Posted by Bob on February 29, 2016, at 15:10:29
In reply to Re: Parnate » Bob, posted by SLS on February 29, 2016, at 7:20:14
> >
> > I was doing some reading on Parnate today and was surprised to learn that the drug has a half-life of a mere 2.5 hours. Is it recommended to dose this drug multiples times per day to compensate for this short half-life?
> >
> > Bob
>
> It is recommended to take Parnate in divided doses. You can divide them by taking one dose in the morning and one in the early afternoon.
>> Parnate gets in quickly and binds to MAO permanently. Any excess is metabolized quickly, but the number of inactivated MAO enzymes remains the same. The necessity to dose on a regular basis is to offset the synthesis of new MAO.
>
> Several people on Psycho-Babble take all of their Parnate dosage once in the morning. If orthostatic hypotension becomes a problem, I would consider taking Parnate 3 times a day, with your final dose to be taken at 3:00 PM if insomnia is a problem. Blood pressure usually ebbs at 4:00 PM. I used to have a cup of coffee at this time to reduce hypotension. However, the longer I took Parnate, the less hypotension was a problem.
>
> What is your current treatment regime, if you don't mind my asking?
>
>
> - Scott
>
Hey Scott... thanks for the detailed answer. You are always quite informative with your posts.My current regimen is getting slowly more complex. I currently take the following:
Nortriptyline 200mg (75mg 2x per day and 50mg at bedtime)
Brintellix 10mg (5mg 2x per day)
Aripiprazole 4mg (2mg 2x per day)
Lithium 112.5mg at bedtime
Lithothyronine T3 25mcg in the morning
Pramipexole .375mg (.125mg 3x per day)
I assumed that Parnate might have to be taken multiple times per day to stabilize blood levels. Seems like the levels would get pretty low with a once per day dosing and a 2-hr half-life. I've found for some reason that for me it seems even for meds with a relatively long half-life it helps to dose more than once per day. This is especially true when starting a new medicine.I'm not getting a super-robust response from what I'm now taking and everything I take eventually fades in effectiveness. I recently added small amounts of pramipexole which is actually helping somewhat. MAOIs are the only class of drug I haven't tried to date and there is suggestions that they are more suited to atypical depression (which I seem to have) and are less prone to losing effectiveness over time. Then again I've seen people on this very forum who claim to have lost effect with MAOIs.
I have mulled over the idea of taking Parnate (or even Nardil for that matter) but I fear having to taper off of my current nortriptyline and brintellix. My doctor will absolutely not allow the nortriptyline (and obviously the brintellix) to coexist with Parnate. I have had some pretty bad experiences with withdrawal in the past and I don't want to spend weeks getting through the transition on the edge of suicide - especially if I find that the MAOIs are not tolerable or effective for me. That would suck, particularly since the MAOI would be bookended with two potentially hellish transitions. I'm also not currently prepared to find a new doctor.
I think I saw recently where you said if you don't achieve remission with your current regime you may try an SNRI? Is the Parnate + nortriptyline not helping enough?
Bob
poster:Bob
thread:1086592
URL: http://www.dr-bob.org/babble/20160131/msgs/1086609.html