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Re: Scott - More help with Parnate + Augmentation » SLS

Posted by ColoradoSnowflake on August 2, 2009, at 16:09:42

In reply to Re: Scott - More help with Parnate + Augmentation » ColoradoSnowflake, posted by SLS on August 2, 2009, at 6:41:13

> 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
>

Hi Scott:

Thanks so much for the ideas, explanations and suggestions! It all makes a lot of sense. I am always trying too many things at once, too soon, too much, and then don't have a clue!

The Provigil works very well. Today I am trying the Nuvigil and can already see it doesn't last as long for starters. But for free, I'm happy to have it. I do think the Provigil augments the Parnate's AD qualities! So that's good! And I'm not tired on it, until the end of the day when I really drag, but that's OK.

I'll up the Nortriptyline to 25mg tonight. What a relief that will be not having to cut those little capsules full of powder in half! I pray it doesn't double my carb hunger!! It would be great if it helps me sleep. It will be interesting to see. Should I take it at bedtime or a little earlier? How long is the half life?

I'll stick with 50mg Parnate. I'm confused about when to take it. Does it matter? I've been taking 30mg a.m., then 20mg about 2pm. I tried all 50mg. in the a.m. and that was a BAD idea to do that and then exercise. I fell down once (a little fall) and scared my classmates. I was dizzy a lot because of leaning over so much as part of the exercises. I did fall out my backdoor but don't know if it was the Parnate or the thongs. I'm not getting rid of either one!
Do you think that dosing is ok? I like the 30mg. in the morning because that plus coffee plus Provigil gets me going!

Thanks for the reminder that I wont be 100% overnight. I'm like Lucy (Peanuts) and want "Ups and ups and more ups!" Right now!
I really am very grateful to feel as much better as I do!

Thanks again Scott!! It is so great to have your experience, expertise and willingness to help us on this forum!!

gayle


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