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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by blackcat23 on November 9, 2005, at 15:23:39
Hello--
I've been on Parnate for a little over a week now (current dose 30mg-- 10 mg three times daily), and have already seen great results with mood, energy, motivation, and desire to socialize. I'm very excited about this, but I've had quite severe postural hypotension (dizziness when standing too suddenly, especially in the morning and evenings). Two nights ago, I passed out when I got up to go to the bathroom in the middle of the night and injured my chin/hip. My doctor prescribed fludrocortisone to fix the postural hypotension.Has anyone else tried fludrocortisone? Does it help? How long before you saw results? Did you notice visible water retention?
Other questions for Parnate users:
Are you able to exercise without dizziness? I haven't tried yet, but would like to eventually.
I've found that caffeine (coffee or soda) enhances the effects of the medicine. Do you drink coffee?
Has Parnate affected your appetite? I haven't had much desire to eat since taking it.Thanks for your help!
blackcat23
Posted by fires on November 9, 2005, at 20:58:18
In reply to parnate and fludrocortisone, posted by blackcat23 on November 9, 2005, at 15:23:39
When I was on Parnate my doc gave me Reglan to help with OH - and it did help.
I believe that midodrine is commonly used now.
If Florinef is going to help you should see results very soon.
I take Florinef for another reason. What dose are you taking?
Posted by blackcat23 on November 9, 2005, at 21:46:51
In reply to Re: parnate and fludrocortisone » blackcat23, posted by fires on November 9, 2005, at 20:58:18
I'm taking .1 mg a day of flodrocortisone. In addition, I take 50 mg of Cytomel (a thyroid supplement), 200 mg of Lamictal. I never had the OH until the Parnate, of course. I've been taking it for a little over a week at 30 mg. I ramped up my dose to 30 mg. quickly, so am wondering if that contributed to the extreme OH as well.
Anyway, I'm curious about the other meds you mentioned. I'll research them as well-- do you know if there are advantages to the others over the flodrocortisone?
Thanks for your response. I really appreciate it!
Posted by fires on November 10, 2005, at 14:21:18
In reply to Re: parnate and fludrocortisone, posted by blackcat23 on November 9, 2005, at 21:46:51
> I'm taking .1 mg a day of flodrocortisone. In addition, I take 50 mg of Cytomel (a thyroid supplement), 200 mg of Lamictal. I never had the OH until the Parnate, of course. I've been taking it for a little over a week at 30 mg. I ramped up my dose to 30 mg. quickly, so am wondering if that contributed to the extreme OH as well.
>
> Anyway, I'm curious about the other meds you mentioned. I'll research them as well-- do you know if there are advantages to the others over the flodrocortisone?
>
> Thanks for your response. I really appreciate it!
I think that increasing your dose of Parnate quickly probably made the OH worse. When I was increasing my dose fairly rapidly toward 90 mg, I had a BP of about 70/45 while in bed. I had quite a few episodes of "going blind and deaf" about 30 seconds to 1 min. after standing up -- yet I never fainted.Nurses didn't believe me at first, because they would take my BP right after standing. I finally told them to wait 30 seconds before taking my BP -- then they did get low readings.
The use of Reglan for OH is very off-label, but since it worked I was on it for about 15 years.
I take 0.1 mg of Florinef x2 per day, for another condition. I didn't know that it was used for Parnate OH.
I know that Florinef is generally considered safe for long term use, and that it has few side effects. Reglan can cause severe side effects in some people. I couldn't find my reference for theuse of Midodrine for OH.
I also take 200mg of Lamictal per day now, along with 300 mg of Wellbutrin and 8 mg of Rozerem and .5 mg of clonazepam (instead of Parnate).Good Luck
Posted by Ilene on November 10, 2005, at 23:38:57
In reply to parnate and fludrocortisone, posted by blackcat23 on November 9, 2005, at 15:23:39
I've taken 0.2 mg fludrocortisone for almost a year. Before that I took 0.1 mg for a few years. It works great! I really notice on the days I forget to take it. And no, I haven't noticed any water retention.
I.
Posted by fires on November 11, 2005, at 11:11:58
In reply to Re: parnate and fludrocortisone » blackcat23, posted by Ilene on November 10, 2005, at 23:38:57
I'm wondering if you take your 0.2 mg as 0.1mg twice a day?
