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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Rickcr on August 30, 2009, at 22:52:53
I was on Parnate, successfully for over 20 years. About a month ago, I had an apparent hypertensive crisis, after eating in a restaurant. I kind of decided on the spur of the moment to try a new med. (I was also having low blood pressure on Parnate) A psychiatrist prescribed Remeron. I was off Parnate for 15 days, then started remerom (15-30-45 milligrams) two weeks ago. Still I have continued to be very depressed and perhaps the worst depression since I started Parnate.
I have a question about how long I would have to stop Remeron before starting Parnate again. According to Wikipedia there is no documentation about dangerous Parnate/Remeron interactions, but it is difficult to find reliable information. Since the Physicians tend to be conservative, probably my Pdoc will suggest two weeks, but I would like to have more information about this.
Posted by ace on August 30, 2009, at 23:09:17
In reply to Remeron Parnate transtition, posted by Rickcr on August 30, 2009, at 22:52:53
> I was on Parnate, successfully for over 20 years. About a month ago, I had an apparent hypertensive crisis, after eating in a restaurant. I kind of decided on the spur of the moment to try a new med. (I was also having low blood pressure on Parnate) A psychiatrist prescribed Remeron. I was off Parnate for 15 days, then started remerom (15-30-45 milligrams) two weeks ago. Still I have continued to be very depressed and perhaps the worst depression since I started Parnate.
In my experience Remeron is`not too bad....lots of good reports on it...usually a bit off weight gain and significant sedation.
If you changed your mind about Parnate, I am pretty sure you could use the two agents together.
> I have a question about how long I would have to stop Remeron before starting Parnate again.I w`ould start instantly, or use together. I had NO problems with Nardil/Remeron.
I can't see any mechanism where their would be any substainal problemsAccording to Wikipedia there is no documentation about dangerous Parnate/Remeron interactions, but it is difficult to find reliable information. Since the Physicians tend to be conservative, probably my Pdoc will suggest two weeks, but I would like to have more information about this.
I hope the above helps...also be good to see some other opinions on this. Really hope things pick up ASAP
Ace:)
Posted by Rickcr on August 30, 2009, at 23:33:58
In reply to Re: Remeron Parnate transtition » Rickcr, posted by ace on August 30, 2009, at 23:09:17
Thanks for this reply. I really appreciate this advice.
It seems to me (as a newcomer to this list), that of course I could take your advice, and yet, I would be taking advice in a situation where a mistake could be life-threatening. This seems to be a problem in a psych list such as this. I would be great if Dr. Bob would "participate" in an issue such as this, with references to on-line sources where information could be confirmed or some other means of providing/confirming the information. This is just a general comment about on-line psych info. I know that there are plenty of disclaimers that I can only rely on my physician, yet the physician will probably not want to prescribe Parnate and Remeron together, and yet, as you have indicated, this might be a very good combination. Ditto for the time between the two meds, he will want to err on the side of caution, perhaps rather than spending 10 minutes looking up the issue of Remeron Parnate interacion, in the appropriate psychiatric texts, journals or other references.
I would welcome opinions from other posters as well as input from Dr. Bob. Should I be willing to try Remeron and Parnate simultaneously based on the opinion I have received? How do I decide what to do?
Posted by ace on August 31, 2009, at 1:52:35
In reply to Re: Remeron Parnate transtition » ace, posted by Rickcr on August 30, 2009, at 23:33:58
> Thanks for this reply. I really appreciate this advice.
A pleasure!
> It seems to me (as a newcomer to this list), that of course I could take your advice, and yet, I would be taking advice in a situation where a mistake could be life-threatening. This seems to be a problem in a psych list such as this. I would be great if Dr. Bob would "participate" in an issue such as this, with references to on-line sources where information could be confirmed or some other means of providing/confirming the information. This is just a general comment about on-line psych info. I know that there are plenty of disclaimers that I can only rely on my physician, yet the physician will probably not want to prescribe Parnate and Remeron together, and yet, as you have indicated, this might be a very good combination. Ditto for the time between the two meds, he will want to err on the side of caution, perhaps rather than spending 10 minutes looking up the issue of Remeron Parnate interacion, in the appropriate psychiatric texts, journals or other references.
> I would welcome opinions from other posters as well as input from Dr. Bob. Should I be willing to try Remeron and Parnate simultaneously based on the opinion I have received? How do I decide what to do?
Hi mate- I don't think Dr. Bob will participate.
With regards to this issue, I am sure I have data at home about MAOI/Remeron combo, and will research it tonight. I believe I may have a clinical trial (not too sure), I have some anectodes, and also a very good document which explains the biochemical interaction of the two agents, which do indeed deem them safe.
I will get to this ASAP....I do believe it will be safe, however i understand your concern.
Back soon!
