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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 22 to 46 of 46. Go back in thread:
Posted by Maxime on October 16, 2009, at 11:27:49
In reply to Re: Trazadone and Parnate » Maxime, posted by Sunbath on October 16, 2009, at 10:30:06
No, there is no one who could pick it up for me. I don't have any benzos. I am hoping that I will sleep tonight from sheer exhaustion. I feel awful right now. :-(
Posted by Sunbath on October 17, 2009, at 5:23:51
In reply to Re: Trazadone and Parnate » Sunbath, posted by Maxime on October 16, 2009, at 11:27:49
That's terrible! Sorry that you have to go through that! Having no sleep is one of the worst things ever in my opinion.
How did you sleep that night?Are you able to pick up the trazodone today?
Posted by Maxime on October 17, 2009, at 11:02:37
In reply to Re: Trazadone and Parnate » Maxime, posted by Sunbath on October 17, 2009, at 5:23:51
I slept a bit last night, but not much. I am now off to the pharmacy to get the Trazodone. How many mg do you take? I need 200 mg to help me sleep. I hope that's not too much with the Parnate.
I don't understand how the Parnate can make me so tired all day and unable to sleep at night. ???
Posted by Sunbath on October 17, 2009, at 11:42:49
In reply to Re: Trazadone and Parnate » Sunbath, posted by Maxime on October 17, 2009, at 11:02:37
Hey Maxime, great you are getting it finally.
I take 175-200mg/night, but that is the extended release version so it's of course less than an equivalent of an immediate release one.I'm no expert but I think you shouldn't take 200mg the very first night already, especially not when on Parnate?!
Also I don't know if you also experienced this, but some kind of a tolerance to trazodone's sedative effects builds up the first 1-2weeks when I begin taking it (again). During that time I have to gradually increase my dose until I reach a certain level where tolerance doesn't develop any further... I don't know if it's the same for you though..
Maybe to begin with 75 the first night and if you don't feel ready for sleep after 30min-1hr then take another 50-75mg would be safer?What do you think?I also think it's very strange that we get tired during afternoon but are full of energy at night..
In current psychiatry vol 2002 they say:"An altered diurnal sleep cycle is another
MAOI-related side effect. Some patients get
extremely drowsy in the late afternoon but then
may have insomnia at night.26 Attempts to alter
this odd cycle by changing the timing of adminis-
tration have generally not helped. We add a stim-
ulantpemoline (18.75 to 35.5 mg), d-ampheta-
mine (2.5 to 5 mg), methylphenidate (5 to 10 mg), or
modafinil (50 to 100 mg)either in the morning or during
afternoon sleepiness, with good effect and no hypertensive
crises. We supervise the effect on blood pressure of the first
few doses. Another helpful alternative has been to administer
trazodone at night to initiate sleep."In another article I found they said that this effect wasn't completely understood.. maybe it's a mystery :D
Good luck Maxime, have a nice sleep tonight!!!
Posted by delna on October 18, 2009, at 4:04:55
In reply to Re: Trazadone and Parnate » Sunbath, posted by MAxime on October 14, 2009, at 21:50:03
Hi,
How are you doing on the Parnate? Have the suicidal thoughts gone or even improved? What dose are you up to and hows the sleep?
Hope you are better
Love
D
Posted by delna on October 18, 2009, at 8:39:46
In reply to Parnate- how are you going » MAxime, posted by delna on October 18, 2009, at 4:04:55
Posted by Maxime on October 18, 2009, at 11:36:40
In reply to Parnate- how are you going » MAxime, posted by delna on October 18, 2009, at 4:04:55
Thanks for asking. I am up to 30 mg of Parnate. I feel like sh*t. I am so tired during the day and not sleeping at night. I tried 200 mg of trazodone last night but it didn't work. I am thinking of suicide all the time and have come close to acting on my thoughts.
I'm not giving up on the Parnate yet because it's too early. I need to get the dosage up.
If I could get a decent night's sleep I think it would make a big difference to my mood.
Posted by delna on October 18, 2009, at 12:03:29
In reply to Re: Parnate- how are you going » delna, posted by Maxime on October 18, 2009, at 11:36:40
> Thanks for asking. I am up to 30 mg of Parnate. I feel like sh*t. I am so tired during the day and not sleeping at night. I tried 200 mg of trazodone last night but it didn't work. I am thinking of suicide all the time and have come close to acting on my thoughts.
