Posted by ParnateStarted2008 on December 12, 2008, at 17:03:08
In reply to Re: Nardil + Insomnia - Re to 'ParnateStarted2008' » ParnateStarted2008, posted by Vincent_QC on December 12, 2008, at 9:18:02
> > I dont think your Pdoc is very well informed about the different techniques at tackeling Anxiety and Depression. He does have a sound technique tho. Your different like every one else. Many Many people (not most) only get the good effects of Parnate at doses above 60, sometimes WAY higher. Parnate is weird like that. FDA MAX is 60 but really... Parnate's milage varies alot. I just say this from all the post's ive read over the years, not just this site. AND 2 psychiatrists told me 60mg's isnt a very high dose! These drugs are from the 50's, we know alot more about them now. Their underutilization just keeps the standard FDA dose the same and says nothing else. Many doctors still abide exactly. Wouldn't it be great if all docs could get on the 2008 train and do a little research and see whats happening out there/here.
> >
> > Tell your pdoc to read Ashton's Manual on Benzos. Your doctor is somewhat right that the faster your off benzos, the faster U wont have Benzo effects/withdrawl etc. This is not true in many cases. Slow is usually alot better. Benzos are the best first line treatment against anxiety. All these damn ssri/other AD companies are just maketing pro's trying to steal the market. I think a benzo is safer then a ssri/other AD when used properly. ssri's/ other AD's are personality changing drugs with way more side effects and withdrawl effects of their own. Personality withdrawl can be just as hard as benzo withdrawl. Im not against ssri's/AD's, they definitely have their place. But the stigma that benzos are old and rarely used because AD's are better and safer for anxiety is not right. doctors are smarter then that?
> >
> > Maybe he is a great doctor, Maybe you and him arn't a good match.
> > I know i put alot of opinions here... just wanted to express what I thought about your post..:) Im at 70 mg's now.
> > Below 60 I felt OK AD effects but no anxiolytic, above 60 I do: I laugh, im happier and go lucky. Below 60 just task oriented and driven, Felt like Wellbutrin a bit.. Thats just me
> > keep us poster Vince
> > Later
> >
>
> Thanks for the answer mister ParnateStarted2008 ;-)Oh I have a question, maybe dumb but.. is a "pdoc" a regular family doctor or a Psychiatrist? Im guessing its a psychiatrist when people use that term.
Hi Vincent, fellow Parnate Starter. I am amazed by your story and struggles and accomplishments. Your story is extremely interesting to me. Here is a little bit about who I am:
-I live in Canada, British Columbia. I went to college in Alberta on and off over the last 6 years.
-I'm 23 years old, almost 24
-Ive had social phobia all my life
-By 17 I became agoraphobic and depressed and began my journey of medication and councelling.
-Between the age of 18-23 I have abused alcohol heavily and benzo's only a few times
-This summer I was diagnosed with Bipolar2
-I often get completely obsessed with psychotropics to 'fix/help my life' as do alot of people here I bet
Thats me in a NutShell
>
> For your information, I live in the Canada, mean that the medical system here is Public, we don't pay for the Hospital or to see a Doctor. So we have no choice over the pdoc or family doctor we get, or even the medical care we get, everyone have the same quality of service and we have to WAIT and WAIT a long time before seeing a doctor or a pdoc.
>What province are you from? I pick my doctors (family and psychiatrists) and usually give them an interview on what they treat, knowledge with my problems/medications, etc. That also alows me to see if I will get along with him/her. There are different clinics here and I can easily go to any one of them and ask which doctors are taking new patients (i've moved around here and Alberta and had many different doctors and Psychiatrists). If my doctor refers me to a Psychiatrist whom I do not like I will get refered to a different one or have CanadaMentalHaelth facilities find me one.
