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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 deuce224 on May 27, 2006, at 12:16:47
I am taking 40 mgs of parnate and have mild side effects but no antidepressant effect. My question is has anyone taken 40 mg's with no positive effects only to find out that they got great effects from doses like 60 mg's. I don't want to put a stop to parnate without giving it a fair shot as it is one of my last shots. thanks, joe
Posted by Crazy Horse on May 27, 2006, at 12:53:49
In reply to parnate question-dosage?, posted by deuce224 on May 27, 2006, at 12:16:47
> I am taking 40 mgs of parnate and have mild side effects but no antidepressant effect. My question is has anyone taken 40 mg's with no positive effects only to find out that they got great effects from doses like 60 mg's. I don't want to put a stop to parnate without giving it a fair shot as it is one of my last shots. thanks, joe
It took 60 mgs. before i got a response. If you go to 60 mgs and get a good response my advice is to stay there as long as possible...i went higher and began to experience severe insomnia and daytime fatigue. So don't give up at 40 mgs, 50 or 60 could be the perfect dose for you. Some even require higher doses than this, but again my opinion is less is better, unless of course a higher dose is absolutely needed for a response. I wish you the best.
Monte
Posted by Caedmon on May 27, 2006, at 16:25:01
In reply to Re: parnate question-dosage? » deuce224, posted by Crazy Horse on May 27, 2006, at 12:53:49
Maybe you need to get to 80% MAO inhibition first. Take a look at this:
[from CLINICAL PSYCHOPHARMACOLOGY SEMINAR: ANTIDEPRESSANT DOSING, Paul Perry, Ph.D, BCPP, Brian C. Lund, Pharm.D.
http://www.tu.edu/user_files/10/17.html ]>>Grasso et al (1991) studied five adult patients, 33 to 61 years old who received tranylcypromine (TCP) for management of their affective illness. Each patient was given TCP 20 mg/d for at least one week. Blood levels of TCP were drawn at 0, 14, 20 and 24 hours following the last dose of the drug. Each patient, except for one nonresponding patient who was switched to ECT, was then restarted at 30 mg/d or 40 mg/d for at least one week. Blood samples were drawn at times similar to those for the first set of samples. Platelet MAO activity was measured. From these data, a statistically significant correlation (r2 = 0.60) between % MAO inhibition and TCP dose was found. This relationship was described by equation 3 and presented in figure 2.
% MAOI = 118.8 (log TCP dose) + 98.7 (Eq. 3)
Even though no patient in this study achieved a % MAO inhibition greater than 64.8%, the resulting logarithmic relationship indicates that 80% MAO inhibition can be achieved with a tranylcypromine dose of 0.7 mg/kg/d (p < or = 0.05).>>
So, you might try a dose that corresponds to .7 mg/kg. If that doesn't work, there is evidence of antidepressant efficacy increasing up to 130 mg/day for tranylcypromine, as I recall. Good luck!- Chris
Posted by deuce224 on May 27, 2006, at 17:25:00
In reply to Re: parnate question-dosage?, posted by Caedmon on May 27, 2006, at 16:25:01
thanks Caedon, I am 6'1" and 215 lbs so according to this study I would need at least 60 mg's. Something to think about.
Posted by Karen44 on May 27, 2006, at 23:15:13
In reply to parnate question-dosage?, posted by deuce224 on May 27, 2006, at 12:16:47
I got a good response to 30 mg. of Parnate for years and was even able to go off of Parnate for some 10 years before I got depressed again over a bunch of health issues that hit me all at once. I went up to 30 mg. with no help. So, we went up to 40 mg., and I have been on 40 mg. for around two weeks with no noticable change. So, Dr. recommended Risperidone, .5 mg. so I would sleep at night becuase I have had insomnia. I feel better but still can't go to sleep at night. Anyone know if Risperidone is capable of helping for insomnia??? Thanks
Posted by willyee on May 28, 2006, at 20:48:07
In reply to Re: parnate question-dosage?, posted by Karen44 on May 27, 2006, at 23:15:13
There could be times when a 50 mg dose of parnate will tighten my body up,and i DEFINATLY know its there,which is good,i dont mind those side effects,long as i feel something,i wont to know its working and feel better.
HOWEVER there are times when i swear i can take a 50 mg dose and its like i took total placebo,nothing nodda,i just dont get it,ace is the what umm nardil champ,,,,,,,,well im the parnate looser cause im not getting desired results.
I since have found no alternative,a semi stimulating med,well one i havent tried,ive attempted to augment,that is still a option as i have had success,but when i talk to my doc and have enough i will increase my parnate dose,its the only thing i can think of,i do notice woman seem to respond to lower doses,im not wanting to get slapped here lol,but i assume the average woman in general is usualy smaller than the average man in weight and height,so it the sex itself or body type i wonder plays a role.
