Psycho-Babble Medication Thread 705238

Shown: posts 1 to 19 of 19. This is the beginning of the thread.

 

Question for Parnate users

Posted by Morhoun on November 19, 2006, at 13:17:50

I've been reading up in the archives on Parnate and have a question for those who've used or are using.

My ailment is severe unipolar depression. Dealt with episodes throughout life but the last 8 months have been extreme. Tried Serzone, Cymbalta, Remeron, Seroquel (low dose) and Lexapro. Also had a brief experience with Wellbutrin years ago.

I don't seem to do well with SSRIs. They make me either too anxious or to sedated. I'm extremely med sensative in general. The one drug that has helped has been the stimulant Adderall XR but it has mixed results. I go from extreme elation to extreme desparation. It seems to just make me more emotional in general. The highs are great, the lows are unbearable. Seems weird to have with an extended release formula but it get it none the less.

So, I'm considering the big guns...MAOIs, parnate in particular. My reason being, I need something effective soon and, I think that I need something that hits dopamine or is stimulating. I would like to avoid sexual side effects if possible.

My question (at long last) is...given my experiende with Adderall which mainly effects dopamine if I understand it correctly, is it reasonalbe to think I may get the same rollercoaster effects from Parnate? I've read parnate posts saying it made people more emotional and that scares me a bit. Any input would be greatly appreciated. Suggestions for other meds to try would be also.

 

Re: Question for Parnate users » Morhoun

Posted by Caedmon on November 19, 2006, at 14:47:02

In reply to Question for Parnate users, posted by Morhoun on November 19, 2006, at 13:17:50

Hi Morhoun, I have been on 40mg of Parnate (tranylcypromine) for about six months now. I think it's pretty effective. I have been through Zoloft Prozac Cymbalta Lexapro amitriptyline Seroquel trazodone Risperdal buspirone Topamax Depakote Ritalin Provigil selegiline Effexor Wellbutrin ... and some others, I can't recall offhand.

My experience is not that Parnate makes me feel *great*, or even that it makes me "not depressed"; but, rather, that it makes it POSSIBLE for me to take other steps to be in remission. I find I have a lot of lightbulbs turn on in my head now. I can problem-solve better (well, I'm capable of it now, too!).

My main issue lately has been hypomania, on and off, which Parnate does NOT help and in fact might even contribute to it. I also take Wellbutrin, mainly to offset some of the sleepiness and lethargy I was having. (Oh, and caffeine, haha. Lots nowadays. Welcome to graduate school.)

My experience is that no medication has ever been an adequate substitute for solidly rational thinking, problem-solving, and good old-fashioned physical exercise. :) I also wake up early, and at the exact same time, every-single-day, as I'm quite sensitive to circadian rhythm disruptions.

Sorry, back to you...

> My question (at long last) is...given my experiende with Adderall which mainly effects dopamine if I understand it correctly, is it reasonalbe to think I may get the same rollercoaster effects from Parnate?>

I don't think it's possible to say. Parnate is very different.

You have a lot of options still. If it seems like Parnate might work for you, maybe it is worth trying. <shrug> I'm pretty much easy-going on MAOIs, I think they're great, but they are sort of prima donna antidepressants.

- Chris

 

Re: Question for Parnate users » Morhoun

Posted by Phillipa on November 19, 2006, at 14:47:10

In reply to Question for Parnate users, posted by Morhoun on November 19, 2006, at 13:17:50

Have you considered EMSAM the transdermal delivery sytem of seligline? Sounds like you need a pick me up and the reason a lot discontinues was insomnia. Good luck Love Phillipa

 

Re: Question for Parnate users » Morhoun

Posted by Quintal on November 19, 2006, at 16:14:17

In reply to Question for Parnate users, posted by Morhoun on November 19, 2006, at 13:17:50

I took Parnate earlier this year for social anxiety and mood problems similar to the ones you are describing. I was prescribed 30mg/day but found this made my depression and anxiety worse. I was feeling so bad that soon I began to take more as I noticed that the MAOI veterans posting on this board who had the most success were generally taking much more than 30mg. At doses higher than 40mg I found Parnate had a similar effect on me to cocaine. I began the day by getting a large hit of 30mg as soon as I woke up and continued to pop pills throughout the day 'as needed' to give me a boost whenever I felt my mood or energy dip. At night the stimulant effect of Parnate wore off and the sedative effect of the Klonopin I was taking took over and I would fall into a stupor.

