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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by e's wife on November 13, 2002, at 15:32:11
My husband has major depressive disorder that is recurrent and treatment resistant. Over the last 20 years, he's tried many combinations of tricyclics and SSRI's which eventually fail. He's just started Parnate (as of yesterday up to 40mg/day) and is also taking Lithium which he has taken for many years. Since beginning the Parnate 10 days ago, he's been feeling very, very tired. He does not feel depressed as of day 6 or so, but still feels the tiredness. During the wash out period leading up to the Parnate, he took Zyprexa and Lithium (+ Valium for anxiety as needed). Just cut out the Zyprexa yesterday (which might be contributing to the fatigue). Just wondering if anyone else experienced the tiredness when beginning Parnate and if we can reasonably expect it to go away. Thanks!
Posted by Lia Mason on November 13, 2002, at 17:05:14
In reply to Experiences with beginning Parnate--extreme fatigu, posted by e's wife on November 13, 2002, at 15:32:11
Hi,
I tried Parnate many years ago. I get sedated by *everything* and Parnate was actually one of the rare ones that didn't sedate me. I felt very energized by it. I believe sedation would be an atypical reaction so I'm inclined to think the culprit is another drug or depression that the parnate hasn't addressed yet. That said, all of these drugs are very individual and atypical does not mean impossible.
Lia
Posted by ZeeZee on November 13, 2002, at 18:05:39
In reply to Experiences with beginning Parnate--extreme fatigu, posted by e's wife on November 13, 2002, at 15:32:11
My past experience with Parnate was that it was energizing (in a good way) and very effective. However, my recent experience was that of a very weird sedative effect like I've never felt before while also having insomnia and feeling somewhat wired. I had to stop because of these symptoms. I wasn't just tired, or sleepy, I felt like I was "slipping away" or dying, if that makes any sense.
Good luck to your husband. Parnate can do wonderful things, hope this side effect abates.
Posted by fierc on November 14, 2002, at 3:02:51
In reply to Experiences with beginning Parnate--extreme fatigu, posted by e's wife on November 13, 2002, at 15:32:11
> My husband has major depressive disorder that is recurrent and treatment resistant. Over the last 20 years, he's tried many combinations of tricyclics and SSRI's which eventually fail. He's just started Parnate (as of yesterday up to 40mg/day) and is also taking Lithium which he has taken for many years. Since beginning the Parnate 10 days ago, he's been feeling very, very tired. He does not feel depressed as of day 6 or so, but still feels the tiredness. During the wash out period leading up to the Parnate, he took Zyprexa and Lithium (+ Valium for anxiety as needed). Just cut out the Zyprexa yesterday (which might be contributing to the fatigue). Just wondering if anyone else experienced the tiredness when beginning Parnate and if we can reasonably expect it to go away. Thanks!
Parnate was aweful the first 2 weeks i was on it. I got about 2-4 hrs of sleep the first 10 days and was up dazed and sedated rest of the day. Fortunately it finally passed. I now take a different MAOI Moclombimide and have experienced no side effects which struck me as weird cause I never do good with meds. Hopefully he can stick with it and it will pass in a few more days.
Posted by cubbybear on November 14, 2002, at 10:49:09
In reply to Re: Experiences with beginning Parnate--extreme fa, posted by fierc on November 14, 2002, at 3:02:51
Hi FIerc! At last,, I have found someone (you) who has had experience with Parnate AND Moclobemide. The reason I stopped taking Parnate was that I moved to a foreign country (Thailand) where it is unavailable. After failure with Remeron earlier this year and mixed feelings about Zoloft, (which I'm stopping tonight),. I've come to the conclusion that the MAOIS are probably the best meds for me, and so, if all goes as planned, I will start Moclobemide (Aurorix) in two weeks. I'm very curious to know how you do with it. Can you tell me how long you've been taking it, dosage, and your overall opinion about it? I'm also curious about where you live, since Moc. is not available in the U.S. Would appreciate any info you'd like to share about Moclobemide.
Thanks!
