![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 42. Go back in thread:
Posted by Phillipa on December 15, 2009, at 0:18:52
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
Hi Gayle a lot of thyroid issues is hasimotos thyroiditis. It really doesn't matter if it's autoimmune or not treatment the same. Don't you get your thyroid levels checked regularly? I get mine done from an endo each eight weeks it fluctuates so much. Could the falling be due to one of the autoimmune disorders you already have? Does the doc think a new or other one. Once a Rheumatologist said I was what he called a mish mash of autoimmune diseases. But so far none others. Have you had an MRI? Just curious. Oh dear the dog I have the same kind and I feel so horrible for you? Nothing you can do? If you like you could write me about the pup. We do have that in common. You maintain such an upbeat attitude I admire you greatly. Love Phillipa
Posted by willyeee on December 15, 2009, at 0:30:46
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
If you need access to more parnate legally email me brklyn234@yahoo.com
Posted by SLS on December 15, 2009, at 6:32:44
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
Hi Gayle.
I am sorry that you have had to experience a worsening of depression since adjustments were made to your treatment regime. I would not be too worried, though. If it is simply a matter of your being underdosed, you should be able to recapture the full response once the drug dosages are returned to previous levels. Tell your doctor that you are willing to take Florinef for hypotension if necessary. My guess is that the hypotension will abate over time, anyway. Please post to keep us apprised.
- Scott
Posted by Doric on December 15, 2009, at 12:22:29
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
I have a suggestion you can discuss with your doc.
I have been on Parnate for years for MDD and though I am fortunate in that BP and diet present no real concerns, the 120mg I require to achieve remission made me feel overheated/wired/agitated.
To overcome this I cut back the Parnate to 60mg a day (3X20mg, or about once every six hours) and introduced 5mg of Dexamphetamine about every three hours and it worked well. There was no loss of mood, function or cognition, no side effects and I was a lot more relaxed and calmer.
Modnafil, is also a consideration, depending on price
Good Luck
Posted by bulldog2 on December 15, 2009, at 18:32:57
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
> Hi
> I've sort of been limping along since my pdoc lowered my Parnate from 80mg to 60mg. I had a lot of withdrawal problems....Good grief, my liver must be shot from my alcohol abuse'''I seem to have more problems with this sort of thing.
>
> I've been having so much itching of my skin all over and chills (as well as depression) that I went to my internist today.
>
> He said I'm in a rough spot because I seem to need the 80mg for depression but it does affect my balance and does make me fall.
>
> I asked him if I could have the tests for Hashimoto's Thyroiditis since I have taken thyroid for 20 years. He looked at me really funny and said I had had Hashimotos for many years and hadn't anyone ever told me??!! No one had. He said I had severe R.A. with high factors(which of course I know), and other auto immune disorders often come with that. He couldn't believe I hadn't had the Celiac test either. So I'm getting a whole bunch of blood tests.
> I sure hope I don't have Celiac. This Parnate diet along with avoiding the foods I'm allergic to is hard enough.
>
> I don't see my pdoc until the end of January. I am getting more and more depressed on 60mg. but I haven't fallen.
>
> Also, I had to have my 17 year old Shih Tsu dog put down on Thursday and that has broken my heart. I'm in so much grief around her loss I'm not sure what's going on with me.
>
> I'm still wondering that I am having so much Parnate withdrawal itching and chills for so long.
>
> Has anyone else experienced that???
>
> I'm like Willy, the Parnate has taken away a deep fear as well as a constant desire to kill myself. I do NOT want to go off Parnate.
>
> I'm only taking 10mg of Nortrip. That is enough to give me really good sleep but it also gives me a lot of fatigue in addition to the parnate fatigue. The Provigil helps but not wholey. I can't take any ssri's or snxi's and I've been on so much other cr*p that hasn't helped me a bit, there's not much left. But maybe my pdoc will have an idea.
>
> Gee, you just think you have it figured out and something jumps out and bites your *ss. It never ends.
>
> I think I'll just grit my teeth, pretend I'm having a good time (the story of my life) and get through this next HARD part until Christmas and New Years is over. And then focus on my meds again.
>
> It's so quiet here on PB lately. I wonder if anyone out there enjoys the holidays?? More power to them.
> Or if people have hunkered down to get through it. Or if people object to their thoughts popping up on every Google search about depression? I do.
