Posted by christophrejmc on June 6, 2006, at 7:48:16
In reply to My Parnate Experience...what went wrong?, posted by Crazy Horse on May 30, 2006, at 11:22:57
I'm currently taking EMSAM and I think most would agree with me that it's just as bad as Parnate with regards to insomnia (I'm typing this after a sleepless night). Still, I think it may be worth trying if you've exhuasted all other options.
Was your doctor willing to try any benzos for the insomnia? In my opinion, Seroquel and (perhaps especially) chloral hydrate would not be appropriate medications in your case. I know a lot of pdocs have been using Seroquel as a sedative, but I think the very real risks and side-effects of neuroleptic medications outweigh any benefits except in cases of psychosis, mania, or serious obsessive symptoms (eg: suicidal ideation). Also, I believe that, like most atypical neuroleptics, Seroquel is a direct agonist at certain serotonin receptors--mixing any serotonergic drugs with an MAOI is definitely not something to take lightly. Chloral hydrate and Halcion are both considered to lead to habituation and development of tolerance so are usually only prescribed for short-term use. Also, all of these are particularly horrendous in terms of lingering, day-after drowsiness and fuzzy-headedness.
I know exactly what you mean about the daytime fatigue.. I would literally pass out during class when I was on a comparatively tiny 30mg dose. I tried adding Provigil, which helped the first couple of days before it quit on me and just made me extremely anxious (it also caused a significant change in blood pressure). My doctor has had a lot of success with adding Ritalin to MAOIs, perhaps that would be something to discuss with your doctor if you go back on Parnate.
Unless you're doctor insisted that you stay the course with Parnate (or it was clearly providing you relief from your depression), I don't think being more aggressive would have been very effective. He may have had concerns about your safety--doctors are reluctant to even prescribe MAOIs alone let alone in potential dangerous combinations. Unfortunately, unnecessary litigation (I take it you've heard of Libby Zion?) has caused many psychiatrists to put their [I assume Dr. Bob still considers "*ss" a violation of civility?]es before their clients' sanity, especially as far as MAOIs are concerned.
If you haven't tried Nardil yet, I would definitely recommend doing so; orthostatic hypotension was the only side-effect I ever experienced while on it.
Best of luck whatever you do.
-CJMC
poster:christophrejmc
thread:650434
URL: http://www.dr-bob.org/babble/20060604/msgs/653540.html