>
> I'm not giving up on the Parnate yet because it's too early. I need to get the dosage up.
>
> If I could get a decent night's sleep I think it would make a big difference to my mood.Maxime, how long has it been on 30mg? I'm sad that you are still suicidal. I gave up on Parnate myself and missed 2 days but restarted yesterday at 20mg. Know that you are not alone I am also struggling with suicidal feelings and crippling side effects.
Do you feel you will get a better response at 40mg. If so how much longer do you have to wait?I'm sure a good nights sleep will help. Problem is how to get one. You seem so resistant. I don't know if low dose seroquel has been suggested or if you have tried it but I believe its good.
I hope you find a good sleep aid- sorry I can't help on that one....insomnia has never been a problem for me.Well take care and keep in touch.
Lots of love
D
Posted by Meltingpot on October 18, 2009, at 12:15:03
In reply to Re: Parnate- how are you going » Maxime, posted by delna on October 18, 2009, at 12:03:29
Maxime,
Can't you try taking 10mg of Zyprexa now and again just to get some sleep. I'm not sure if would work for you but Zyprexa has always zonked me out.
It would be definately worth a try.
Denise
Posted by delna on October 18, 2009, at 12:28:33
In reply to Re: Parnate- how are you going, posted by Meltingpot on October 18, 2009, at 12:15:03
> Maxime,
>
> Can't you try taking 10mg of Zyprexa now and again just to get some sleep. I'm not sure if would work for you but Zyprexa has always zonked me out.
>
> It would be definately worth a try.
>
> DeniseDenise
I second that. It really gives great sleep...
Posted by Maxime on October 18, 2009, at 13:06:37
In reply to Re: Parnate- how are you going, posted by Meltingpot on October 18, 2009, at 12:15:03
Zyprexa makes me lactate so that's out of the question. I've always had trouble with insomnia, even before the Parnate. I guess I am used to existing on 3 hours sleep, although at time I just want to collapse.
Posted by ColoradoSnowflake on October 18, 2009, at 15:53:54
In reply to Re: Parnate- how are you going » Meltingpot, posted by Maxime on October 18, 2009, at 13:06:37
Hi Maxime:
I'm so sorry you're feeling so bad. I can absolutely empathize!! I didn't know if I was going to make it or not. It just went on and on and on.
After I got to 30mg./day Parnate and felt really bad, my pdoc told me to just keep upping it 10mg every few days, and he didn't even need to talk to me until 80mg/day He was prepared to go higher. I didn't feel any better until glimmers of hope at 70mg. I still felt pretty bad because I was taking amytriptyline at night for sleep, which was working for sleep but unbeknownst to me was greatly adding to the Parnate fatigue and distress during the day. I was a mess. It wasn't until Scott more firmly encouraged me to drop the amytrip and take nortrip instead. I had really resisted because I was so afraid of insomnia. Like you Maxime, I've always had insomnia, and been suicidal since I was a little girl.When I finally dropped the amytrip and took the nortrip instead it was like Shazammmmmm!!! The BOMB!
I really felt G O O D!! But, when that settled in, I realized I was still pretty tired during the day from the Parnate. Pdoc added the Provigil and that made it all work and I feel great! And no suicidal thoughts!! and no panic attacks, not even anxiety!!I'm still trying to "perfect" my dosing schedule.
I can take all 70mg Parnate plus 25mg Nortript and go right to sleep. But I'm thinking maybe late afternoon then again at dinnertime might be better timing. I'm not sure yet. But it's a small thing. I'm beginning to think it isn't that critical, at least for me, when I dose. Parnate seems very forgiving that way.I hope you get your financial aid squared away so you can take the time you need to get the Parnate squared away, without worrying about finances too much.
When it all comes together for you I think you'll feel great! and want to work again!!, along with having a good life!
Hang in there Maxime. You're not alone!!
I wouldn't add too much other stuff. Just let the Parnate (and whatever is good for your sleep,) work it's magic. It will....it just takes some time....and for some of us, a little more time.Hugs and best wishes,
Gayle
Posted by Maxime on October 18, 2009, at 16:32:24
In reply to Re: Parnate- how are you doing? Maxime, posted by ColoradoSnowflake on October 18, 2009, at 15:53:54
Thanks Gayle. I wish I could find something that would help me sleep. I am not sure if I am tired during from the Parnate, or from simply not getting any sleep.
