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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by tensor on February 10, 2014, at 5:44:12
I'm currently at 50mg of Parnate for depression and anxiety. If I remember correctly it started working at 40mg but the effect wore off after a while and we increased to 50mg. There are not many side effects with the most notable being sleep problems and daytime fatigue (worst). Although I considered myself to be in remission I felt insecure about going back to work, the energy was in the low end and the anxiety was there. I did a lot of exercising to counteract this, but now I have had a period where work is out the question and I have skipped my workout a few times.
So it seems like I respond and then it fades, what do you think I should do, increase dosage? Augment? Will daytime fatigue increase with dosage? I have been on Parnate for about six months in total.Thanks.
Posted by David Hanifin on February 10, 2014, at 8:34:58
In reply to Parnate losing its effect, posted by tensor on February 10, 2014, at 5:44:12
Hi Tensor, I found when I increased the dose of parnate to 60mg I got a calmer response with less anxiety. Unfortunately the fatigue did increase. Having said that I was only on 60mg for about 4 weeks. Of course everyone is different here and many have found that after a period of time the fatigue wears off. Many have also augmented with a stimulant. Talk to your doc about this effect and make sure you get your blood pressure checked - I got a little hypotension at times on parnate (low blood pressure).
Posted by tensor on February 10, 2014, at 9:40:47
In reply to Re: Parnate losing its effect, posted by David Hanifin on February 10, 2014, at 8:34:58
> Hi Tensor, I found when I increased the dose of parnate to 60mg I got a calmer response with less anxiety. Unfortunately the fatigue did increase. Having said that I was only on 60mg for about 4 weeks. Of course everyone is different here and many have found that after a period of time the fatigue wears off. Many have also augmented with a stimulant. Talk to your doc about this effect and make sure you get your blood pressure checked - I got a little hypotension at times on parnate (low blood pressure).
Hi,
I don't know if it's a temporary dip, but I think it has become more unreliable lately. The daytime fatigue is the main issue, I do have modafinil but that one is even more unreliable. I have also had some bouts of anxiety. My doc doesn't have any experience with MAOIs, I'm his first. The problem would be solved if I could take it at bedtime, but it doesn't work. Stims are not an option, the one I could try before Parnate was Concerta and it just made me sleepy.
/tensor
Posted by jono_in_adelaide on February 10, 2014, at 23:00:09
In reply to Re: Parnate losing its effect » David Hanifin, posted by tensor on February 10, 2014, at 9:40:47
You could try pushing the dose, and/or adding nortriptyline (start off with 25mg at night, and work upto 75mg at night over a couple of weeks, then increase again if needed to 100 or even 150mg
It will make you a bit drowsie at first, but this soon passes
Posted by tensor on February 10, 2014, at 23:29:11
In reply to Re: Parnate losing its effect, posted by jono_in_adelaide on February 10, 2014, at 23:00:09
> You could try pushing the dose, and/or adding nortriptyline (start off with 25mg at night, and work upto 75mg at night over a couple of weeks, then increase again if needed to 100 or even 150mg
>
> It will make you a bit drowsie at first, but this soon passesWhat do you think of a tiny dose of edronax/reboxetine? It would be a little cleaner.
/tensor
Posted by jono_in_adelaide on February 11, 2014, at 23:59:42
In reply to Re: Parnate losing its effect » jono_in_adelaide, posted by tensor on February 10, 2014, at 23:29:11
I cant see any reason why you couldnt take reboxetine with Parnate - I'd start off at half a pill (2mg) once a day and work up to 4mg twice a day over a week or so just to be safe.
I sugested nortriptyline because as well as being an NA reuptake inhibitor, it has actions at the 5HT2 receptors which can help with depression and anxiety in and of them selves, although, you're right, reboxetine is much cleaner, and no weight gain
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