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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by ColoradoSnowflake on May 28, 2009, at 9:46:17
Hi! I've been leveled out on Parnate 20mg a.m., 10mg noon for two weeks. I also take 25mg amitriptyline for sleep. I feel a little better but don't think the Parnate has kicked in yet. My problem is I'm SO tired all the time. I can't take much less amitrip and still sleep. My pdoc said to take all the Parnate (30mg) at night. This seems counter-intuitive to me and I'm afraid it will mess up my sleep! It seems maybe I should give it more time as is? What do you think?
I have gotten so much good information about Parnate from you guys. Thanks!! Gayle
Posted by Phillipa on May 28, 2009, at 13:13:44
In reply to Parnate Timing Help Please, posted by ColoradoSnowflake on May 28, 2009, at 9:46:17
I don't like to see unanswered threads although I don't know your answer I can try and recruit some parnate users or past ones to answer. Thinking of you and glad to hear so far so good. Phillipa
Posted by ColoradoSnowflake on May 28, 2009, at 13:34:33
In reply to Re: Parnate Timing Help Please » ColoradoSnowflake, posted by Phillipa on May 28, 2009, at 13:13:44
Thanks so much Phillipa! I'd appreciate it! You're a doll! Gayle
Posted by greywolf on May 28, 2009, at 18:30:38
In reply to Re: Parnate Timing Help Please -- Phillipa, posted by ColoradoSnowflake on May 28, 2009, at 13:34:33
If you want to mess up your sleep patterns, take all 30mg at night. You'll be watching movies at 4 a.m.
I take 60mg Parnate and try to take the last dose before dinner, otherwise the insomnia's a killer.
Greywolf
Posted by Phillipa on May 28, 2009, at 20:02:23
In reply to Re: Parnate Timing Help Please -- Phillipa, posted by greywolf on May 28, 2009, at 18:30:38
Glad you had some useful info. Love Phillipa
Posted by Ron Hill on May 28, 2009, at 20:32:12
In reply to Parnate Timing Help Please, posted by ColoradoSnowflake on May 28, 2009, at 9:46:17
> Hi! I've been leveled out on Parnate 20mg a.m., 10mg noon for two weeks. I also take 25mg amitriptyline for sleep. I feel a little better but don't think the Parnate has kicked in yet.
Hi Gayle. How many weeks have you been on Parnate? If more than two weeks with little or no improvement, the Prescribing Information document for Parnate says to increase the dosage. See page 11 of the following link:
http://us.gsk.com/products/assets/us_parnate.pdf
> My problem is I'm SO tired all the time.This is a start-up side effect. For me (and others on PB) this start-up side effect subsided as soon as I ramped up to my optimal dosage. I take 80 mg/day.
> My pdoc said to take all the Parnate (30mg) at night. This seems counter-intuitive to me and I'm afraid it will mess up my sleep! It seems maybe I should give it more time as is? What do you think?If I were to take 30 mg of Parnate at bedtime, I would be awake all night. INSOMNIA!!!!!! IMHO, perhaps your p-doc is wrong on this one.
Similar to your current dosing schedule, I take 50 mg first thing in the morning, and 30 mg at about 2 pm.
-- Ron
dx: Bipolar II, with ultra rapid cycling (15 days for one complete cycle), and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
80 mg/day Parnate
Posted by ColoradoSnowflake on May 28, 2009, at 22:36:44
In reply to Re: Parnate Timing Help Please -- Phillipa » greywolf, posted by Phillipa on May 28, 2009, at 20:02:23
Thanks for the personal experience info and Parnate website! I'm NOT taking any Parnate at night!!
I've only been at 30mg for ten days, so maybe some of the "start-up fatigue" will still go away. I probably do need a larger dose and will talk to my pdoc about it in a week or so. He's good about listening to my ideas and working with me.
Thanks again! It means so much to hear from people who have "been there, done that"!! Gayle
Posted by Ron Hill on May 28, 2009, at 23:45:16
In reply to Re: Parnate Timing -- Phillipa-Greywolf-Ron, posted by ColoradoSnowflake on May 28, 2009, at 22:36:44
> I probably do need a larger dose and will talk to my pdoc about it in a week or so.
