Posted by Geezer on December 14, 2002, at 10:52:48
In reply to Re: Parnate to SSRI After ECT???, posted by ItsHowdyDudyTime on December 13, 2002, at 18:03:48
> > Has anyone made a successful transition from Parnate to an SSRI following ECT treatments? I completed a series of 11 ECT treatments one week ago. I have been taking Parnate (currently 40mg. in divided doses) for the past six weeks. I just can't tolerate the Parnate - it makes me so tired I fall asleep in the afternoon. It is my understanding I would have to be off the Parnate completely for two weeks before starting an SSRI and continue to follow the MAOI diet for one month. Prozac is the only drug that ever gave me any relief (prior to poop-out after 18 months)......I am thinking of going back to Prozac and possibly adding pstims. I am DEFINITELY trying to live with TRD and just about at the end of my rope. The constant tired feeling is more than I can tolerate - I am not going to spend the rest of my life in bed. Any suggestions welcome. Thanks.
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> Geeezer, this is just a guestimation or speculation, so take it with a grain of salt. But your problem with Parnate might have to do with the fact that you are trying it right at the end of an ECT trial. Keep in mind ECT increases dopamine a lot all by itself. Throwing in a potent dopaminergic antidepressant like Parnate right at the end or in the middle of a session of ECT might amount to a simple surplus of dopamine, with resulting psychosis or "flattening" affect and catatonic feelings as you have been describing in your posts.
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> In Max Fink's book "Electroshock: Restoring the Mind" Dr. Fink mentions this. He discusses using ECT for treatment of parkinsons disease. He talks about how people with parkinsons who take dopamine agonists like leva dopa usually have to sharply reduce their dopamine agonists during and after the ECT sessions. IF they dont, oftentimes they will become frankly psychotic or catatonic. Get the book and read it for yourself if you want.
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> I read your posts and this crossed my mind. ECT plus Parnate might equal TOO MUCH dopamine in your brain. On the other hand, if you stop the ECT and wait six months to a year, you might be able to handle 30 to 40 mg parnate just fine. Or possibly another MAOI such as Nardil. Some can tolerate Nardil or Marplan just fine but just cant hack Parnate.
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> Howdy DoodyHey Howdy,
Welcome back. That is a good possibility re: the dopamine effect from Parnate following ECT. The last ECT treatment was 9 days ago so we will see if that has any effect. I do have Max Fink's book here and will go back and read it again. At this point I would have to say Parnate is the most unpredictable AD I have ever taken, it might wake you up.....put you to sleep.....leave you with fits of anger - right now I am fighting sever insomnia at night. This all changes from day to day so each day holds a nasty surprise. Went through the futile effort of calling the pdoc-he doesn't return calls (the two before him just gave up on me and told me to find another pdoc...thinking of changing over to plumbers or electricians for better results).
I would love to get back to an SSRI even if it did last for only a year. The best effect from an SSRI (actually everyone here complains about it) is "emotional blunting" or that "who gives a d***" attitude. Until someone comes up with an AD that works better I'll opt for the "who cares zone".
Let me know how you are doing.
Geezer
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poster:Geezer
thread:131335
URL: http://www.dr-bob.org/babble/20021210/msgs/131791.html