Posted by Terry8 on June 28, 2011, at 9:19:03
In reply to Atypical depression - medication no longer helping, posted by policebox on June 27, 2011, at 18:43:15
> One further complication is that I experience intermittent episodes of elevated blood pressure and heart palpitations (which last for 1 to 2 hours) since beginning Parnate. Ive been unable to find a pattern to these episodes. I adhere to the MAOi dietary restrictions. I have tried both taking the full 30mg or 40mg in the morning, or taking 10mg tablets spread-out throughout the day, but neither way seems to make a difference. Normal blood pressure readings have been around 123/74 and 121/77. But, when a period of elevated blood pressure strikes, it will go up to 150/90, 145/90, 143/84, 138/86, etc., usually after 1 to 2 hours after taking the medication, regardless of the dosage or period of time between it and the previous dose. And again, it doesnt happen every day.
>I've had exactly the same reaction to Parnate. The only difference is that my normal blood pressure is more a bit lower, more like 80/50 or 90/60, but I'd spike to about the same point -- 140/90 or 150/100 -- with heart palpitations and sometimes a moderate headache, often following a dose (usually one of the ones later in the day) and sometimes for no reason that I can fathom (though I did eventually pin down a few food triggers that one wouldn't expect, and taking the doses further apart did seem to help some). I'm currently stable on 40 mg a day, but had this reaction anew with each dosage increase (I started at 10 mg and titrated more slowly than you did). But here's the good news: it mostly went away with time for me, perhaps after six weeks at each new dosage. We never increased the dose until the spikes had calmed down enough that I felt confident about handling the next increase (like you, I'd said more than once that there was no way I could go higher, but time proved otherwise). Since you've only been on the med for a month total, there's still a very good chance the blood pressure spikes will calm down a bit.
Next bit of possibly good news: my full response to Parnate only kicked in after about 12 weeks. I also had the immediate positive upswing for a few days after starting, but it was actually followed by a week or two of feeling worse than when I'd started. This repeated with each dose increase: a couple good days, a week or two of dooooooom, and then a slow march upward.
My inclination is to give it more time. Your mileage may vary, of course, and I know how frustrating it is to be patient when feeling like crap, but these's a chance things might still improve just where you are. I hope you find some relief soon!
poster:Terry8
thread:989596
URL: http://www.dr-bob.org/babble/20110619/msgs/989652.html