![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by LLL on August 12, 2002, at 8:55:53
For those who've read my prior threads please excuse the repetition - but - I'm back on Parnate, something that very much helped me in the past for my panic disorder and agoraphobia. Initially when getting back on it I developed tachycardia and had to back down the dose to only 1/2 tablet per day and add 1/2 each week. Well I worked my way up to the larger of the halves in the am and the smaller in afternoon without any tachycardia! and was doing just fine. The other day I decided to take the whole tablet in the am, since I was taking most of it anyway, and felt really "weird" and didn't like it. Well, anyway, this seems to have kicked in my fears of medicine and it's effects and I had a really anxious day as a result. This anxiety has carried over and now I have my radar on all the time looking for the slightest "different" feeling and getting anxious about it. The trouble is I find I'm getting really sleepy late afternoon and early evening, but I don't find that it feels good - it's not a relaxed feeling - it's a sedated "but out of my control" kind of feeling. Then when I think I should take a small dose of xanax to calm my thinking, I fear I'll be overly sedating myself and begin the cycle of anxiety and blah, blah, blah! Those with panic disorder out there - please help! The MAOI's are the only drugs I can tolerate! I believe what I'm going through is strictly psychological. In the years I was off all AD's I developed somewhat of a pharmacophobia, my recent nightmare of an experience with Effexor just seemed to confirm it. While on SSRI's - they truly make my panic out of the blue without having to even think about it.
I need to stop this viscous cycle. I was doing really well until I took the whole pill a couple of days ago.
If I can stick with this and get up to a higher dose I'm hoping the anxiety will diminish as it did in the past. Any support would be much appreciated.
Thanks,
Lisa
Posted by katekite on August 12, 2002, at 10:10:45
In reply to Sabotaging Myself - Pls Help!, posted by LLL on August 12, 2002, at 8:55:53
While the actual half-life of Parnate is short, the MAO inhibition lasts longer (or there wouldn't be a required 2 week washout period). So if you took extra a couple of days ago its probably normal that you still are feeling the effects. To get back to the old level of MAO inhibition you had prior to the extra dose, you could probably skip half your daily dose once or twice today or tomorrow, to let things settle back down faster. -- kate
Posted by LLL on August 12, 2002, at 10:41:01
In reply to Re: Sabotaging Myself - Pls Help!, posted by katekite on August 12, 2002, at 10:10:45
But how do I get up to a therapuetic dose at this rate? 10 mgs a day is not going to do anything. I think it's helping a little because I'm not feeling that much "physical anxiety" but my thinking sure is in a "whip up a panic attack" stage. At what dose do you think the antianxiety effect will begin?
Posted by katekite on August 12, 2002, at 15:09:07
In reply to Re: Sabotaging Myself - Pls Help! » katekite, posted by LLL on August 12, 2002, at 10:41:01
No idea -- I'd guess therapeutic effects are completely individual and so is how long it takes to get used to a given dose.
But if you can split the pill in half you could also probably get it even smaller and go up slower than half to whole: maybe that would be easier on your system.
kate
Posted by katekite on August 12, 2002, at 15:09:08
In reply to Re: Sabotaging Myself - Pls Help! » katekite, posted by LLL on August 12, 2002, at 10:41:01
No idea -- I'd guess therapeutic effects are completely individual and so is how long it takes to get used to a given dose.
But if you can split the pill in half you could also probably get it even smaller and go up slower than half to whole: maybe that would be easier on your system.
kate
Posted by LLL on August 12, 2002, at 20:24:28
In reply to Re: Sabotaging Myself - Pls Help!, posted by katekite on August 12, 2002, at 15:09:07
I was taking the 10mgs. divided, although unevenly, between 3/4ths and 1/4th or 2/3rd's and 1/3rd because the pill is impossible to cut down the middle. I don't understand why taking the whole 10mg at one time would have such an effect. Although I'm back to dividing it once again I also find that I feel quite sedated and still feel a little "weird". I skipped the 2nd dose which is the smaller portion of the pill this afternoon and feel somewhat better, but still some sedation, even after 12 hours. This is a VERY unpleasant feeling for me. How in the world could 6-7 mgs in the morning cause me to feel this way and last all day long?
I don't understand why I'm having such a different experience this time. First it was the tachycardia, then I felt the usual increased energy and now sedation?! Anyone have a clue?
