gourmet aged cheeses, soy sauce, sauerkraut, tap beer, and I think one other thing. I am not a disciplined person by nature, and the diet is easy for me to follow. I carry chlorpromazine around in case of a reaction, but I haven't had one. Knock on wood.
Well, time to go take care of some life activities. Just thought I'd check in; best wishes to all!
P.S. I've tried all sorts of dosing regimens, and am finding it hard to settle on one. It's very complicated, because there are active metabolites formed, and trying to maintain optimal levels of them is hard. I hate how the morning dose only becomes significantly activating about three hours after I take it, bolstering my suspicion that there are amphetamine-like metabolites. The best dosing regimen I've found for that is 20mg morning, noon, dinner, and bed; but with the bedtime dose I cannot sleep, even with Ambien. As of now, I'm taking 30mg morning, 30mg 5-6 hours later, and 20mg 5-6 hours after that. Any comments on this?
Posted by Optimist on October 13, 2004, at 13:43:09
In reply to Re: King Vultanothers/Parnate at 40 how's it working?, posted by Chairman_MAO on October 13, 2004, at 10:48:05
Wow, that's exciting stuff Chairman! I'm so happy for you! Parnate has had me deeply intrigued for the last while... even though my depression tends to be minor, you can't deny the efficacy of Parnate.
The robust antidepressant effect, that tends to break through at a level that other AD's can't seems intriguing as well. Something about MAOi's seem to be a step ahead of the others.
It seems that the problems with MAOi's seem to be much over hyped. Many pdocs seem unrightly scared of MAOi's. I think there's a lot of misinformation out there.
Posted by jboud24 on October 14, 2004, at 18:47:01
In reply to Re: King Vultanothers/Parnate at 40 how's it worki » Chairman_MAO, posted by Optimist on October 13, 2004, at 13:43:09
Awsome, I love hearing success stories with MAOI's. After multi-SSRI poop-out I've been searching for something better for myself. I believe my next choice will be either Nardil or Parnate when I go to see my p-doc next. I'm leaning towards parnate simply because I cant gain more weight and I need a bit more energy. I'm hoping Parnate will be that answer for me.
But if you are having insomnia on it, why not consider taking a dose regimen like 25, 30, 25 or maybe 30, 30, 20 with the third dose no later than 5-6 pm.
Good Luck with Parnate, and let us know how you do on it.
Justin
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