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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 ed nieg on May 21, 2019, at 17:50:36
I've been on it for a few months and I just can't take it anymore, the insomnia is opposing the AD effects of Parnate. I basically feel like I'm at square one and not taking anything, except for the fact that sleep is impossible. I've tried TCAs, benzos, etc. and none really work for the insomnia.
Do I begin a slow taper? I'd like to come off as quickly as possible so I can begin a washout and regain normal sleep.
Posted by linkadge on May 28, 2019, at 14:38:46
In reply to How to taper off 40 mg Parnate?, posted by ed nieg on May 21, 2019, at 17:50:36
You can probably reduce 10mg every 5-7 days.
You might try a lower dose with some kind of medication for sleep. Parnate can be a very effective medication, but I agree, the insomnia is difficult.
You might try 25-50mg of Seroquel. The insomnia is, in part, mediated by elevated dopamine. A low dose of dopamine antagonist like Seroquel, might help.
I remember being on parnate, and I discontinued because of insomnia. It is a decision I regret because, as I was reducing, we also added some Seroquel. In the middle of the cross taper, I felt really good, but this faded when I got off parnate completely. I always wish I had stuck to some parnate with Seroquel.
Linkadge
Posted by SLS on May 31, 2019, at 10:40:55
In reply to How to taper off 40 mg Parnate?, posted by ed nieg on May 21, 2019, at 17:50:36
Hi.
> I've been on it for a few months and I just can't take it anymore, the insomnia is opposing the AD effects of Parnate. I basically feel like I'm at square one and not taking anything, except for the fact that sleep is impossible. I've tried TCAs, benzos, etc. and none really work for the insomnia.
>
> Do I begin a slow taper? I'd like to come off as quickly as possible so I can begin a washout and regain normal sleep.I agree with Linkadge.
I must ask, though, how has Parnate improved your depression? Are you responding to it better than all of your previous treatments? In the past, doctors have used trazodone to treat Parnate insomnia. I like the idea of trying Seroquel first if you have not done so already.
Are you having problems falling asleep or staying asleep? I had both when I combined Parnate with desipramine. My doctor at the time gave me Halcion (triazolam) with Ativan (lorazepam). Halcion is potent, and will put you to sleep fast. However, its half-life is very short, and rebound awakenings is a problem. To address this, Ativan was added because it has a longer half-life. I doubt that you will persuade a doctor to prescribe Halcion, but Ambien might make a good substitute. Ambien and Ativan can be taken together safely. However, I cannot recommend the dosages that would be appropriate for you. Perhaps searching the Internet will help.
- Scott
Posted by Stargazer2 on June 26, 2019, at 0:19:25
In reply to Re: How to taper off 40 mg Parnate? » ed nieg, posted by SLS on May 31, 2019, at 10:40:55
I tapered off 75 mg Nardil in about a month.. it was a lot easier than I thought it would be. I think I went down 15 mg every 5-7 days.
This is the end of the thread.
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