> Or being exposed in other ways on the internet, which I don't like, either.
>
> I hope our pals come back.
>
> Best Wishes and Happy (as possible) Holidays to All!
>
> Gayle
>
> ps Scott, I'm watching with great interest to see how you do. It's scary to see you have to give up on Parnate. I hope you don't have to suffer.
> Good luck and wishes and more! Hugs, GayleOne ex babbler had good luck with ritalin and parnate. You could try deplin with is used to augment ads. Deplin is a prescription but natural supplement that helps the brain create more neurotransmitters. You might want to add fish oil to the mix. I have found whey protein to be helpful. Whey protein is easily broken down by the body and helpful in producing neurotransmitters.
Maois help the body make more neurotransmitters. So if you're limited in the amount of parnate you can take feed the body supplements and or meds to make more neurotransmitters.
Posted by floatingbridge on December 15, 2009, at 21:38:01
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
Gayle--
You lost your sweet dog? I am so sorry. Jeez, I think you've had a lot of losses lately. (Hugs) 17 years is like a lifetime. I still think of my lab every day, and it's been three years. We really rely on our canine (and other) animal companions.
So, what about what Scott mentioned? (I don't know the med he named.) Did your internist have any insight or suggestions for you since he said you seem to need the 80? I know the stimulants are out--unless you would respond to something like ritalin or vyvanase (a slow release dexadrine), and you are already on the provigil.
Yes, falling can't be allowed--too risky. When do you see your pdoc again? Can you consult before the holidays? It would be great for you to enjoy yourself....
The celiac test. Hmmm. Would you feel better IF you indeed did have celiac and adhered to the diet--or would it be just another thing to monitor (and deny yourself) without any tangible reward? And other blood tests? Keep us in the loop, if you would.
I know what you mean about the google searches and then finding one's own post pop-up. Sigh.
I'm sorry you've been having a difficult time, Gayle--I hope you get your relief asap. You deserve it!
hugs,
fb
Posted by kirbyw on December 16, 2009, at 0:14:44
In reply to Re: Parnate - 60mg isn't enough » ColoradoSnowflake, posted by SLS on December 15, 2009, at 6:32:44
Gayle
About just going up to 70 mg just to see what happens. Be as careful as possible about preventing falls.
Rick
Posted by bulldog2 on December 16, 2009, at 15:21:26
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
> Hi
> I've sort of been limping along since my pdoc lowered my Parnate from 80mg to 60mg. I had a lot of withdrawal problems....Good grief, my liver must be shot from my alcohol abuse'''I seem to have more problems with this sort of thing.
>
> I've been having so much itching of my skin all over and chills (as well as depression) that I went to my internist today.
>
> He said I'm in a rough spot because I seem to need the 80mg for depression but it does affect my balance and does make me fall.
>
> I asked him if I could have the tests for Hashimoto's Thyroiditis since I have taken thyroid for 20 years. He looked at me really funny and said I had had Hashimotos for many years and hadn't anyone ever told me??!! No one had. He said I had severe R.A. with high factors(which of course I know), and other auto immune disorders often come with that. He couldn't believe I hadn't had the Celiac test either. So I'm getting a whole bunch of blood tests.
> I sure hope I don't have Celiac. This Parnate diet along with avoiding the foods I'm allergic to is hard enough.
>
> I don't see my pdoc until the end of January. I am getting more and more depressed on 60mg. but I haven't fallen.
>
> Also, I had to have my 17 year old Shih Tsu dog put down on Thursday and that has broken my heart. I'm in so much grief around her loss I'm not sure what's going on with me.
>
> I'm still wondering that I am having so much Parnate withdrawal itching and chills for so long.
>
> Has anyone else experienced that???
>
> I'm like Willy, the Parnate has taken away a deep fear as well as a constant desire to kill myself. I do NOT want to go off Parnate.
>
> I'm only taking 10mg of Nortrip. That is enough to give me really good sleep but it also gives me a lot of fatigue in addition to the parnate fatigue. The Provigil helps but not wholey. I can't take any ssri's or snxi's and I've been on so much other cr*p that hasn't helped me a bit, there's not much left. But maybe my pdoc will have an idea.
>
> Gee, you just think you have it figured out and something jumps out and bites your *ss. It never ends.