Gayle, if it were me, I'd print the Parnate Prescribing Information document so you can show him the section on page 11 regarding dosage.
> He's good about listening to my ideas and working with me.
That's great! Sounds like a good p-doc.
-- Ron
Posted by desolationrower on May 29, 2009, at 1:04:34
In reply to Re: Parnate Dosage » ColoradoSnowflake, posted by Ron Hill on May 28, 2009, at 23:45:16
Hi gayle. It took a month at an effective dosage for most of the fatigue to go away. At this point i have no insomnia (although the depression-induced hypersomnia isn't a problem as much either. ) and don't have a problem taking parnate before bed.
I think what you really should do is get a shorter half life sleep aid. amytryptiline is ~15hours. so its still affecting you during the next day.
other than caffeine, mint gum and chewing on chiles or candied ginger helped me stay away.
-d/r
Posted by ColoradoSnowflake on May 29, 2009, at 14:42:20
In reply to Re: Parnate Dosage, posted by desolationrower on May 29, 2009, at 1:04:34
Thanks so much for all the great input. I'm going to act on everything (except maybe chewing on chili's)!! starting out by being more patient!
Thanks, guys! Gayle
Posted by Elanor Roosevelt on May 31, 2009, at 22:21:43
In reply to Re: Parnate Dosage, posted by ColoradoSnowflake on May 29, 2009, at 14:42:20
taking the parnate at night won't work with a sleeping pill?
Posted by greywolf on May 31, 2009, at 22:55:58
In reply to Re: Parnate Dosage, posted by Elanor Roosevelt on May 31, 2009, at 22:21:43
> taking the parnate at night won't work with a sleeping pill?
I've tried Parnate at night with Lunesta and Ambien and it didn't work for me.
I try to take the last dose of Parnate at dinner or before, if possible.
Greywolf
Posted by ColoradoSnowflake on May 31, 2009, at 23:02:28
In reply to Re: Parnate Dosage, posted by ColoradoSnowflake on May 29, 2009, at 14:42:20
I do take amitriptyline at night for sleep and it works great for me,but probably it is making me more tired during the day, as was suggested. I have a few Ambien on hand and some 100mg trazadone that I thought about trying, but don't want to mess with the Parnate so I think I'd better wait for my pdoc. I still don't think I"ll take the Parnate at night. Thanks for the suggestions.
Gayle
Posted by ColoradoSnowflake on June 3, 2009, at 9:53:30
In reply to Re: Parnate Dosage, posted by ColoradoSnowflake on May 31, 2009, at 23:02:28
My pdoc isn't in until next week. He's semi-retired and job shares with a young pdoc and she wont prescribe an MAOI with a tricyclic. So upped my Parnate on my own yesterday to 40mg; (20mg morning and 20mg noon.) I wasn't so tired in the afternoon. I took the amytripyline at night and slept ok. I wont make any more changes until I talk with him. I check my BP all the time and it's low if anything so I think it's all ok. Thanks for all your input and help. Gayle
Posted by bitkit on June 3, 2009, at 15:04:57
In reply to Re: Parnate Dosage, posted by ColoradoSnowflake on June 3, 2009, at 9:53:30
It's funny you mention low blood pressure, Gayle. Mine's been corpse-like (never above 95/65) since I upped the dose to 40mg a week ago.
On tiredness: My own afternoon Parnate-induced exhaustion seemed to go away last week, too. Depression makes me tired all the time, but there's a difference between the two experiences! I expect yours will, too.
As for babblemail: I would love to correspond about our Parnate experiences since we started at the same time and are now at the same dose, too. I can't seem to find a link for it, though.
Where do I access it?
