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Decided to stay on Parnate. Questions + comments?

Posted by halcyondaze on January 24, 2007, at 14:05:12

In reply to Re: Parnate side-effects? » psychobot5000, posted by Quintal on January 24, 2007, at 10:01:47

I've decided to stay on Parnate rather than going on Nardil. Parnate just works for me like no other antidepressant ever has before. There are a couple of things I am looking for feedback on, however.

1) DOSAGE: Currently, I am being prescribed 90 mg per day. I am fortunate to have a psychiatrist who is willing to examine the literature and talk directly to psychopharmacologists with expertise in prescribing MAOIs, and so she has agreed that the typical FDA-recommended dose (30 to 60 mg) is not consistent with what generally works, and that 80 to 120 mg is considered a better "range," especially for treatment-refractory patients. My questions are: What is the highest dose of Parnate you have been prescribed? What benefits did you find at higher doses that were absent at lower doses?

2) AKATHISIA: It has been pretty unbearable, and I am certain it is due to Parnate, as it has never happened on any other medication before. My doctor prescribed Cogentin (0.5 mg at night) but last night I had an episode of orthostatic hypotension after taking the Cogentin. We were thinking about Propanolol but doesn't that cause even MORE orthostatic hypotension than Cogentin? Is there anything else I can take for akathisia?

3) WEIGHT: When I first started taking Parnate (both times), I found that I lost a LOT of weight in a very short amount of time. However, as I became used to the effects of the drug, this side effect became absent and I started gaining (also because of the bingeing I do when the Seroquel and Sonata kick in). How can I stop this weight gain? Would going off for a few days and then re-starting it kind of "jump start" the profound appetite loss I experienced at the beginning?

4) GENERIC VS. BRAND: I'm still getting brand name Parnate. It's $30 versus $10 on my insurance but with the Sonata ($50 but my doctor writes it up so I have two months), Seroquel ($50 but my psychiatrist also writes this up or gives me samples), Cogentin ($10), Differin ($50), and Duac ($30), meds are quite an expense for me and I could use the $20. What have your experiences been with the generic version? Parnate is such a fickle drug, I'm nervous about changing formulation.

Thanks all.


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Psycho-Babble Medication | Framed

poster:halcyondaze thread:725840
URL: http://www.dr-bob.org/babble/20070119/msgs/726000.html