>
> I think I'll just grit my teeth, pretend I'm having a good time (the story of my life) and get through this next HARD part until Christmas and New Years is over. And then focus on my meds again.
>
> It's so quiet here on PB lately. I wonder if anyone out there enjoys the holidays?? More power to them.
> Or if people have hunkered down to get through it. Or if people object to their thoughts popping up on every Google search about depression? I do.
> Or being exposed in other ways on the internet, which I don't like, either.
>
> I hope our pals come back.
>
> Best Wishes and Happy (as possible) Holidays to All!
>
> Gayle
>
> ps Scott, I'm watching with great interest to see how you do. It's scary to see you have to give up on Parnate. I hope you don't have to suffer.
> Good luck and wishes and more! Hugs, GayleHi Gayle
Really sorry about the loss of your dog. I've had to put down three of my dogs in the last six years due to advanced cancer.Every one took a little piece of my heart.The pain lessens with time but I still see them in my mind every day.
Posted by Maxime on December 16, 2009, at 16:16:21
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
How about trying 70 mg of Parnate?
Posted by Maxime on December 16, 2009, at 16:18:46
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
Gayle, I am so sorry to hear about your dog. Poor you. You are getting it from all ends. Take care.
Posted by zana on December 16, 2009, at 17:58:38
In reply to Re: Parnate - 60mg isn't enough » ColoradoSnowflake, posted by Maxime on December 16, 2009, at 16:18:46
Dear Gayle,
I am so sorry to hear about your dog! I hope you are planning on getting another one. There's a dog out there that needs you. I don't know what I would do without mine.
On top of everything. It just seems so unfair. And of course the holidays are coming up and we're all supposed to be filled with good cheer.
I hope you get all this medical stuff sorted out. It sounds like a complicated picture.
I like the suggestions that you try to raise the Parnate to 70mgs and see if you recapture some of the antidepessant qualities without the falling.
And Scott's idea about the med sounds promising.
Sounds like such a tough time. I'm so sorry. It seemed like things were going really well for a while. With a few twicks, maybe you can get back there. I hope so.
Hugs and Love,
Zana
Posted by ColoradoSnowflake on December 16, 2009, at 19:48:07
In reply to Re: Parnate - 60mg isn't enough, posted by willyeee on December 15, 2009, at 0:30:46
Posted by ColoradoSnowflake on December 16, 2009, at 19:51:28
In reply to Re: Parnate - 60mg isn't enough » ColoradoSnowflake, posted by SLS on December 15, 2009, at 6:32:44
Hi Scott:
I'll ask my pdoc about Florinef when I see him in January.
I do feel a lot more stable on my feet on 60mg, but don't even care about leaving the house!When do you start the Effexor? Good luck!
Posted by ColoradoSnowflake on December 16, 2009, at 20:10:01
In reply to Re: Parnate - 60mg isn't enough, posted by Doric on December 15, 2009, at 12:22:29
Hi Doric:
It sounds like Parnate has worked really well for you for a long time! How many years have you been on it?
I take 30mg parnate and 100mg Modafinal first thing in the a.m.
Then 30mg. parnate and 50-100mg modafinal at noon.Then 10mg nortriptyline at 5 or 6 pm. It still makes me so tired I sleep like a log but am exhausted when I get up in the am at 10am instead of my regular 8am. I'm going to ask him about going off it. Maybe I'll start experimenting with not taking it first.
I am on a stimulant, modafinal.
Fatigue has been my worst worst worst complaint since forever. And nothing I've ever taken has really helped much.I hate going to bed at night because I don't want to get up in the morning feeling as awful as I do when I "come to" and have to put everything I have into it, to get up.
I had this on 80mg parnate, too, but I've been so happy not to have insomnia, that it was ok.
I could take more Modafinal, but at 200mg it gives me that icky "too much coffee" feeling.
I'm happy to hear it's worked for you so well for so long!
Thanks for your suggestions!
Gayle
Posted by ColoradoSnowflake on December 16, 2009, at 20:30:26
In reply to Re: Parnate - 60mg isn't enough, posted by bulldog2 on December 15, 2009, at 18:32:57
Bulldog:
Thanks for the ideas. I'll ask my pdoc about deplin when I see him.I do take lots of good fish oil, twice a day, and I ordered a new kind which is supposed to be even more potent. It's supposed to help R.A (rheumatoid arthritis)also. I got that LifeExtension 5-loxin Boswellia formula you were talking about as well as Sodzyme/wolfberry and also Bromelain, for R.A., but I'm kind of afraid to add more things.
