Posted by SLS on August 2, 2009, at 6:41:13
In reply to Scott - More help with Parnate + Augmentation, posted by ColoradoSnowflake on August 1, 2009, at 22:02:15
Hi Gayle
> OK, I'm having a few problems: fatigue, insatiable carb hunger and poor sleep.I don't think you ought to try to correct all of these problems at once. The Provigil might help with the daytime sleepiness. You can keep that. However, you might find that this problem mitigates over time. On the flip side, you might find that Provigil helps the depression, too. Either way, you might want to try coming off the Provigil at some point as an experiment. Regarding the insatiable hunger, that might dissipate a great deal once you begin to titrate the nortriptyline closer to a therapeutic dosage, which can be 50-100mg. Most people end up at 75mg. At too low a dosage, the antihistamine (H1) properties probably predominate over the NE reuptake inhibition. Try going up to 25mg. It might even help with sleep.
> Please don't tell me that sleep deprivation is part of Parnate's power!!
I am quite sure that it is not. Although I usually look at insomnia as a good prognosis phenemonon, it does not have to be present for Parnate to work. You might need to take a sleep aid at some point. Chronic sleep deprivation is counterproductive, I believe. You might catch a buzz after a single night's sleep deprivation, but that trick doesn't work on consecutive nights. The thing that might contribute to the therapeutic effect is the suppression of REM sleep.
> Another thing. Do you find Parnate to be inconsistent? Like a couple of days its working real well, then a day not? for no apparent reason? Just wondering.Your recovery from depression will not be a steady one. Expect periodic worsenings. However, the goal is to establish a trend towards further improvement. Going up to 60mg of Parnate sounds good to me. I'm just not sure when would be the best time to attempt this. You probably will have no problem handling the higher dosage, but you might as wait awhile so you can see what the higher dosages of nortriptyline do for you.
- Scott
poster:SLS
thread:909763
URL: http://www.dr-bob.org/babble/20090801/msgs/909818.html