Posted by Caedmon on June 2, 2006, at 19:50:53
In reply to Re: Bizare reaction to Parnate!-Any advice?, posted by Tom Twilight on June 1, 2006, at 14:00:01
I am three weeks into taking Parnate 40mg. I thought the sedation would never end. So much for being a stimulating antidepressant, I thought!
Past few days it suddenly changed and now I'm all *energetic* and the brain fog is gone. It is a very speedy feeling. It does take time. I've read that it can unfortunately take months before sedation goes away. I think a little modafinil/ adrafanil would go a long way for many of us!
~~~~
"Phenelzine and tranylcypromine have been reported to cause severe daytime drowsiness in a small number of patients. Use of caffeine and vigorous exercise were not helpful. It is noted to be transient but only after months of being on the drug. It is suggested that hypersomnolent bipolar depressed patients seem to be at the greatest risk. The substitution of isocarboxazid is effective in some patients (Teicher et al 1988). On the other hand, MAOI-induced insomnia is estimated to occur in 4-17% of patients. Trazodone 50-200 mg/d was effective in treating this problem in 12 of 13 affected patients (Nierenberg and Keck 1989)."
- from http://www.tu.edu/user_files/10/19.htmlAlso:
J Clin Psychiatry. 1990 May;51(5):192-3.
Afternoon fatigue and somnolence associated with tranylcypromine treatment.
Joffe RT.
Department of Psychiatry, St. Michael's Hospital, Canada.
The author examined a series of 23 depressed and 15 obsessive compulsive disorder outpatients who were treated with 40-80 mg/day of tranylcypromine to determine the frequency and clinical features of fatigue and somnolence. Four (all depressed) of the 38 patients experienced hypersomnolence and fatigue in the late afternoon. The somnolence was severe enough to impair their ability to work and drive. Afternoon fatigue and somnolence appear to be important and not uncommon side effects of tranylcypromine treatment.
PMID: 2335494 [PubMed - indexed for MEDLINE]
***
Am J Psychiatry. 1988 Dec;145(12):1552-6.
Severe daytime somnolence in patients treated with an MAOI.
Teicher MH, Cohen BM, Baldessarini RJ, Cole JO.
Department of Psychiatry, Harvard Medical School, Boston, MA.
Eight patients with hypersomnolent, anergic major depression benefited markedly from treatment with relatively high doses of phenelzine or tranylcypromine but experienced intense afternoon somnolence and disrupted sleep. Reducing the dose of monoamine oxidase inhibitor (MAOI) or substituting isocarboxazid sometimes provided relief, but altering the schedule of drugs or meals did not. Bedtime sedation alleviated the disrupted sleep but had little effect on daytime somnolence. The mechanism underlying this side effect is unknown; sleep deprivation, narcolepsy, or hypotension does not account for it. Patients given an MAOI should be assessed for this disturbance and cautioned to avoid risk of injury when it occurs.
PMID: 3273886 [PubMed - indexed for MEDLINE]
~~~~Good luck,
- Chris
poster:Caedmon
thread:651487
URL: http://www.dr-bob.org/babble/20060530/msgs/652123.html