I'm sorry if this makes me sound spoiled, I really dont mean to do do that or to brag, but I feel the upmost sympathy for you and couldn't imagine being stuck with a doctor I dont like. Maybe its because of your province. This sounds very odd to me. I can always go to a walk in Clinic anytime and get a referral to a Psych or even ask if they are taking new patients when not doing their walk in clinic hours...>
> So, yes, last summer I go by myself to the emergency of the regular hospital, since we can't go directly to the psychiatrist hospital, we have to go to the emergency and see a psychiatrist there and wait in a close room with others people, when they find a place to "dispatch" you, at the psychiatrist hospital, you move there...but sometimes it's a long process...and I was not interrested to wait 3 weeks in this close room... I was on more than 12mg/day of Xanax, I was unable to speak, I was totally lost, I was at the same time on 337.5 mg/day of Effexor-xr... I had to wait 3 days in that close room, with others people with worse conditions than mine... I had no right to go outside even just to smooke a cigarette, I had to put a nicotine patch, I had no right to have people visiting me...I had to wait my place at the psychiatrist hospital...After 3 days, In the middle of the night, I just sing a paper telling that I was refusing to receive my treatment and I return to my home...
>Where are you.. that sounds horrible. Here I can walk straight in with a note from my psychiatrist if I need to. When I was sent without my own consent I was placed in a room by myself for 24 hours so they could monitor me, it sucked, but then im out in a new room, usually shared, and able to walk around the unit regularely untill im well enough to leave.
I feel really bad writing this because I make it sound so easy. My illness is not easy or is finding a good doctor. I've gone through hell and came back many times..I see my family doctor the morning after, we do a withdrawl cedule of the Xanax, a slow reduction cedule, He give to me some "Mirtaprazine" (Remeron) to help me to sleep, and I do my withdrawl alone at home...and It was the worst period of my life... It take more than 2 months before I begin to feel more well...Cutting the Xanax pills in small pieces was just a loose of time...I ask my family doctor to put me again on Valium at the stade of 2 mg/day of Xanax. I withdrawl fast from the Xanax, a lot more faster than what my family doctor wanted, he said that it was dangerous to do it fast like this... I Remember that in one week I go from 12mg/day to 4 mg/day in one shoot.>
>Thats crazy!
>
>I had terrible withdrawl effects you can trust me on that. The psychiatrist I had at the time was on vacation for 1 month so I was not able to reach him!!!
>
> Anyway, after that "adventure"...I meet again the pdoc I had at the time, he put me on Cipralex (Lexapro), told me that it was the most effective SSRI in the world, the most selective also for the SE, with the less side effects!!! lol Never believe a pdoc...it was the harder AD I try in my life, the one with the most side effects, I already do migraine 3 times a week, but with the Cipralex it was everyday...I gain a 40 pounds, and still gain weight and the headache never fade away also...My SE are probably a lot high cause the side effects from the cipralex don't fade away even if I stop it since 1 1/2 months now. I never felt any improve on the Cipralex (Lexapro). In fact, I lost all the interest I had in my life on it, at the end I was not able to stay 2 minutes in front of my laptop, I had no concentration at all, I had severe insomnia, more bad than usual, I was tired all day long, always lying in my bed, no motivation at all...The pdoc at the time told me to take 30mg/day of Cipralex insistead to the 20mg I was taking and I just say no!!! He add some "Ritalin" on the top of it to give me some energy but it was worst, I was just feeling more anxious, anyway coffee boost more the energy than Ritalin...he add also some Wellbutrin in the top of that...It was a crazy combo and I was so TIRED of everything that I stop cold turkey all the drugs at the end of October...
>I tried cipralex too. I was on it for about 1.5 months. I dont remember very much because it made me soo tired I just slept everywhere even on a hard floor for 24 hours. I tried up to 30mg's too. It did absolutely nothing.