By the end of the fourth week I was taking somewhere between 80-120mg Parnate a day. I had to come off it as my pdoc stuck rigidly to the 30mg limit stated in the BNF and claimed higher doses could only be harmful. Many people take Parnate but only a few abuse it as I seem to have done, so I hope that does not deter you.

I had no sexual dysfunction while taking Parnate, in fact my sex drive seemed to increase after taking a dose. Sexual dysfunction is a side effect I find intolerable and get quite a lot with other antidepressants so I would recommend Parnate to you on those grounds.

Since you have found dopamine agonists effective for your depression may I suggest Amisulpride? Amisulpride is an atypical antipsychotic that is a dopamine agonist at low doses. It is not available in the US however, but Cabergoline - a dopamine agonist drug licensed for Parkinson's Disease may be a reasonable alternative if the pdoc is willing to experiment. Here is a link to a current thread about dopamine agonists that I you think may find useful: http://www.dr-bob.org/babble/20061110/msgs/703230.html

Q

 

Re: Question for Parnate users » Morhoun

Posted by Racer on November 19, 2006, at 16:34:33

In reply to Question for Parnate users, posted by Morhoun on November 19, 2006, at 13:17:50

I've never taken Parnate, but I have taken Adderall, and had to discontinue due to increased depression. If you haven't tried other stimulants, it might be worth giving them a try. It might also be worth trying a combination of a stimulant and another antidepressant.

If the dietary restrictions don't deter you, it's probably worth trying Parnate. Most of the people here who have tried various classes of drugs all seem to agree that the MAOIs are consistently effective.

Good luck.

 

Re: Question for Parnate users

Posted by linkadge on November 19, 2006, at 17:37:01

In reply to Re: Question for Parnate users » Morhoun, posted by Racer on November 19, 2006, at 16:34:33

I tried parnate. I don't know if I'd consider it a big gun, maybe for some people. It made my depression somewhat worse. It made my mood a little darker. It gave me energy, but thats about it.

Linkadge

 

Re: Question for Parnate users » Morhoun

Posted by blueberry on November 19, 2006, at 18:35:51

In reply to Question for Parnate users, posted by Morhoun on November 19, 2006, at 13:17:50

You might try solian (amisulpride) or ritalin. Ritalin would probably do well with you, based on adderall experience, but requires more frequent dosing. Solian stimulates dopamine at low doses (50mg-100mg) and is clinically researched for depression, anxiety, and dysthymia. It can be ordered overseas.

Sometimes merely shoring up neurotransmitters makes some of us feel more depressed. Like me. Sometimes blocking receptors works better. And sometimes stimulating the release and firing of neurotransmitters works better. Parnate is going to shore them up, like your other meds did, by a different mechanism.

It is just my opinion but I think there is a fair percentage of unipolar patients who actually respond better to bipolar strategies, such as prozac/zyprexa combo.

 

Re: Question for Parnate users

Posted by Jost on November 19, 2006, at 21:50:39

In reply to Question for Parnate users, posted by Morhoun on November 19, 2006, at 13:17:50

The effects of Parnate on neurotransmitters are produced differently from those of stimulants like Adderall.

Stimulants usually are dopamine agonists, ie they cause higher amounts of dopamine to be made, in a dose-related way.. The rhythm of dopamine production is influenced by when you take the pill.

MAOIs, monoamine oxidase inhibitors, reduce the presence of an enzyme, MAO (monoamine oxidase), which breaks down neurotransmitters. Therefore, Parnate and Nardil, for example, don't directly affect your body's production of neurotransmitters, they reduce the catabolism of them. Thus the levels and production is your body's own natural production, not one that is somewhat artificially enhanced.

Parnate does have a metabolite that's amphetamine-like, so you can have some feeling of energy (often, but not always) from it-- but the main AD effect isn't caused by that.

As with all ADs, you really have to try it, to see how it affects you.

Jost

 

Re: Question for Parnate users

Posted by halcyondaze on November 19, 2006, at 23:17:31

In reply to Re: Question for Parnate users, posted by Jost on November 19, 2006, at 21:50:39

I found it very stimulant like. It was like Adderall Lite for me.