Posted by blackcat23 on November 11, 2005, at 15:17:11
In reply to Re: parnate and fludrocortisone » blackcat23, posted by Ilene on November 10, 2005, at 23:38:57
It's great to hear that both of you have had relief from your OH. I hope I will be able to report similar results soon! Ilene, do you take an MAOI as well? Was that the cause of your OH? Perhaps increasing my dose to .2 mg would help me.
For the past three days, I have taken 0.1 mg in a single dose when I get up in the morning. Would it be helpful to take it twice a day? Since taking Parnate, I have consitstently noticed the faintness when standing in the evenings before going to bed and in the middle of the night when getting up to go to the bathroom. Oddly, it's not as bad during the day, although I did notice it yesterday after climbing subway stairs. Scary! Fainting in public in NY would not be a good thing.
So far, the fludrocortisone hasn't made a big difference in the evening dizziness. Maybe taking a an additional .1 mg later in the day in addition would be helpful. Thanks for the continued feedback. I hope this hypotension will be resolved since I have found the Parnate to be very effective for my mood. Thanks so much!
Posted by Ilene on November 13, 2005, at 22:12:48
In reply to Re: parnate and fludrocortisone » Ilene, posted by fires on November 11, 2005, at 11:11:58
> I'm wondering if you take your 0.2 mg as 0.1mg twice a day?
I'm supposed to, but I don't.
I.
Posted by rjlockhart on November 13, 2005, at 22:23:43
In reply to Re: parnate and fludrocortisone » fires, posted by Ilene on November 13, 2005, at 22:12:48
i havent heard from you in a while.
i thought you went to a hospital.
I hope everything is ok.
Posted by Ilene on November 13, 2005, at 22:29:29
In reply to Re: parnate and fludrocortisone, posted by blackcat23 on November 11, 2005, at 15:17:11
I don't take an MAOI now, but I used to take Marplan. I don't recall any light-headedbess from the Marplan, and I've always experienced some. It's gotten worse as I've gotten older. I was taking 0.1 mg fludrocortisone, but when I was in the hospital last year they put me on 0.2 mg. I was having ECT at the time, and they may have raised the dose because of how I reacted to the anesthesia. (That's just a guess.) My BP is still low, but I don't usually start to black out under normal conditions.
I've heard that light-headedness when going to the bathroom in the middle of the night can be quite dangerous, because you can't see very well and you can fall. I hang onto the bedstead until it passes.
Good luck,
I.
Posted by Ilene on November 13, 2005, at 22:40:11
In reply to Re: ILENE!, posted by rjlockhart on November 13, 2005, at 22:23:43
> i havent heard from you in a while.
>
> i thought you went to a hospital.
>
> I hope everything is ok.
>
>
I've been very depressed and hardly posting.Yes, I was in the hospital for about 10 days in the middle of October. It was a nice respite ("nice" being a relative term)--let's just say it was a bit of a de-stressor. I liked my pdoc there, too. In fact, I liked him better than my regular pdoc. I got the impression he was thinking about what I was saying.
I was still very depressed after I got out, though, even suicidal at times, but I just shut up about it because the only thing that would happen would be going back to the psych ward and having my shoelaces and belt taken away. They can't do too much except tide you over and mess with your meds. They took me off Prozac and put me on Cymbalta.
I'm feeling strangely better tonight. Maybe the Cymbalta is kicking in. Who knows?
I.
Posted by rjlockhart on November 14, 2005, at 20:36:44
In reply to Re: ILENE! » rjlockhart, posted by Ilene on November 13, 2005, at 22:40:11
Cymbalta is a serotonin norepinephrine reuptake inhibitor.
It could be alot better than Prozac. I felt it more stimulating. But with the Wellbutrin, they may both bind are stimulating and could cause a anxiety reaction.
Cymbalta i think you should give a try, the standard dose is 60mg, the max is 120mg. I dont know what its like at higher doses, i was on 30mg for a while but i switched becuase of some problems.
But try it out, Cymbalta starts to work in about a week and full effect in about 2. Prozac.....6weeks i think.
Take Care
Matt
Posted by Ilene on November 14, 2005, at 23:51:34
In reply to Re: ILENE!, posted by rjlockhart on November 14, 2005, at 20:36:44
I've been on Cymbalta for about 4 weeks and I've been feeling a little better for the past two days. I have no idea whether it's the Cymbalta, an anti-seizure med that my regular doc gave me for something completely different, or a random mood shift. I'm trying not to get too worked up about it, because I've felt better for a while before and then relapsed for no reason.
The Cymbalta hasn't increased my anxiety, either.
Thanks,
I.
This is the end of the thread.
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