Posted by Vincent_QC on December 27, 2008, at 10:28:57
In reply to Re: Parnate + orthostatic hypotension (30mg/day) » Vincent_QC, posted by SLS on December 27, 2008, at 8:13:48
> Hi.
>
> I believe that there is still a good chance that your body will accommodate to the hypotensive effects of Parnate. It may take several weeks once you reach 60mg for it to mitigate. As you point out, you and I have different biologies, so there are no guarantees that you will respond the same way I have.
>
> It is too bad that the GSK and PDR literature recommend 60mg as the maximum dosage of Parnate. I have found that many of the doctors who have the most experience with Parnate suggest that the true dosage range for efficacy is 40-80mg.
>
> There is clinical and pharmacological evidence that Parnate at dosages above 100mg exerts effects not seen at the lower dosages. I found 150mg very tolerable. It was more helpful to me at that time than were the lower dosages.
>
>
> - Scott
>Hi Scoot ;-)
I totally agree with you again. I'm maybe less tolerant with the orthostatic hypo effect provocated with the old MAOI's, but you know what, I begin already to get use to it. I mean that I know I will not die of it. So having less anxiety in face of that problem make it to became not a problem, I don't know if you understand what I mean? My english is not at is best...sorry...If I feel dizness and a change of my vision with tinnitus, I try to think about something else and my heart pulse slow down immediately and everything return to the normal after 3 minutes... But like you write, it tend to fade away with time, that less bad than what I experienced 3 days ago...I still have some orthostatic hypotension, but less frequently...I think higher dosage than the one recommend by the official compagny who make the parnate (GSK) will be more efficient. The only recommend a dose of 30 MG by day!!! And it's write in capital letters that's a dose above 30 mg is not necessary and cause more orthostatic hypotension and more side-effects.
The main problem with MAOI's is that little to no NEW studies are made on them, since the compagny don't do money with them, they don't invest money on research about them...I'm sure a good study between an old MAOI and the newer SSRI's or SRNI's will show a higher rate of success with MAOI than SSRI'S or SRNI's... I found one study about MAOI's and TCA'S showing a highest success rate and the superiority of MAOI's, I think it was the doulbe success rate with the MAOI's... Why do you think they don't investigate more in that kind of research....just because of the money...
Since Effexor-XR patented expire, I know that a new drug will come soon in the States...FAD approve already a new drug made with a metabolite of venlafaxine(Effexor). I guess it will be exactly the same level of sucess rate...
Cymbalta was suppose to be superior to Effexor-xr and "supposedly" but is it really more good than Effexor-Xr ? I can tell you that no.My family doctor is a lot involved in research about drugs and anxiety problems and he assist to the launch of the Cymbalta in Canada...a conference made by the compagny who fabric Cymbalta. To be accepted by health Canada, the compagny had to show some studies about the fact that Cymbalta is equal than effexor-xr...nothing more...and they succedd to do it...but that doesn't make it a more good drug than Effexor-XR.
The same happen in Canada and in the States also, when the Celexa(Citalopram) became not patented and generic version begin to surface, the compagny put some money in the developpement of a new drug made with the pure enantiomer of racemic citalopram. It's the same ingredients but they remove all the inactive ingredients inside the Citalopram, made a pure version and sell it under the name Cipralex(Escitalopram).
It's a good example of pharmaceutical companies who want to extend the lifetime of a drugs...A very popular strategy in this industry.
Who suffer from this? The patients only !!! I can write others example, Paxil CR...Luvox XR...they all have an ideal half-life in the blood in the regular form, why they need to do extended version ??? That's wasn't necessary but their patented expired so it's the way the companies find to make more money!
Anyway my family doctor don't recommend Cymbalta or newer version of Paxil CR or Luvox XR as well and prefer to prescribe older drugs like MAOI's when the regular SSRI's, Wellbutrin or Effexor-Xr don't work, since TCA's don't work for social phobia and have a more high profile of side-effects than old MAOI's in general, that's the way he work...
I think that completely uncessary to have more AD on the market for now...since the more specific they seem to work on the brains, and the worst they are...My Cipralex experience was a disaster, it's almost killed me...
So no more newer drug for me, until they will found something that really work for social phobia...and something NEW also, not an old metabolite drug modified!!!
Anyway, out of subject again...lol Too much coffee I think...I can't stop my fingers! ;-)
Well, like I write before, I plan to up my dosage to 60mg...and stay at this state and wait to see what happen...I think it will be a slow process...cause my new psychiatrist have a slow approach...i'm suppose to be only at 20mg now and I already up the dose to 30mg...he will not be happy for sure but I don't care, i'm the one who suffer from 14 years of social phobia, panic disorder, general anxiety and depresison, that's not him and it's normal that I want to feel and see some improve soon...I understand also that I have to not go too fast, but I don't think up my dosage of 10mg every 2 weeks is what you can call going too fast no???
Well that's enough for now, have a great day and take care of you ok ;-)
poster:Vincent_QC
thread:870680
URL: http://www.dr-bob.org/babble/20081223/msgs/871005.html