Of course, I also have a history of substance abuse so I, too, ended up abusing it. However, I eventually stopped doing this and I can say - it is the closest thing to a cure I've ever known.

(Minus the cystic acne, mind you.)

I stabilized on 120 mg a day. It was wonderful. I want to go back on.

 

Re: Question for Parnate users

Posted by Jost on November 20, 2006, at 10:54:01

In reply to Re: Question for Parnate users, posted by halcyondaze on November 19, 2006, at 23:17:31

120 mg is an extremely high dose of parnate. Not many doctors would prescribe it, nor do many people need that dose.

The typical range is 30-60 mg. I took more, but I don't think many pdocs are that willing to go much above that range.

I did sense a difference if I didn't take it on schedule, more or less, but didn't get any high.

Reactions are quite individual, though.

Jost

 

Re: Question for Parnate users...Blueberry

Posted by Morhoun on November 20, 2006, at 13:24:36

In reply to Re: Question for Parnate users » Morhoun, posted by blueberry on November 19, 2006, at 18:35:51

> You might try solian (amisulpride) or ritalin. Ritalin would probably do well with you, based on adderall experience, but requires more frequent dosing. Solian stimulates dopamine at low doses (50mg-100mg) and is clinically researched for depression, anxiety, and dysthymia. It can be ordered overseas.
>
> Sometimes merely shoring up neurotransmitters makes some of us feel more depressed. Like me. Sometimes blocking receptors works better. And sometimes stimulating the release and firing of neurotransmitters works better. Parnate is going to shore them up, like your other meds did, by a different mechanism.
>
> It is just my opinion but I think there is a fair percentage of unipolar patients who actually respond better to bipolar strategies, such as prozac/zyprexa combo.
>
>

I'm curious why you think Ritalin might be a better option. I've considered trying other Stims but part of the problem is stimulants in general take away my appetite and I really need to gain weight, not loose it.

Stims are sort of hard on me in general so I thought Parnate might be easier. Meds give me problems with muscle soreness and shaking and I wonder if that would actually be worse with Parnate since it's affecting more transmitters. Thanks for input

 

Re: Question for Parnate users

Posted by Morhoun on November 20, 2006, at 13:25:57

In reply to Re: Question for Parnate users » Morhoun, posted by Quintal on November 19, 2006, at 16:14:17

> I took Parnate earlier this year for social anxiety and mood problems similar to the ones you are describing. I was prescribed 30mg/day but found this made my depression and anxiety worse. I was feeling so bad that soon I began to take more as I noticed that the MAOI veterans posting on this board who had the most success were generally taking much more than 30mg. At doses higher than 40mg I found Parnate had a similar effect on me to cocaine. I began the day by getting a large hit of 30mg as soon as I woke up and continued to pop pills throughout the day 'as needed' to give me a boost whenever I felt my mood or energy dip. At night the stimulant effect of Parnate wore off and the sedative effect of the Klonopin I was taking took over and I would fall into a stupor.
>
> By the end of the fourth week I was taking somewhere between 80-120mg Parnate a day. I had to come off it as my pdoc stuck rigidly to the 30mg limit stated in the BNF and claimed higher doses could only be harmful. Many people take Parnate but only a few abuse it as I seem to have done, so I hope that does not deter you.
>
> I had no sexual dysfunction while taking Parnate, in fact my sex drive seemed to increase after taking a dose. Sexual dysfunction is a side effect I find intolerable and get quite a lot with other antidepressants so I would recommend Parnate to you on those grounds.
>
> Since you have found dopamine agonists effective for your depression may I suggest Amisulpride? Amisulpride is an atypical antipsychotic that is a dopamine agonist at low doses. It is not available in the US however, but Cabergoline - a dopamine agonist drug licensed for Parkinson's Disease may be a reasonable alternative if the pdoc is willing to experiment. Here is a link to a current thread about dopamine agonists that I you think may find useful: http://www.dr-bob.org/babble/20061110/msgs/703230.html
>
> Q

Yah, I was reading that thread yesterday actually. I'm also looking at Abilify. Thanks for the input.

