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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by ben on November 24, 2012, at 13:55:22
I know that Parnate should be used with stimulants under very good control but I think I need one.
I`m taking 120mg Parnate in the morning beside mood stabilizers (Lithium, Lamotrigine and Oxcarbazepine) and other meds; Doxepine for sleep and augmentation of the MAOI as well as Thyroxin for Hypothyroidism (caused by lithium). The combo is really good and I`m stable on it for month after I tried a lot of several combos and most of all ADs.
The problem is that I feel a lot of fatigue especially in the afternoon and evening. There is a lack of drive to do something. I changed the regimen of the Parnate by splitting the dose to twice or three doses daily. I tried several variants but nothing worked. I remember when I started with Parnate then the tiredness was worser. With each increase of the dose it was better until 80mg then it stopped. We went higher because 80mg caused a poop-out and since I`m on 120 mg it didn't happen again.
Do you have any experiences in taking Parnate with stimulants? My blood pressure is 110/80 mm Hg. I`m espacially interested im Methylphenidate and Dexamfetamine. I take Methylphenidate for sleep deprivation to keep awake. I hadn't a bad experience with this combo but the dose was very low (30mg) - my pdoc recommended. I think I have to take more (after discussion with my pdoc). Dexafetamine would be interested because I gained a lot of weight on this combo. My own research is that a lot of patients suffer from weight gain during taking Parnate (especially in combo with lithium). Do you have any inputs about Dexamfetamine and Parnate for stimulation and weight loss?
Thanks
Posted by alchemy on November 25, 2012, at 18:53:09
In reply to Parnate and Stimulants / fatigue / weight gain, posted by ben on November 24, 2012, at 13:55:22
I don't have long term experience with Parnate, I am just coming off of 40mg. (btw, when did you notice that Parnate was helping?)
I thought Parnate was more likely to cause weight loss...? It seems to make me less hungry. I did notice that for me I needed to spread it out during the day (which is a pain).
I have taken Ritalin a few times with it and didn't notice a problem. But of course I am not at a high dose. My pdoc would kill me if he knew that, but because I saw that many people took both I felt ok about it. I'm pretty sure I read some instances where people were at a higher dose of Parnate along with stimulants.
Strange for me, but Ritalin seemes to been like a sugar pill for me with Parnate.
Anyway, I'm sure you will get some more relevant experiences or answers here.
Posted by ben on November 25, 2012, at 22:02:01
In reply to Re: Parnate and Stimulants / fatigue / weight gain, posted by alchemy on November 25, 2012, at 18:53:09
@alchemy: Parnate kicked in very quickly but each dose pooped out after ca. 2 weeks so we have to go up. From 100mg I was stable but I take a lot of other drugs too how I mentioned. My pdoc has one patient who is over 200mg/day without any problems of blood pressure or great eating restrictions.
I tried to eat chocolate, cheese and wine as well as beer. I dont have problems when I drink a glass of wine or beer. As well as eating chocolate or cheese. I stared very slowly with these drinks and nutrition and watched carefully how my blood pressure is reacting and my overall feeling is. One I had a pressure of 180/90 mm Hg and I had to take a Nifedipine 10mg Tablet slow release. These tablets I have allays in my pocket, wallet and bags.Please DO NOT try to eat or drink these things without discussing it with your doc and without any emergency medication (nifedipine). You should also have a blood pressure measuring machine to monitor your blood pressure.
Posted by ChicagoKat on November 28, 2012, at 13:26:51
In reply to Parnate and Stimulants / fatigue / weight gain, posted by ben on November 24, 2012, at 13:55:22
Any stim will help to curb your appetite, and I know from personal experience how MAOIs can cause weight gain, but it was my understanding that Parnate was not as bad in that department, but then I have never personally tried it. And it's kinda weird that you get sedated on Parnate, it's supposed to be activating. But then, all our brains are different. Hell, my beloved Nardil that used to help *so* much with my anxiety, turned on me and made me anxious. Now that is REALLY weird.
It does sound like you need some kind of stim, but ask your pdoc and be very careful. You are on a damn high dose of Parnate, plus you take a TCA too. If you could lower your dose of Parnate, or if you could take something else for sleep it would be a lot safer to add a stim. And in addition to helping with your fatigue, a stim would augment your MAOI for your depression, so you would not need to worry about stopping the doxepin very much. Whatever you decide I wish you luck.
Kat
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