I plan to get some whey protein at Costco tomorrow....can't hurt!
Thanks also for your condolences. It really is hard to lose a pet. I see her everywhere, step over her, open/close a door for her..it's so odd. I know I'll feel better with time. Thank you!
Posted by ColoradoSnowflake on December 16, 2009, at 20:55:48
In reply to Re: Parnate - 60mg isn't enough » ColoradoSnowflake, posted by floatingbridge on December 15, 2009, at 21:38:01
Hi fb:
Thanks for the ideas and support! It feels a lot better to know others are with you and know what you're going through!I got my blood test results today and my internist said I don't have Celiac! My son (the chinese medicine practitioner one) doesn't believe it. He has been telling me for many years I have gluten intolerance. He always tells me he thinks if I did the gluten-free diet I would feel worlds better. I think I do have celiac, but to be honest I'm glad my doc said no because I don't think I could do another diet at this time. I'll do less gluten stuff but only as its pretty convenient. I'm bad.
Doc also said the itching, chills are the parnate. I've got some allergic reaction to it, which I think is right. Parnate triggered my R.A. when I tried to go on it 15 years ago. My doc said I have a lot of autoimmune disorders and my numbers are so high it's a wonder I do as well as I do. So I'm going to stay at 60mg parnate and see if my body calms down with the chills and itching. I wish I could go lower. It's amazing to me that cutting back Parnate would be as big a deal to my body as it has been! It really made me very ill and depressed for 3 days, then one good day, then another 5 days of being sick, and still the itching and chills.
How are YOU fb? Just waiting for January?
I hope you do better with christmas than I do!!Take care,
Hugs,
Gayle
Posted by ColoradoSnowflake on December 16, 2009, at 21:11:51
In reply to Re: Parnate - 60mg isn't enough, posted by kirbyw on December 16, 2009, at 0:14:44
Rick:
How do you get away with doing such a small dose of Parnate??? Have you always taken such doses? I know you said you would go off of it for awhile then on again? It killed me getting on it...5 months of feeling HORRIBLE! It makes me wonder if maybe it's not good for me.
Did you ever have to take larger amounts? Add other drugs..anything like that?
Sounds like you had a lot of guts and determination to keep working when you were depressed...and no one knew it.
I think a lot of us know just how that feels.This drug has confused me from the get-go. Nothing about it makes sense to me.
At least I don't get insomnia from it. Do you? I can't remember.Thanks for your interest and suggestion!
Gayle
Posted by ColoradoSnowflake on December 16, 2009, at 21:23:37
In reply to Re: Parnate - 60mg isn't enough, posted by zana on December 16, 2009, at 17:58:38
Hi Maxie and Zana:
Thanks for your kind condolences. It really is a bitch. Now I'm the only living, breathing thing in the house....pretty creepy.
I'm just putting one foot in front of the other to get through all my houseguests/parties/activities, in one piece, and deal with the meds again in January.
I hope you guys are doing well.
Maxie, do you have any complaints about the Parnate? Do you have a "chemical" feeling? or "out of your body" feeling? Just wondering.Thanks again and take care,
Gayle
Posted by Phillipa on December 16, 2009, at 22:01:55
In reply to Parnate: maxine and zana, posted by ColoradoSnowflake on December 16, 2009, at 21:23:37
Gayle wow you do have a lot of autoimmune never heard of it effecting autoimmune have you googled that? I feel for you. So the doc says stay on it. You are doing so great in managing to function and all the other ordeals your're dealing with. Please feel better soon? Love Phillipa
Posted by Maxime on December 16, 2009, at 22:21:34
In reply to Parnate: maxine and zana, posted by ColoradoSnowflake on December 16, 2009, at 21:23:37
> I hope you guys are doing well.
> Maxie, do you have any complaints about the Parnate? Do you have a "chemical" feeling? or "out of your body" feeling? Just wondering.