Catherine
> My pdoc isn't in until next week. He's semi-retired and job shares with a young pdoc and she wont prescribe an MAOI with a tricyclic. So upped my Parnate on my own yesterday to 40mg; (20mg morning and 20mg noon.) I wasn't so tired in the afternoon. I took the amytripyline at night and slept ok. I wont make any more changes until I talk with him. I check my BP all the time and it's low if anything so I think it's all ok. Thanks for all your input and help. Gayle
Posted by ColoradoSnowflake on June 3, 2009, at 22:48:06
In reply to Re: Parnate Dosage, posted by bitkit on June 3, 2009, at 15:04:57
Hi Catherine: I think maybe I see a little difference on the 40mg in that I'm not quite so exhausted until 4 or 5 pm whereas it was noon! Yes, I can tell the difference also between depression exhaustion and Parnate exhaustion. Sounds like you, also, are an expert on exhaustion. I just HATE it!! I have NEVER had any energy since I had a "depression breakdown" 15 years ago!! I still haven't given up hope that I'll feel normal energy again someday. Come on Parnate!!
Babblemail seems easy. My name is highlighted on my posts. Just click on my name and an empty e-mail comes up. For yours to work you just have to update your registration to "OK" for sending and receiving Babblemails! Then we can both e-mail! Thanks, Gayle
Posted by Elanor Roosevelt on June 4, 2009, at 0:16:07
In reply to Re: Parnate Dosage » bitkit, posted by ColoradoSnowflake on June 3, 2009, at 22:48:06
can you take smaller doses x 2 to prevent the tiredness from ruining your evening?
Posted by ColoradoSnowflake on June 4, 2009, at 15:57:29
In reply to Re: Parnate Dosage, posted by Elanor Roosevelt on June 4, 2009, at 0:16:07
Hi Elanor. I'm taking 20mg in the morning and 20mg. at lunchtime. Did you mean smaller doses than that? Thanks, Gayle
Posted by desolationrower on June 7, 2009, at 6:58:14
In reply to Re: Parnate Dosage » Elanor Roosevelt, posted by ColoradoSnowflake on June 4, 2009, at 15:57:29
hm actually i remember ea few days i tried taking just one pill in the morning then 2 in the afternoon and one in the evening to try to stave off the fatigue until i reached a reasonable bed time.
-d/r
Posted by ColoradoSnowflake on June 11, 2009, at 16:04:51
In reply to Re: Parnate Dosage, posted by desolationrower on June 7, 2009, at 6:58:14
How did that work? I'm now on 40mg.; 20mg AM and 20mg about 2:30pm along with 1/2 a caffeine tablet. That seems to work better. I don't think it (Parnate) has kicked in very much yet. Very disappointing. Gayle
Posted by desolationrower on June 19, 2009, at 8:36:01
In reply to Re: Parnate Dosage » desolationrower, posted by ColoradoSnowflake on June 11, 2009, at 16:04:51
> How did that work? I'm now on 40mg.; 20mg AM and 20mg about 2:30pm along with 1/2 a caffeine tablet. That seems to work better. I don't think it (Parnate) has kicked in very much yet. Very disappointing. Gayle
:( sorry
i think i went up to a higher dose about that time. I was drinking a lot of caffiene (partially just because i had a job and needed an excuse to get up. and the office had a starbucks machine!)
have you thought of going up to 60mg yet?
-d/r
Posted by ColoradoSnowflake on June 20, 2009, at 11:47:26
In reply to Re: Parnate Dosage » ColoradoSnowflake, posted by desolationrower on June 19, 2009, at 8:36:01
Yes, I think I did go up to 60mg Thursday. I laid out 6 10mg pills for the day (?), went to exercise class, felt really tired, ran into my instructor and almost knocked her down. She asked me if I was OK and of course I said "Yes, I'm fine", but I wasn't. Got home, no pills on the counter. Did I take ALL or NONE? I sat down to think about it and woke up 3 hours later sitting straight up, made it to the couch and slept another hour, felt bad the rest of the day. I wont do that again. I'm on 60mg. for sure now. I also drink a lot of coffee and take a couple of half caffeine tablets a day. I'm trying to figure out how to space the parnate out. I'm back up to 25mg amytriptyline so I sleep ok. My pdoc has told me he's ok with working up to 100mg parnate (eek). I have an appt with him next week. So we'll see. I think it's going to continue getting better.
Thanks so much for asking! I appreciate it!
Any suggestions?
Gayle
This is the end of the thread.
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