Posted by Jonathan on August 30, 2002, at 20:54:46
In reply to Parnate-Dosage, posted by Mischief on August 30, 2002, at 2:00:41
... it seems to depend which country you live in!
Here in the UK the British National Formulary (BNF) recommends a starting dose of 10 mg twice daily, increasing the second daily dose to 20 mg after a week if necessary (a total of 30 mg/day), and cutting back to a maintenance dose of only 10 mg/day after a few weeks; "doses above 30 mg daily under close supervision only" which usually means only for hospital in-patients.
http://www.bnf.vhn.net/bnf/documents/bnf.868.html#BNFID_3346
The US Physician's Desk Reference (PDR), however, recommends almost double the UK dose: a 'usual' dose of 30 mg/day (the UK maximum) increasing in 10 mg increments to 60 mg/day if needed. You can find the same figures online at RxList:
http://www.rxlist.com/cgi/generic2/tranylcypromine_ids.htm
I'd place more reliance on the US figures - I suspect that a significant number of British patients who would have benefitted from 40 to 60 mg/day never have an opportunity to try such a high dose because their doctor decides that tranylcypromine doesn't work for them when 30 mg/day proves too little.
A much larger proportion never get to try it at all because doctors don't like to prescribe irreversible MAOIs: "You have to adhere to a strict diet and Parnate is the worst of all - it's also a stimulant!"
I like strong, mature, blue cheeses like Stilton and warm, cloudy, cruddy "real ale" even more than most Brits, but any doctor who believes I'd hesitate to give them up in order to get out of this hell hasn't a clue how depression feels.
I hope the pdocs in your country are more enlightened than mine, Mischief.
Jonathan.
poster:Jonathan
thread:118185
URL: http://www.dr-bob.org/babble/20020829/msgs/118281.html