Posted by Caedmon on June 2, 2006, at 11:31:53
In reply to Re: Parnate turned me into a cat., posted by Jost on May 8, 2006, at 21:06:09
I've been on 40mg of tranylcypromine for a couple weeks now and I would have to give it a BIG thumbs up for both depression and social anxiety! I am not in remission on either end, but I am much improved. It feels very natural, not apathy-inducing like SSRIs. I have energy and motivation now to do a lot of things - for example, I've taken up jogging, which used to be a hobby of mine. :-)
Side effects have been afternoon sedation - which, sometimes, is intense, although it is less intense now than it was at the start of treatment - and I had a period during which I experienced very mild heart palpitations while laying down. (The heart palpitations are gone now that I've reduced my caffeine.) It has dropped my blood pressure to an average of 107/60.
I'm debating three options in my head. I really think I could get at least the depression into remission (the social anxiety I have had for years, and I think that's just gonna take time and "exposure", yuk). I thought I could try:
(1) Adding a stimulant (methylphenidate, d-amphetamine)
+ Help w/ inattentiveness and sociability (still fairly low areas for me)
+ Compensate for Parnate side effects (tiredness, hypotension)
+ Evidence-based
- Increased physical anxiety, insomnia(2) Adding lithium
+ Decrease depression
+ “Bridging” antidepressant in case I ever need to switch ADs
+ Neurotrophic effects
+ Evidence-based
- New/ more side effects(3) Adding gabapentin
+ Decrease anxiety, depression
+ Hypnotic (cheaper than Ambien!)
+ Few side effects
- Lacks evidence of efficacy(4) Increase dosage of Parnate (60mg?)
+ Theoretical advantage of MAO inhibition approaching 80%+
+ Further decrease anxiety, depression
- Increase tiredness, arrhythmias(?)What do you think is a good option? Any other ideas? Comments? Questions? Thanks,
- Chris
poster:Caedmon
thread:635693
URL: http://www.dr-bob.org/babble/20060530/msgs/651910.html