Ace:)
Posted by ace on August 31, 2009, at 1:58:12
In reply to Re: Remeron Parnate transtition » Rickcr, posted by ace on August 31, 2009, at 1:52:35
Hi mate- check out this....
http://www.dr-bob.org/babble/20040417/msgs/338003.html
I have the article at home alluded to....Peace,
Ace:)
Posted by Phillipa on August 31, 2009, at 12:15:53
In reply to Re: Remeron Parnate transtition » ace, posted by ace on August 31, 2009, at 1:58:12
Ricker wasn't it you that was in remission on another combo could there be two Rickers? And to backup Ace Dr. Bob doesn't participate. Phillipa
Posted by Rickcr on August 31, 2009, at 14:10:24
In reply to Re: Remeron Parnate transtition, posted by Phillipa on August 31, 2009, at 12:15:53
> Ricker wasn't it you that was in remission on another combo could there be two Rickers? And to backup Ace Dr. Bob doesn't participate. Phillipa
No it wasn't me that was using any other combo. I have used Parnate off and on since 1982, and recently changed to Remeron, but no other anti-depressant meds since I began Parnate.
I imagine that Dr. Bob cannot participate since he would have to be responding to hundreds of posts each day. But we have to be careful about the accuracy of information. I have tracked down several of the different references to Parnate with Remeron, and they can all be traced to one single reference from the Journal of Clinical Pharmacology from the 1990's. I can't find the full article, just the reference to this article in several articles published in Current Psychiatry. Of course this doesn't mean that this study wasn't valid, but its interesting that all roads lead to the same article. There is no other scientific reference available, that I have been able to find. Yet most drug websites warn that a two week waiting period is necessary, between Parnate and Remeron, which is apparently not the case. But its interesting to see how the information kind of filters down from one source, for better and for worse.
Posted by ricker on August 31, 2009, at 23:06:26
In reply to Re: Remeron Parnate transtition, posted by Phillipa on August 31, 2009, at 12:15:53
> Ricker wasn't it you that was in remission on another combo could there be two Rickers? And to backup Ace Dr. Bob doesn't participate. Phillipa
Hi Jan, must be 2 Rickers? I have not posted in a while. The OP has good taste in forum names ;-)
Take care, Rick
Posted by floatingbridge on August 31, 2009, at 23:47:33
In reply to Re: Remeron Parnate transtition, posted by Phillipa on August 31, 2009, at 12:15:53
Phillipa, I'm confused, too. Babble doesn't allow identical names. Could the other Ricker be ricker with a small r?
And Ricker, hope you get the info you need to get you back into remission!
fb
Posted by Rickcr on September 1, 2009, at 18:59:24
In reply to Re: Remeron Parnate transtition » Phillipa, posted by floatingbridge on August 31, 2009, at 23:47:33
Just for those who were confused I am rickcr not ricker.
Rick!
Posted by Phillipa on September 1, 2009, at 20:47:47
In reply to Re: Remeron Parnate transtition, posted by Rickcr on September 1, 2009, at 18:59:24
Well that explains it totally spelling with a c and not an e. Bad eyes. Phillipa
Posted by zzzz7 on September 7, 2009, at 19:46:18
In reply to Re: Remeron Parnate transtition » Rickcr, posted by Phillipa on September 1, 2009, at 20:47:47
How did this work out for you? (I'm wondering about the safety of mirtazpine/Parnate myself.)
Posted by kirbyw on September 17, 2009, at 18:53:31
In reply to Re: Remeron Parnate transtition, posted by zzzz7 on September 7, 2009, at 19:46:18
In answer to the question, I have been unable to find out totally reliable information about this transition. I am still taking Remeron, and strongly considering returning to Parnate and leaving about 5 days between the two. Its kind of surprising how little information there is. I suspect I just don't know where to look on the internet, and the fact that I live in a country where Parnate is not available is a problem because local Psychiatrists are not familiar with it.
I am posting now as Kirbyw only because my previous posting name rickcr doesn't work with my password.
I tried to go through the re-registration process using the same user name and the system wouldn't let me. So I simply began a completely new registation process.
Posted by Phillipa on September 17, 2009, at 20:44:05
In reply to Re: Remeron Parnate transtition, posted by kirbyw on September 17, 2009, at 18:53:31
Thanks for letting us know. I'd post this on admin as well as have gotten mail from others who couldn't get back so quit and went elsewhere. Phillipa
Posted by kirbyw on September 17, 2009, at 20:54:31
In reply to Re: Remeron Parnate transtition » kirbyw, posted by Phillipa on September 17, 2009, at 20:44:05
yes I tried several times to resolve my password problem. I know I had the correct password and user name, but the server kept telling me that my password was wrong. I will post to admin as you suggested.
rick
Posted by kirbyw on September 26, 2009, at 13:22:13
In reply to Re: Remeron Parnate transtition » kirbyw, posted by Phillipa on September 17, 2009, at 20:44:05
For anyone who is interested, regarding this transition, all the information that I could find indicated that a few days would be a safe transition time from Remeron to Parnate.
Then I finally got my Costa Rican Pdoc to investigate it in his clinical textbooks and he also said that four or five days should be fine.To err just a little bit on the side of caution we agreed on 7, I am now on 3rd day of Parnate after 7 days of disconting and remeron and no problem, knock on wood.
I have to take a low dose of Parnate because of its interaction with Lopressor, a heart med, (my blood pressure gets too low and I get too much postural hypotension) but I have seen that Parnate helps at 20 mg. Don't know if I will get to 30 mgRemeron has some good points---no diet worries, increased libido, and no blood pressure issues. All of these are important to me, but the bottom line was that the "core" of my depression was not improving on Remeron, or so it seemed on a rather short trial. But I didn't want to wait any longer and risk getting more depressed, so decided to get back on Parnate.
This is the end of the thread.
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