For instance i started taking parnate at 180 pds,and never ever went near 100 mg.
Currently im 6 ft 230 pds so perhaps its simply my body.Who knows i suppose.
Posted by Jost on May 28, 2006, at 21:24:08
In reply to Re: parnate question-dosage?, posted by willyee on May 28, 2006, at 20:48:07
When I took parnate, I didn't necessarily base my idea of its impact on the reactions of one day vs another day. Some days I felt better than other days, for reasons that had to do with -- lots of factors.
Maybe you can't evaluate in microbursts for any AD, but need to focus on the big picture-- how you're doing overall, not how you're doing at any particular moment-- to see what benefits it offers.
Jost
Posted by willyee on May 28, 2006, at 23:30:51
In reply to Re: parnate question-dosage?--willyee, posted by Jost on May 28, 2006, at 21:24:08
I understand what ur saying totaly,and its absolutly true.
However i think i kinda learned how to totaly isolate a bad day from external situations to pyhsical,this was done only over time.
I keep my actual life,vs this life seperate,for ex on my webpages i dont mention nothing about any of this,and vice versa there are a lot of emotional problems ,normal ones like ex girlfriend,arguemtns with friends etc that you would find on a webpage of mine.
All i want from my medication is some form of consistency,so that i can approach both the good and bad parts of life with the same mentality.
Tonight i took a fairly high dose of parnate,i took 50 and mg and felt as if i were falling asleep,but never did totaly,i then took 20mg which was earlier but not far after the 50,for a total of 70 mg,and i feel ok right now,not great but there is no sick feeling in my gut,im not feeling any pity for myself or fear etc,i just am "here" and thats all i want.
But again i think u make a very valid point,it takes a lot of self examination to determine or seperate depression and the blues,from an emotional disorder.Even on a daily basis.
thanks!
Posted by Jost on May 29, 2006, at 10:24:21
In reply to Re: parnate question-dosage?--willyee, posted by willyee on May 28, 2006, at 23:30:51
Willyee, do you take parnate on a regular schedule, ie the same number of pills, at similar times each day?
Or do you take them based on a feeling of what you might need, and then take more if it doesn't seem to help?
Getting a steadystate of the drug, more or less, and sticking with that might smoothe out some of the jaggedness. Also, it might keep you from over-interrogation of your reactions.I won't say there aren't ebbs and flows, or immediate reactions, to parnate's presence. But it's pretty hard to calculate that--esp. by intuition, or ebbs and flows of mood, energy, tension, etc.
Many things can cause you to think something's helping at a moment (or not).. But "real" life, or "normal" problems aren't separate from neuropsychological or "abnormal" problems.
They're more two approaches to or descriptions of the same things--or ways of saying "these reactions bother me a lot; while these reactions don't as much"--but the reactions (or patterns of reaction) may be intertwined..
It would freak me out if I kept wondering how I was reacting to a drug--the question itself raises doubts and fears-- by its very nature, the question responds to and triggers more doubt and anxiety--. maybe just practice telling yourself, they are working, even if you can't quite put your finger on it, rather than wondering so much.
Jost
Posted by willyee on May 29, 2006, at 22:29:31
In reply to Re: parnate question-dosage?--willyee, posted by Jost on May 29, 2006, at 10:24:21
No i dont take a strict dose,at a strict time.This is my fault as well as my docters as they never really enforced or recomended any.
I suppose comming off as i do which is i suppose a know it all,they just assume i know how to take it and i dont,but i dont think they do either.
Im currently trying to change all that,among many things,noth exteranl and internal,i.e strict med regime,and strict lifestyle changes,suche as a bed time,a routine etc.
I have a long way to go,its just hard to be consisent with the drug not helping,but so far this is day two only at a higher dose and although far from perfect i do feel slightly better.thanks
Posted by Jost on May 29, 2006, at 22:42:45
In reply to Re: parnate question-dosage?--willyee, posted by willyee on May 29, 2006, at 22:29:31
Hi, Willyee.
Try talking the parnate at regular intervals.
Because parnate tends to be "activating," it's often suggested that you not take it after 3:00pm. You could take it twice a day, for example, when you get up and at 2:00-3:00 pm.
Pick a schedule that seems to make sense for you, --then just stick to it, for a while.
If you find you can't sleep--or have a lot of fatigue, esp. in the late afternoon, as sometimes happens, you could adjust. But give it a couple of weeks, once you pick times.
I would really urge you--I know you can't just do this right away, but just to try--not to be quite as harshly self--questioning. These questions only make you more afraid. Give the medication the benefit of the doubt--and try, try to give yourself the benefit of the doubt.
Nothing is irreversible--but give it time, too.
Of course, next time you see a Pdoc, you can and should ask--because s/he may have an idea, or be able to think it out with you.
best, Jost
This is the end of the thread.
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