Posted by bulldog2 on October 21, 2009, at 10:35:46
In reply to Parnate-Sharing Dr Ivan Goldberg's A's to my Q's, 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 too
>
>
>
> My 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.
>
> ----------
> 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 DA question about how long to stay on parnate? Does Dr. Goldberg mean a total trial of 8 weeks? Or eight weeks at the highest dose you have achieved?
poster:bulldog2
thread:921755
URL: http://www.dr-bob.org/babble/20091021/msgs/921788.html