I had sleep attacks on Nardil, but not an all day feeling of being drugged. Parnate never did that before, just increased energy and sense of well being.
Posted by Ritch on August 12, 2002, at 22:26:07
In reply to Sabotaging Myself - Pls Help!, posted by LLL on August 12, 2002, at 8:55:53
> For those who've read my prior threads please excuse the repetition - but - I'm back on Parnate, something that very much helped me in the past for my panic disorder and agoraphobia. Initially when getting back on it I developed tachycardia and had to back down the dose to only 1/2 tablet per day and add 1/2 each week. Well I worked my way up to the larger of the halves in the am and the smaller in afternoon without any tachycardia! and was doing just fine. The other day I decided to take the whole tablet in the am, since I was taking most of it anyway, and felt really "weird" and didn't like it. Well, anyway, this seems to have kicked in my fears of medicine and it's effects and I had a really anxious day as a result. This anxiety has carried over and now I have my radar on all the time looking for the slightest "different" feeling and getting anxious about it. The trouble is I find I'm getting really sleepy late afternoon and early evening, but I don't find that it feels good - it's not a relaxed feeling - it's a sedated "but out of my control" kind of feeling. Then when I think I should take a small dose of xanax to calm my thinking, I fear I'll be overly sedating myself and begin the cycle of anxiety and blah, blah, blah! Those with panic disorder out there - please help! The MAOI's are the only drugs I can tolerate! I believe what I'm going through is strictly psychological. In the years I was off all AD's I developed somewhat of a pharmacophobia, my recent nightmare of an experience with Effexor just seemed to confirm it. While on SSRI's - they truly make my panic out of the blue without having to even think about it.
> I need to stop this viscous cycle. I was doing really well until I took the whole pill a couple of days ago.
> If I can stick with this and get up to a higher dose I'm hoping the anxiety will diminish as it did in the past. Any support would be much appreciated.
> Thanks,
> Lisa
Lisa,I can relate to that "sedated-but out of control" feeling. I get that feeling often with mixed bipolar depression. I can get that feeling at night before I go to sleep and I can *tell* by the feeling that I will have an early morning awakening. It is almost like an epileptic "aura" of sorts. Have you ever tried any Neurontin? That might help that uneasy/tired/restless icky feeling a lot.
Mitch
Posted by LLL on August 12, 2002, at 22:40:50
In reply to Re: Sabotaging Myself - Pls Help! » LLL, posted by Ritch on August 12, 2002, at 22:26:07
No I never have tried Neurontin. What is it used for and what does it do for panic/agoraphobia? Are you suggesting I take it along with the Parnate? Frankly I felt much better on NOTHING (except for the fact that I'm pretty restricted by my agoraphobia right now). I'm pretty afraid of trying anything new at this time, since I seem to be the one to have the "rare" side effects.
Thanks for your suggestion and I will keep it in mind as an alternative if the Parnate doesn't
work out for me this time.Lisa
Posted by Ritch on August 13, 2002, at 9:02:13
In reply to Re: Sabotaging Myself - Pls Help! » Ritch, posted by LLL on August 12, 2002, at 22:40:50
> No I never have tried Neurontin. What is it used for and what does it do for panic/agoraphobia? Are you suggesting I take it along with the Parnate? Frankly I felt much better on NOTHING (except for the fact that I'm pretty restricted by my agoraphobia right now). I'm pretty afraid of trying anything new at this time, since I seem to be the one to have the "rare" side effects.
> Thanks for your suggestion and I will keep it in mind as an alternative if the Parnate doesn't
> work out for me this time.
>
> LisaLisa,
Yes, I was wondering if your doctor may have mentioned it as an adjunct to the Parnate. You didn't mention taking any benzos with your MAOI, so that's why I brought up the Neurontin. It is used as adjunctive medication for partial seizures and often used for bipolar (mainly for associated anxiety). I was taking it for a while, but combined with everything else it was aggravating daytime sleepiness, and I don't like dosing 3-4 times a day (which it requires to work really well). That is interesting that you say you felt much better on "nothing"! So, you must have the unexpected panic (and associated agoraphobia), not the situational type that I experience.
good luck,
Mitch
Posted by LLL on August 13, 2002, at 9:40:40
In reply to Re: Sabotaging Myself - Pls Help! » LLL, posted by Ritch on August 13, 2002, at 9:02:13
I use xanax. However, the sedation I was feeling was just exacerbated by the xanax and then I'd end up feeling more anxious about it all. I decided not to take any Parnate today because I feel I can't stand how I was feeling. I do have situational panic, however, things like this set me into a whirlwind of 24 hr/day high anxiety/near panic feeling. I'd almost rather deal with a panic attack and get it over with than deal with this continuous anxiety I'm now feeling. Stopping the Parnate abruptly I'm sure will only make it worse!