 

Re: Question for Parnate users....Jost

Posted by Morhoun on November 20, 2006, at 13:28:34

In reply to Re: Question for Parnate users, posted by Jost on November 19, 2006, at 21:50:39

> The effects of Parnate on neurotransmitters are produced differently from those of stimulants like Adderall.
>
> Stimulants usually are dopamine agonists, ie they cause higher amounts of dopamine to be made, in a dose-related way.. The rhythm of dopamine production is influenced by when you take the pill.
>
> MAOIs, monoamine oxidase inhibitors, reduce the presence of an enzyme, MAO (monoamine oxidase), which breaks down neurotransmitters. Therefore, Parnate and Nardil, for example, don't directly affect your body's production of neurotransmitters, they reduce the catabolism of them. Thus the levels and production is your body's own natural production, not one that is somewhat artificially enhanced.
>
> Parnate does have a metabolite that's amphetamine-like, so you can have some feeling of energy (often, but not always) from it-- but the main AD effect isn't caused by that.
>
> As with all ADs, you really have to try it, to see how it affects you.
>
> Jost
>

Excellent info, thanks. I was hoping someone would address the technical stuff for me. I guess this explains why some people augment Parnate with Adderall or other stims.

 

Re: Question for Parnate users » Morhoun

Posted by Quintal on November 20, 2006, at 14:17:52

In reply to Re: Question for Parnate users, posted by Morhoun on November 20, 2006, at 13:25:57

Hi Morhoun,

I tried Abilify myself after reading that it was a D2 partial agonist/modulator hoping it would be stimulating and stabilizing at the same time. It gave me akathisia - a restless inner tension so bad I couln't sit still or sleep, so I had to quit it fairly soon. This seems to be a common side effect of Abilify when taken alone and is rare with Solian and Parnate.

Q

 

Parnate escapee

Posted by elanor roosevelt on November 21, 2006, at 7:28:53

In reply to Re: Question for Parnate users, posted by linkadge on November 19, 2006, at 17:37:01

Parnate made me "not depressed"
the upbeat side of me left town
i was able to lose some med-related weight
i stopped drawing
i stopped laughing
i stopped marketing my business
i stopped socializing
and slowly, the hovering sadness took over each evening
then the self-loathing and despair
in the middle of the day when i was dosed i was flat and fragile
i had so many related issues and i am at such a rough time in life, i figured the self-loathing and despair were "reality" triggered
even went to my pdoc and told him i was okay
i was kind of kidnapped by the meds
had this happen on neurontin years ago
i don't know what let me see it was the meds
but i am very very grateful to have it "washed out" now

 

Re: Thank You All

Posted by Morhoun on November 22, 2006, at 8:51:02

In reply to Question for Parnate users, posted by Morhoun on November 19, 2006, at 13:17:50

Thanks You All

 

Re: Question for Parnate users

Posted by Morhoun on November 27, 2006, at 14:46:54

In reply to Re: Question for Parnate users » Morhoun, posted by Quintal on November 20, 2006, at 14:17:52

> Hi Morhoun,
>
> I tried Abilify myself after reading that it was a D2 partial agonist/modulator hoping it would be stimulating and stabilizing at the same time. It gave me akathisia - a restless inner tension so bad I couln't sit still or sleep, so I had to quit it fairly soon. This seems to be a common side effect of Abilify when taken alone and is rare with Solian and Parnate.
>
> Q

Can I ask what dose you took?

 

Re: Question for Parnate users » Morhoun

Posted by Quintal on November 27, 2006, at 16:15:42

In reply to Re: Question for Parnate users, posted by Morhoun on November 27, 2006, at 14:46:54

I took 5mg according to the packet.

Q

 

Re: Question for Parnate users

Posted by mindevolution on November 29, 2006, at 1:14:29

In reply to Re: Question for Parnate users, posted by Morhoun on November 27, 2006, at 14:46:54

> > Hi Morhoun,
> >
> > I tried Abilify myself after reading that it was a D2 partial agonist/modulator hoping it would be stimulating and stabilizing at the same time. It gave me akathisia - a restless inner tension so bad I couln't sit still or sleep, so I had to quit it fairly soon. This seems to be a common side effect of Abilify when taken alone and is rare with Solian and Parnate.
> >
> > Q
>
> Can I ask what dose you took?
>

careful of solian, some studies say there are low eps, others show akathisia risk is 30-40%. for me I got akathisia from it, the seriously suicidal type for months on end.


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.