Posted by delna on October 27, 2009, at 12:50:51
Hi,
Hope people are doing well.Much to my surprise, my pdoc actually came home to see me because i was in such a bad state. I'm off the Parnate totally, now. Although he has seen me being a zombie before (as we have worked together on projects before, when I was in a drug company) he was quite taken aback to find me lying in bed half-dead.
Anyway, he said that from my reaction to Parnate (well, more the fact that I hardly reacted positively at all) he felt that it was the right decision to give it up for the time being (since I am too suicidal to hang on through the erratic period). He had planned to augment with Nortriptyline and was NOT convinced that 200mg Provigil was the highest dose one can take with Parnate.
I think I underestimated his knowledge on the drug (I thoroughly grilled him) and he seemed to know what he was talking about. But still the fact that he is usually unavailable made Parnate not the ideal drug for me. So it is on hold for now.
For other Parnate takers out there, he simply confirmed a few things which I wanted to share:
1) It behaves erratically in the beginning (especially giving mild 'highs' that poop out) but then it finally settles done, eventually lifting the mood very well and improving energy levels. 6 months is what he told me today. He said he has seen miracles on it (This may be especially useful for Sunbath to hear and is what Gayle has been saying all along)
2) Low dose, nortriptyline augmentation makes a HUGE difference! This again echos what Gayle said.
3) He uses small dose amytripyline for insomnia but said that there are many other meds that can be used safely. I'm sorry to those suffering from insomnia but I didn't press him for more options
4) It has good action against obsessions even though they are not documented.
5) If you fail on Parnate, Nardil may well help you instead.
6) Stimulants can be added and really help response alot. For me (since I like Provigil) he maintained that i could be on a high dose.
Also, I found this link about the sedation and hypotension being transient: Pg 494 if the link is not working fully:
http://books.google.com/books?id=kyS-bfvJvVUC&pg=PA87&lpg=PA87&dq=tranylcypromine+sedation&source=bl&ots=giSdsFSK_p&sig=c0LFGIZ93PEgPedgFK0cbuW4hDQ&hl=en&ei=kXfhSq7nMZPVkAWvv_y4AQ&sa=X&oi=book_result&ct=result&resnum=11&ved=0CDQQ6AEwCjgU#v=onepage&q=tranylcypromine%20sedation&f=false
As for me, he has given me low dose nortryptyline just to cover this period till I can start the effexor (because I am in a critical state). He has lots of plans for augmentation with effexor (like some suggested my by favorite scientist, Stahl!). He said Nortyptline will not really help the anxiety so I am to take clonazepam as needed just for these 15 days.He also told me that there are many permutations and combination's left to try so to not give up hope. I think I needed to hear that.
Well, just thought I'd update. Thanks for reading.
Love
D
poster:delna
thread:922895
URL: http://www.dr-bob.org/babble/20091021/msgs/922895.html