Posted by Ben on March 5, 2022, at 12:32:01
In reply to Re: Parnate and fatigue, posted by undopaminergic on March 5, 2022, at 10:00:21
> > Hello
>
> Hello!
>
> > I have bipolar disorder type II
> > I am taking Parnate since several years along with other meds (see below). The mood is quite stable but I experience most days a bad fatigue in the afternoon. I tried to split the Parnate dose but if I take the second dose too late I have problems with sleep. If I forget to take the second one I also have the fatigue. Beside the fatigue I have anhedonia and a lot of weight gain. I am thinking its time to change the medication. When I remember right, I was reeding from Scott, that the TCA Nortriptylin is better than Doxepin in this case of problems?! Do you have any ideas or experiences ?
> >
>
> Two thoughts:
>
> 1) Try to get off the doxepin, it is very sedating; even if you take it at night, there may be a "hangover" next day. If you need its antidepressant effects, then yes, nortriptyline could be a better alternative.
>
> 2) Maybe introduce a stimulant; be cautious, especially with amphetamines, but even methylphenidate can be problematic in certain sensitive individuals.
>
> -undopaminergic
>Hi
Thanks for your thoughts.I dont feel a hangover only a fatigue in the afternoon. But i know that Doxepine is very sedating and the H1 antagonism leads also to Weight gain.
I tried d-amphetamine and metylphenidate in several doses and galenic forms. I tried also modafinil with no effect. Amphetamines are conflicting with my sleep also in low doses and in the right timing of intake. Methylphenidate seems better concerning sleep but the stimulating effect is much lower than Amphetamines. So these options are not the best. I Hope switching to Nortriptyline will do the Trick also the weight management. Thanks,Ben
poster:Ben
thread:1118824
URL: http://www.dr-bob.org/babble/20220128/msgs/1118870.html