I am going to titrate up on the Parnate more quickly that I have been. For some reason my pdoc was really conservative with the titration schedule.
But right now, I just want to die. :-(
Posted by Maxime on October 18, 2009, at 17:10:15
In reply to Re: Parnate- how are you doing? Maxime, posted by ColoradoSnowflake on October 18, 2009, at 15:53:54
Forgot to ask, how much Provigil are you on? When I was on Parnate last time, I took Adderall and it worked well. Maybe I need to add a stim. I don't think my pdoc will let me add one until I am at my max dosage of Parnate. He doesn't believe in trying out more than one med at a time.
Posted by ColoradoSnowflake on October 18, 2009, at 17:23:31
In reply to Re: Parnate- how are you doing? Maxime » ColoradoSnowflake, posted by Maxime on October 18, 2009, at 16:32:24
Maxime:
I'm so sorry you feel so bad. What's worse, if you are like me, you're going to feel "more bad" before the good kicks in.
I'm sure you are tired from both: not sleeping AND the Parnate.
I was determined to take as much Parnate as I had to to feel better or die from it, no kidding (under my pdoc's supervision). I had read several places where hospitalized people were titrated up to really hight doses, felt better, then gradually titrated down to a more common level. I think there is something in the brain that has been badly depleted and needs to be replaced, that Parnate does this, but it takes time.... and for some people, it takes a lot of time (like me). But the brain will be "refilled". I obviosly don't have any scientific knowledge about this, it is purely subjective! It took me 5 months to get to a good place, but I had the amytriptyline detour. I wonder how long it would have taken me if I had started with the Nortriptyline.? I'll never know. But my pdoc had made me promise I would hang in with the Parnate for SIX months. I'm glad he did.
The insomnia is a BIT--!! I have to be careful or meds affect me so much the next day the sleep isn't worth it. I'm sorry Scott isn't around. Like Sunbath said, Scott thinks the Parnate insomnia should be treated very aggressively. Scott had some really good ideas about that. He (Scott) even took Haldol with something else very strong for his own worst insomnia. I think maybe Sunbath remembers this and could fill us in.
Insomnia is no joke. I do think you'll get it worked out, but in the meantime it's no fun.
Hugs and more hugs,
Gayle
Posted by ColoradoSnowflake on October 18, 2009, at 17:36:39
In reply to Re: Parnate- how are you doing? Maxime, posted by ColoradoSnowflake on October 18, 2009, at 15:53:54
Hi Maxime:
I think we posted simultaneously!
I take 200-250-300 mg Provigil. I could't take Parnate without a stimulant.
Some people do augment with Adderall very successfully. I have a long history of amphetamine abuse so I have to be really careful about how much I take.
If I'm going to have a "down, easy day" I'll take only 100mg Provigil (50 at 8am 50mg at noon).
I wont go over 300mg no matter what.
I also take some caffeine tablets instead of Provigil sometimes.
It works for me!
Posted by Phillipa on October 18, 2009, at 20:04:25
In reply to Re: Parnate- how are you doing? Maxime, posted by ColoradoSnowflake on October 18, 2009, at 17:36:39
What if you sleep during the day when your're tired? Phillipa
Posted by Maxime on October 19, 2009, at 14:23:42
In reply to Re: Parnate- how are you doing? Maxime, posted by Phillipa on October 18, 2009, at 20:04:25
Phillipa, I would love to sleep during the day but I don't want to mess up my sleep cycle more than it is. Although if the insomnia keeps up, I may have to give in.
Posted by Phillipa on October 19, 2009, at 20:01:54
In reply to Re: Parnate- how are you doing? Maxime » Phillipa, posted by Maxime on October 19, 2009, at 14:23:42
Maxie think of it as shift work and you work the night shift. Phillipa
Posted by MAxime on October 20, 2009, at 12:41:56
In reply to Re: Parnate- how are you doing? Maxime » Maxime, posted by Phillipa on October 19, 2009, at 20:01:54
> Maxie think of it as shift work and you work the night shift. Phillipa
No can do. My mum needs my help during the day.