>
> Thanks again and take care,
>
> Gayle
>No complaints at all about the Parnate. Sometimes I feel a bit speedy on it but that's it. The Nortriptyline is causing an awful taste in my mouth which is turning me off the little food I was eating. All in all, I am doing really well!
Posted by kirbyw on December 17, 2009, at 0:47:05
In reply to Re: Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 16, 2009, at 21:11:51
> Rick:
>
> How do you get away with doing such a small dose of Parnate??? Have you always taken such doses? I know you said you would go off of it for awhile then on again? It killed me getting on it...5 months of feeling HORRIBLE! It makes me wonder if maybe it's not good for me.
>
> Did you ever have to take larger amounts? Add other drugs..anything like that?
>
> Sounds like you had a lot of guts and determination to keep working when you were depressed...and no one knew it.
> I think a lot of us know just how that feels.
>
> This drug has confused me from the get-go. Nothing about it makes sense to me.
> At least I don't get insomnia from it. Do you? I can't remember.
>
> Thanks for your interest and suggestion!
>
> Gayle
Gayle
Its interesting that back in the 80's many PDocs thought that 30 mg was the maximum safe dose for Parnate, although in fact my Doctor frequently had me on 50 to 60 mg after my hospitalization which was in 1982.Actually I have had problems with insomnia this time around at doses above 30 mg. I would like to be on 40 mg. Also I have interactions with my heart medication, if I take higer doses of Parnate I feel really wiped out, tired with low blood pressure, etc. I have good days when 20 or 30 mg seems just about right, and then I have the bad days when I feel like 40 or 50 would be better. That's part of the reason i am now trying Lithium with Parnate. Its complicated. Thanks for responding to my posts.
Rick
Posted by ColoradoSnowflake on December 17, 2009, at 21:07:32
In reply to Re: Parnate: maxine and zana, posted by Maxime on December 16, 2009, at 22:21:34
Posted by ColoradoSnowflake on December 17, 2009, at 21:13:52
In reply to Re: Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 16, 2009, at 21:11:51
Rick:
I'm really interested in how you do with Parnate and lithium.
Please keep us posted!
Good luck!
Thanks,
Gayle
Posted by Doric on December 18, 2009, at 14:18:53
In reply to Re: Parnate - 60mg isn't enough » Doric, posted by ColoradoSnowflake on December 16, 2009, at 20:10:01
Hello Gayle,
We appear to have very similar symptoms indeed, especially regarding fatigue (I cant take anything that can cause sedation) and staying up late at nightproblems which I have managed to overcome at least for nowby reducing the Parnate and adding in a psycho-stimulant. I can dose at 10p.m. in the evening and still get a good nights sleep.
I have melancholic depression, ADD inattentive and sleep apnoea-each condition clinically diagnosed (just call me action Jackson). Its not difficult for you to see that while these conditions can be separately identifiedthat they are all inextricably linked by a thousand threads. I mention this as I only realized I had ADD about 14 months ago and after seeking treatment for it, it has helped a great deal in making sense out of what each medication is doing, and identifying which symptoms are associated with which conditions.
Parnates role is in treating mood and DexA restores physical and mental agility. If I just take the Parnate alone-the depression is alleviated, but the lethargy persists. If I take pyschostimulants on their own, they restore physical function, but the side effects are unbearableand they do little, if anything at all to improve mood. But when administered concurrently, the Parnate overrides the side effects of the pyschostimulants, while the pyschostimulants boost the mood elevating properties of the Parnate.
The inability or difficulty in actually going to bed and getting sleep, for someone suffering from pronounced fatigue, is very prevalent amongst ADD suffers. (http://www.psychiatryupdate.com.au/article/sleep-continuity-and-adhd-may-be-genetically-linked/463393.aspx).
My doctor was not surprised in the least to find that taking stimulants late into the night actually enhanced sleep, because they clear mind traffic and allow you to relax. The problem with Parnate was that I had to have high doses to achieve remission that left me overheated and wired. Introducing pyschostimulants has allowed me to reduce the dose to an acceptable level.
Good luck
Posted by Doric on December 18, 2009, at 15:36:55
In reply to Re: Parnate - 60mg isn't enough, posted by Doric on December 18, 2009, at 14:18:53
PS. Thanks for sharing your experience with Nortryptine, you confirmed my concerns about sedation.
I will requesting a script for Abilify this week for its stimulant and single daily dosing as an
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
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.