Posted by christophrejmc on November 14, 2002, at 15:01:36
In reply to Experiences with beginning Parnate--extreme fatigu, posted by e's wife on November 13, 2002, at 15:32:11
Does he feel fatigued throughout the day or just at particular times? I think there are a few articles regarding the latter on MEDLINE, but they're probably old as dirt.
In my experience, the somnolence fades, but never quite disappears.
-c
Posted by e's wife on November 14, 2002, at 22:45:47
In reply to Re: Experiences with beginning Parnate--extreme fatigu » e's wife, posted by christophrejmc on November 14, 2002, at 15:01:36
> Does he feel fatigued throughout the day or just at particular times? I think there are a few articles regarding the latter on MEDLINE, but they're probably old as dirt.
>
> In my experience, the somnolence fades, but never quite disappears.
>
> -cThanks for your reply. To answer you questions, he feels good in the morning and then gets steadily more tired as the day goes on. He is taking 10 mg around 9 am, 10mg at lunch, and 20mg around 6pm. We're thinking we'll try taking it later in the day and see if that helps the fatigue. The pdoc said that Parnate is more of a morning drug for most people but it sure doesn't seem to be working out that way for him. I hope this diminishes with time. He generally has good energy and this is really annoying for him....but at least he's not depressed....at least for now.
Would be glad to hear more advice if you have any.
Posted by fierc on November 15, 2002, at 1:39:59
In reply to Re: Experiences with beginning Parnate--extreme fa » fierc, posted by cubbybear on November 14, 2002, at 10:49:09
> Hi FIerc! At last,, I have found someone (you) who has had experience with Parnate AND Moclobemide. The reason I stopped taking Parnate was that I moved to a foreign country (Thailand) where it is unavailable. After failure with Remeron earlier this year and mixed feelings about Zoloft, (which I'm stopping tonight),. I've come to the conclusion that the MAOIS are probably the best meds for me, and so, if all goes as planned, I will start Moclobemide (Aurorix) in two weeks. I'm very curious to know how you do with it. Can you tell me how long you've been taking it, dosage, and your overall opinion about it? I'm also curious about where you live, since Moc. is not available in the U.S. Would appreciate any info you'd like to share about Moclobemide.
> Thanks!
I actually had to quit Parnate 2 weeks into it because it was on back order and was not available for 2 months. I went straight to mocloebemide from it. I have been on it now since the end of May, so that is going on to 6 months. Side effects have been very minimal. I had a headache for 4 days about 3 weeks after I began taking it but other than that I have been fine.
I've drank alcohol, eaten cheesy foods, pretty much everything on the don't eat list and only had problems with chinese food. I never had a hypertensive crisis, just a nasty headache, I was in bed for 2 days with.
I live in Canada, and moclobemide is pretty cheap. I get 80% coverage but regular monthly cost is $56 before my discount. I take 4 a day so I think that is 600 mg. And I've been doing quite good on it.If you have anymore questions don't hesitate to ask. I must say after trying about 7 SSRI's, Lithium Augmentation and whatever else i've done MAOI's have done the trick!
Posted by cubbybear on November 15, 2002, at 10:28:31
In reply to Re: Experiences with beginning Parnate--extreme fa, posted by fierc on November 15, 2002, at 1:39:59
Hi Fierc,
Thanks for the very helpful and encouraging info on Moclobemide. As I understand it, it should be perfectly safe to eat all those foods you can't eat when you take Parnate, provided you don't eat excessive amouns of them. As far as the cost goes, here in Thailand, the hospital pharmacy quoted me 35 baht per 150 mg. pill, which is equivalent to 80 U.S. cents Certainly cheaper than the SSRIs. (Then again, EVERYTHING is cheaper here)
As you know, I have to wait 2 weeks before starting the Moclobemide, and am just a bit nervous about that--hopefully I won't experience any Zoloft withdrawal symptoms. You said that you had tried about 7 SSRIs. Did that include Paxil? Did you go through the total hell of withdrawal from Paxil? That's about all I keep reading about these days. I'm so thankful I never got onto THAT stuff. Anyway, let's keep in touch. Glad to hear the Moc. is working out.
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