Posted by jparsell82` on December 31, 2004, at 0:47:34
In reply to Re: About high-dose Parnate treatment » jparsell82`, posted by King Vultan on December 29, 2004, at 20:39:32
> > I've read Chairman_Mao's information and experience about high dose Parnate and the 1989 study on pubmed.org. Anyways, is anybody on Parnate here considering trying this out? Chairman_Mao made it sound really good. Especially because I don't think there are a whole lot of good drugs you can augment Parnate with for Social Phobia, Depression, and ADD. Anyone asked their doctor about trying it? I think it would be hard for me to find a doctor willing to try this. I know of a really cheap Parnate source on the internet but even still it would cost nearly $150 to take 100mg/daily. And I don't know how high you would need to go...
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> I've been on Parnate since August and at 60 mg/day for about 6 weeks now. I am doing reasonably well but am not quite where I want to be moodwise and in a few other areas; for instance, my libido is still very much on the low side, which is surprising in view of Parnate clearly being quite dopaminergic. In thinking this all over, and considering my reactions to the other umpteen drugs I've taken, I believe that one thing that is occurring is that I am suffering some serotonergic related side effects from the Parnate increasing serotonin transmission. It would seem that one of my fundamental problems may be that I simply have too many 5-HT2A receptors, given the severity of the insomnia and certain other side effects I've suffered taking SSRIs.
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> So rather than ask my pdoc to increase my Parnate dosage at this point in time, I've decided to pursue an augmentative strategy of adding a 5-HT2A blockader to see if my thoughts on this may be correct. Risperdal at low dosages (0.5-1.0 mg/day) is apparently the most selective 5-HT2A antagonist available, and my pdoc was quite aware of the potential benefits in using this kind of agent to augment drugs that increase serotonin transmission. I started at 0.125 mg/day for six days and just went up to 0.25 mg/day a few days ago. Even at this extremely low dosage, I'm already noticing some improvements, particularly, in the area of agitation and racing thoughts. I have a tendency when I read or think for my thoughts to get ahead of themselves, resulting in a certain amount of agitation and anxiety. I can already tell that the Risperdal is having some beneficial effects in this area, and I have not noticed any side effects as of yet. I think 0.5 mg/day is probably a good target to shoot for at this point, as I also have some concern about getting too high in dosage and starting to blockade substantial amounts of dopamine D2 receptors, which I certainly don't need given my ADD symptoms and anhedonia, as well as my general lack of any psychotic or manic symptoms.
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> So in my case, while I think it might make sense to go up on the Parnate in the future, particularly given the large improvement I noticed in drive and motivation going from 50 to 60 mg/day, it just seemed to make far more sense to try to augment it with something else at this point in time. My opinion and experience is that especially when you are already at a high dose of a drug, it may make more sense to explore possible synergistic effects with other drugs rather than just throwing more and more of the main drug at it.
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> ToddHey Todd,
I hope this Risperdal works well for you. It probably is the most selective ap you could get. With my social phobia, I've read a study that people with social anxiety disorder have lower binding potential for the d2 receptor than healthy subjects so I'm going to stay away from D2 blockers. (Note: I have been on Risperdal a long time ago combined with Prozac). Anyways, my other problem with Risperdal is I've read it raises prolactin a good deal and I really wouldn't want that. But, all the other anti-psychotics that don't effect prolactin as much or at all aren't selective enough... like you said... and they effect way too many receptors. Perhaps the raise in Prolactin won't pose a problem for you or you can use another med to block that effect... I don't know??My current status with Parnate is as follows. I've increased to 60mg a day now and don't really feel any different than on 30mg. I haven't had many side effects at all since day 1 on Parnate. The only ones I really have now are some insomnia, daytime weakness/drowsiness(really bothers me), urinary hesitance(getting better), weird appetite and maybe some other little things. The only things that bother me are the insomnia which I think I'm gonna try out Zopiclone for that. It has a shorter half-life than Ambien so no morning drowsiness. Plus I tried it before and it was pretty strong. And the other thing is the daytime drowsiness and lack of motivation,etc. which I think may be somewhat(not all) related to my low blood pressure. I always have low blood pressure on Parnate... you have any suggestions? One day, I even ate a bunch of cheddar cheese fries, took 200mg of provigil, a caffeine pill, and some rhodiola rosea because I was tired and my bp was low... I wanted to test it out... still my bp barely raised. Anyways, hopefully when I get the chance to try a short trial of high dose Parnate it will help my ADD also. Good luck with your ideas and let me know of any success or interesting augmentations. Thanks.
Josh
poster:jparsell82`
thread:435178
URL: http://www.dr-bob.org/babble/20041228/msgs/435898.html