>
> The pdoc leave his job and I was switched with the new one..So I see a new pdoc since than, at the same psychiatrist hospital, but the one I get now is one of the best I can get...he win a lot of prize every year for his work...His approach with me is normal and I feel very confident with him. I think they have all their goods and bads sides anyways...The new one seem to not like the benzo drugs, but he also read all my medical folder and he know that i'm addicted to them, so maybe it's why he want me to be free of them soon!!! I think he know more things about the benzo drugs than you and me...and BTW he know the Ashton book...He surf on the web often and it's in his favorite links...He often use it, sometimes for the charts comparaison, sometimes for the withdrawl effects...things like this...He just told me that in my case, benzo drugs can't help me anymore. More of them will just make me feel more depressive and make me feel like a zombie...and like he said, the goal to reach is not to make me feel like a zombie or being numb...
>Thats good news! He sound pretty darn good to me. And I totally understand now how much benzo usage you have done. Glad to hear he knows how to help you with that.
> Well, I meet my pdoc last tuesday morning, I ask him about the fact that I was wondering if I was not Bipolar...I answer some questions, and he told me that I was not bipolar at all...BUT he told me that if I fail to answer to the Parnate, it will be a good things to try something like Lamictal (even if he don't like it at all, St-John syndrome or something like that...)
>This is Extreamly rare 1/1000 and almost non-existant if you titrate slowly as recomended. Lamictal has the lowest side effect profile of any mood stabilizer. It also has an antidepressant effect. Its a good ad-on to any AD to make the AD more effective, just like lithium. Lithium might be better for some people but has more side effects then LAmictal but not many when we compare it to other mood stabilizers.
> He is not against benzo drugs, he just don't like the fact that they just act like a band-aid, without curing the main problem. It's also my decision, not just hers...And I don't want to take them all my life, cause they decrease my cognitives abilities. Since I take them (2005), I lost maybe 70% of my capacities, I mean intellectual capacities as well of my concentration level and my productivity... I don't want to be a Zombie all my life , and I prefer to have anxiety feelings sometimes than feeling just like a numb all day long. Anyway, anxiety is normal, everyone have some anxiety or stress...I just have to learn to control it...and it's what I do now on my CTB...
>
> Like I write before, I try everything except Lithium, Lamictal and others mood stabilizers.
> I always feel worse on all the SSRI's, SNRI's, a lot of the TCA's (they don't work for social phobia and anxiety...and their side effects are SO hard to support...I can't tolerate them at all...), I feel worse on all the drugs like Lyrica, Gabapentin (neurotin), Topomax, wellbutrin xr, ritalin, name them...I try everything, except the Parnate!!!
>
> So the Parnate seem to be the last ressort for now. The new Cymbalta (New in Canada, not in the USA), seem to be a less effective effexor-xr version...since I never improve on effexor-xr, in fact I always feel worse on it, remember my visit at the hospital last summer...So I think that's not worth the trial, and it cost more than 300$ by month here...I can't pay for it and I don't have insurance, so forget it...Anyway, my sister take it since it's on the market, she was on Celexa before and she don't improve at all, she have AD episodes with a lot of anxiety...it's in my familly tree. Genetic problem I think.
>
> The main problem I have with the benzos drugs semm to be the addiction. Give me one pill of Clonazepam (Rivotril) and my brains will be craving for all the bootle at the same time, I totally lost the control on the intake of them. Since I had a street drugs and alcohol addiction in the past, I just can't control myself. You cannot blame me for this, benzo are powerfull drugs, some people don't have the addiction problem and can take them all their life, but in my case forget it. I know myself and I know I will always ask for more, even if they don't do anything now on my anxiety. I take my small amount of valium just to prevent withdrawl effects, I fear to have a seizure, and that's strange sentation in my head make me feel very anxious...
>
> I always find it more hard to stop the more powerfull benzon like Rivotril or Xanax by reducing the dose by 10% each week than just cut more fast the dose. It's why I ask for the valium...that's more easy to stop since it stay in the blood for a long time, the smaller pill is 2mg, you can cut it in 2 parts or 4 parts...it's make it more easy to cut the dose in smallest parts. I plan to reduce my 20mg/day valium by 1 mg each weeks, but not before I get some positives answerd from the Parnate.
