Posted by delna on October 20, 2009, at 23:27:50
Ok,
Since my doctor is so clueless I wrote to Dr Ivan Goldberg with some questions about Parnate.My questions are in normal caps- his replies are in full caps.
Hope this is helpful to other Parnate- newbies tooMy questions are as follows:
1)Which side effects are transient and which aren't?
IT IS IMPOSSIBLE TO STATE TO WHICH SIDE EFFECTS PEOPLE MAY DEVELOP TOLERANCE.
- Hypotension (not only orthostatic and despite dose splitting)
-Afternoon sedation despite the addition of a stimulating drug (Provigil 200mg in my case and normal sleep at night)
2)I am on 30mg/day so far and plan to increase to a much higher dose. Does the drug become more stimulating as the dose is escalated because right now I feel more exhausted and apathetic than usual?
WHILE SOME PEOPLE BECOME MORE STIMULATED WITH HIGHER DOSES OTHER BECOME MORE LETHARGIC
3)Is it true that a combination of Parnate and a stimulant can precipitate dyskinesias? Is Provigil considered to be a stimulant in that respect.
THE COMBINATION OF PARNATE AND ONE OF THE STIMULANTS IS OFTEN A USEFUL ONE. WHILE MANIA, HYPERTENSION, AND DYSKINETIC MOVEMENTS ARE ALL POSSIBLE, I HAVE SELDOM SEEN THEM IN PATIENTS ON THE COMBINATION. PROVIGIL IS A PSYCHOSTIMULANT.
4)How high a dose of Provigil could one take with Parnate (I understand if you do not want to comment on this one as there is no safety guidelines available - but a rough guess would do)
200 MG/DAY IS THE HIGHEST DOSE I HAVE USED . . . IT IS WELL ABOVE THE FDA APPROVED LABELING.
5)How long is a fair trail for Parnate? I believe it is longer than for most drugs. I am specially concerned about how long symptoms like the innate exhaustion of BP depression generally take to lift. (In fact I was led to believe that Parnate is highly stimulating which so far has not been so)
I ASK MY PATIENTS TO TOLERATE AN 8-WEEK TRIAL AT THE MAXIMALLY TOLERATED DOSE OF PARNATE.
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That's it!
So, this means that it is not true that in all people the side-effects will pass. Nor will they improve at a higher dose for some. I think this will influence my decision whether or not to continue.Take care everyone,
Hope Parnate is helping you and that your side effects will pass. I'm not so sure mine will- once a drug sedates me, it always sedates me.... :(Love D
poster:delna
thread:921755
URL: http://www.dr-bob.org/babble/20091012/msgs/921755.html