Posted by ColoradoSnowflake on October 20, 2009, at 13:15:53
In reply to Re: Parnate- how are you doing? Maxime » Phillipa, posted by MAxime on October 20, 2009, at 12:41:56
Hi Maxime:
I, also, try to keep my sleep schedule/cycles normal.I think that's really smart. I live alone and I could get into sleeping all day and staying up all night very easily. I often see people who have allowed this to happen and are even more depressed/unhappy being more out of sync with others. I applaud you. Being on Parnate is a challenge , but it's worth it. I am feeling so much better I can't believe it!! The side effects lesson day by day. It's a crazy drug and takes patience, but Maxie, it's working for me after 15 years when nothing else has!!
Hang in there girl!! Look how far you've come!
Love ya,
Gayle
Posted by MAxime on October 20, 2009, at 15:54:07
In reply to Re: Parnate- how are you doing? Maxime, posted by ColoradoSnowflake on October 20, 2009, at 13:15:53
That's for the positive post. I really hope I start to feel better soon. I'm going to see my pdoc on Friday and ask him for some Ativan. I wish he would give me some Adderall but I don't think he will let me add another med to Parnate until I get to the therapeutic dosage. When I was Parnate last time I used to take it with Adderall and it helped with the daytime fatigue. You're lucky that you don't have any trouble sleeping!
Posted by ColoradoSnowflake on October 20, 2009, at 22:35:23
In reply to Re: Parnate- how are you doing? Maxime » ColoradoSnowflake, posted by MAxime on October 20, 2009, at 15:54:07
Hi Maxine:
You sound a teensy weensy bit better. That good.
This Parnate is really strange. I'm almost at 6 months. I have had the feeling it isn't making me so tired? So I have taken 60mg. today DURING THE DAY!!: 20mg.at noon, 20mg. at 4pm. and 20mg. at 8pm. It's 9pm here. I'll take the other 10mg at bedtimes. I also took 200mg of Provigil. I have been fine today. Just like any other day lately. This leads me to believe I'm at the point that it doesn't matter WHEN I take the Parnate. I don't understand it. Maybe spreading it out now is the best. It really only makes me a little tired now. I think the 20mg at noon gave me a little bit of a stimulant buzz for a few minutes.
That was nice! I think I have been "sick" for so long that it's going to take a really long time to get "filled up" again.
I"m feeling great!! I'm able to do things easily that I haven't been able to do in years. No kidding. This afternoon after doing 20 things earlier and having my grandson, I made 2 birthday cakes for my AA group, decorated them and made 2 birthday cards and made it to my group at 6pm. Unbelievable.
You are going to get there too. It might take you six months?? I could feel glimmers of feeling better in a "deeper" more clear way than I have in 15 years. That helped give me the grit to keep going. Do you feel that yet?
The thought that I will probably have to take Parnate the rest of my life doesn't bother me a bit.
Yes, I really am extremely lucky that I'm not having much trouble with insomnia. I have had trouble sleeping since I was a little girl. I don't understand why I'm not now. I still have the 3am-4am awakening that I've had forever, but I can usually go back to sleep and I don't have that icky obsessive paralyzing fear.
Try to keep a journal. I did because I kept track of everything I ate and my blood pressure. It is amazing to look back and see how terrible I felt for a really long time. My friends thought I was nuts to keep taking something that made me feel so bad, month after month.
It was so worth it!!
I can't wait until this part is over for you!!
You wont believe it!!Love ya,
Gayle
Posted by floatingbridge on October 21, 2009, at 14:46:34
In reply to Re: Parnate- how are you doing? Maxime, posted by ColoradoSnowflake on October 20, 2009, at 22:35:23
Gayle,
Thanks for such an inspirational post--okay, I'm going to hang in there!
And Maxime, you do sound a smidge better, despite your sleep deprivation. I hope so.
Hugs to you both,
fb
Posted by Maxime on October 21, 2009, at 15:13:09
In reply to Re: Parnate- how are you doing? Maxime, posted by ColoradoSnowflake on October 20, 2009, at 22:35:23
Hi Gayle, you write the most inspirational posts. Thank you. It's what I need to hear right now.
I take all my Parnate in one shot. I'm now up to 50 mg. I never split the dosage because when I tried to do that I would always forget the second dose! Luckily I don't get any hypotension from it.
I really hope I don't have to wait 6 months to feel better! I think I am starting to feel a bit better. I am not as suicidal as I was a few weeks ago. Once I get some sleep I will feel better I am sure.
Thanks again for the positive words!
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