>
> You see, everyone is different...you're right on this, but I read a lot about the AD drugs, and for anxiety and social phobia problems, when the AD is just a comorbidity, the MAOI's seem to be the drugs of choice. The nardil come first but the Parnate is the second choice, forget about the reversible MAOI like the Manerix (Moclobemide), that's not effective for social anxiety, no wonder why it's not approve by the FDA... My family doctor who is an expert on AD drugs tell me that it's not more effective than a regular SSRI for social and general anxiety.
>
> The main problem with the Parnate seem to be the insomnia, not the anxiety, I know it's similar with stimulant by his structure and it's DA effect, but since i'm already anxious and I already do a lot of panic attacks, I don't see why I can feel worse on it cause the situation can't be worse than what I live now!!! For the insomnia, it's the same, I don't see why it can be a problem for me since i'm used to sleep only 2 or 3 hours by night and now I know that I can take a little bit of Unisom of Gravol or benadryl to help me to sleep, without having a SE syndrome...
>
> Nardil was also very hard for the anxiety and the insomnia, even at 90mg/day, I was always anxious. I remember that I augment my intake of coffee and cigarettes on it also. The only good effect I get on the Nardil was the fact that I was able to reduce my intake of Clonazepam at the time, I was at 8mg/day and I go down at 4mg/day (It was in the begining of 2007, before I ask to be put on the Valium.
>
> The Parnate seem to act the same on the anxiety side, at 10 mg at least. Finally, my pdoc will probably increase it until I reach the 60 mg...after he will see...it will depend on how I react. I will see how I will feel on 20mg...if it's worst, I will increase my dose more slowly. I have the same point of view than my pdoc now for the SLOW augmentation of the AD dosage. Before, I always wanted to go faster and I often take more pills than I was suppose, but I learn now that faster is not equal to succes...I learn my lesson.
>
> If I well remember, Lexapro, Celexa, Zoloft, Wellbutrin, and all the newer AD's are a lot more harder on the anxiety...for me at least.
>Me too. I have the same amount of side effects on Parnate but they are different and I dont mind tolerating them as long as Parnate keeps working and gets better. Insomnia, over stimulated feelings, short bouts of anger are the main side effects im getting with Parnate. Its pro-libito for me.
> I don't like the fact that the FDA or Health Canada approve them and said that they are less dangerous than the oldest drugs. In fact, I find them more harder on side-effects.
>I agree completely. I feel human on Parnate and to a lesser extent Nardil. All the ssri's, snri's, sndri's and serotonin pumping type AD's ALL made me emotionless and I could never deal with their side effect profile.
> Anyway , it's my point of view. Thanks for the advise...I hope I will react good on the Parnate. I continue to think that it will not be more hard for the anxiety than all the newer drugs. I think my brain don't react like others people, maybe a more stimulant drug will help more, maybe not, I just don't want to start me Parnate treatment with negatives thinks...
>
> I will keep you inform of the situation.
>
> Thanks again!When I tried my first drug, Paxil, for SP I became very manic and happy. Life was the best thing in the world. I could do anything. Nothing could hold me back. I still couldn't give presentations but other then that I became the most talkative/popular/annoying person in any group, I was a King in my eyes. I loved it(this was a symptom of my Bipolar2 to some extent). I lowered the dosage once to try and regain my libito and BAM! Paxil never worked again nor did any other AD except Nardil a little bit. Parnate is the best so far.
Im at 70mg for 4days now. Its doing a OK job for SP. DEPRESSION(i dont think anyone could get depressed if on Parnate lol)well I feel like that anyway.
Ok, sounds like you have a plan in place, good luck.
Chow4Now.
poster:ParnateStarted2008
thread:866860
URL: http://www.dr-bob.org/babble/20081204/msgs/868338.html