I'm feeling pretty hopeless because I respond so anxiously to the SSRI's (spontaneous and continuous panic). Plus my panic disorder makes me anxious over taking anything that I can't just decide to "get out of my body" when I feel like it.
Posted by Ritch on August 13, 2002, at 12:00:54
In reply to Re: Sabotaging Myself - Pls Help! » Ritch, posted by LLL on August 13, 2002, at 9:40:40
> I use xanax. However, the sedation I was feeling was just exacerbated by the xanax and then I'd end up feeling more anxious about it all. I decided not to take any Parnate today because I feel I can't stand how I was feeling. I do have situational panic, however, things like this set me into a whirlwind of 24 hr/day high anxiety/near panic feeling. I'd almost rather deal with a panic attack and get it over with than deal with this continuous anxiety I'm now feeling. Stopping the Parnate abruptly I'm sure will only make it worse!
> I'm feeling pretty hopeless because I respond so anxiously to the SSRI's (spontaneous and continuous panic). Plus my panic disorder makes me anxious over taking anything that I can't just decide to "get out of my body" when I feel like it.
Have you ever tried any Klonopin? I have tried Xanax in the past and it worked Ok, but wore off too fast and I would get rebound anxiety from it that could be viscious (when it withdrew). Klonopin hangs around a long time, that's true. I am down to just .25mg at bedtime, now. I am thinking about Ativan (lorazepam) as an alternative PRN benzo because it is somewhat intermediate acting (not too short, not too long).Mitch
Posted by Mr. Scott on August 15, 2002, at 3:52:39
In reply to Sabotaging Myself - Pls Help!, posted by LLL on August 12, 2002, at 8:55:53
What is a small dose of Xanax?
I would ditch all the AD's for now and get on some Klonopin (The sedation mostly goes away in time, but the anti-anxiety effect does not). Then maybe only if needed try reintroducing an SSRI or MAOI. Celexa or Nardil perhaps?
Scott
Posted by LLL on August 15, 2002, at 9:14:46
In reply to Re: Sabotaging Myself - Pls Help! » LLL, posted by Mr. Scott on August 15, 2002, at 3:52:39
Posted by denise528 on August 19, 2002, at 5:56:19
In reply to Sabotaging Myself - Pls Help!, posted by LLL on August 12, 2002, at 8:55:53
Hi Lisa,
I can so relate to what you are experiencing, that constant feeling of anxiety over nothing, mixed with a tired sick feeling, it's horrible. I hate to put a downer on things but I really believe that this is an indication that the drugs aren't working. I've had exactly the same experience as you on the SSRIs and they too used to work so well for me. No matter what I do, decrease the dose, increase the dose whatever I just wind up feeling worse. On the days that I don't take one I actually feel better but then I try and do without for a while and I go back down.
I just seem to experience different variations of crappy feelings.
Perhaps you should give Zyprexa a try.
Denise
Posted by LLL on August 19, 2002, at 9:15:24
In reply to Re: Sabotaging Myself - Pls Help!, posted by denise528 on August 19, 2002, at 5:56:19
Denise
Thank you for your support. I may be incorrect but my understanding of Zyprexa is that it is a drug used for Schizophrenia and acute mania in bi-polar disorders, neither of which I have. Is this a drug used for panic/agoraphobia? I am on nothing right now and feel just fine - totally normal. It's just that I can't get myself to break through the self imposed restrictions of agoraphobia and do what I need to do. My anxiety tells me that even taking xanax won't really work, although xanax in fact helps me. When I was on the Parnate the phobic response and the anticipatory anxiety just faded away and I was able to go and do what I needed. This lasted for 4 years after cessation of the drug until my recent move and additional stress.
Thanks
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.