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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by cubbybear on June 17, 2003, at 10:35:14
If you're a regular reader of this board, you might recall that I've been living in Thailand. and have to take annual trips to the U.S. to obtain Parnate. I'm currently taking 40 mg. per day. It has been a lifesaver for me for nearly 20 years (not including a few drug "holidays" and failed attempts at trying other ADs last year). My pdoc is in New York and this can create a real communications problem, between his restricted schedule, my teaching schedule, and the time zone difference. It's extremely difficult for me to get hold of him on the phone and, as I mentioned in a letter to him about 3 weeks ago, I'd now like to decrease the dose from 40 mg/per day . to a long-term maintenance dose of 30 mg. This is what I've done in the past and never had any problems with it. (I'm also in the process of VERY slowly decreasing Klonopin dosage. I'm currently on 2 mg/day and decreasing .125 mg. every 7 days) I've been feeling fine from the Parnate but want to lower it to a mtnce. dose of 30 mg.-- also because I need my supply to last at least 6 months or so. My only concern is that , when I re-started the Parnate back in early March, I was nearly incapacitated from the worst depression ever, and don't want to live another day of such suffering again.
Until I can connect with my pdoc on the phone, I'd like to know what all of you experts think: can you imagine any reason why I should NOT decrease my dose from 40 to 30 mg. at this time? Could going down only 10 mg. make it more likely for me to have a subtle relapse? (Again, I never had such a thing happen in the past.)And also--in regard to the benzo-- do you think that being on the Parnate will make my final phaseout of Klonopin easier, more difficult, or would it have no bearing on it? Thanks much for your ideas.
Posted by Questionmark on June 18, 2003, at 0:20:38
In reply to OK to Decrease Parnate Dosage?, posted by cubbybear on June 17, 2003, at 10:35:14
> If you're a regular reader of this board, you might recall that I've been living in Thailand. and have to take annual trips to the U.S. to obtain Parnate. I'm currently taking 40 mg. per day. It has been a lifesaver for me for nearly 20 years (not including a few drug "holidays" and failed attempts at trying other ADs last year). My pdoc is in New York and this can create a real communications problem, between his restricted schedule, my teaching schedule, and the time zone difference. It's extremely difficult for me to get hold of him on the phone and, as I mentioned in a letter to him about 3 weeks ago, I'd now like to decrease the dose from 40 mg/per day . to a long-term maintenance dose of 30 mg. This is what I've done in the past and never had any problems with it. (I'm also in the process of VERY slowly decreasing Klonopin dosage. I'm currently on 2 mg/day and decreasing .125 mg. every 7 days) I've been feeling fine from the Parnate but want to lower it to a mtnce. dose of 30 mg.-- also because I need my supply to last at least 6 months or so. My only concern is that , when I re-started the Parnate back in early March, I was nearly incapacitated from the worst depression ever, and don't want to live another day of such suffering again.
i thought you could pretty much get any prescription drug in Thailand over-the-counter (my friend went there for awhile)-- is this wrong, or do they just not have/sell Parnate there? Thats too bad that it's such a hassle for you.
> Until I can connect with my pdoc on the phone, I'd like to know what all of you experts think: can you imagine any reason why I should NOT decrease my dose from 40 to 30 mg. at this time? Could going down only 10 mg. make it more likely for me to have a subtle relapse? (Again, I never had such a thing happen in the past.)
It's certainly possible, but i doubt it. If anything you'll probably just feel SOMEwhat worse and if so you can always go back up to 40mg. So i would definitely at least try it.
> And also--in regard to the benzo-- do you think that being on the Parnate will make my final phaseout of Klonopin easier, more difficult, or would it have no bearing on it? Thanks much for your ideas.
i don't know. But you might wanna phase out the Klonopin before reducing the Parnate or vice versa-- especially since it will be easier to tell what's affecting what. i would actually stop lowering the Klonopin dose now, and then first reduce the Parnate dose to 30mg (bcz that should not take long at all to tell how it works-- maybe a few days or so?), and then after that continue reducing the Klon.
Good luck to you.
Posted by cubbybear on June 18, 2003, at 1:28:39
In reply to Re: » cubbybear, posted by Questionmark on June 18, 2003, at 0:20:38
> i thought you could pretty much get any prescription drug in Thailand over-the-counter (my friend went there for awhile)-- is this wrong, or do they just not have/sell Parnate there? Thats too bad that it's such a hassle for you.
You can get many prescription drugs OTC here, especially items like skin ointments and anti-biotics. I was stunned to see Zoloft being sold OTC. But benzos have to be obtained through a doctor. No MAOIs are available here ( Parnate and Nardil), which has been a royal pain for me from day one. The only MAOI you can get is Moclobemide (Aurorix). It's a reversible inhibitor of monoamine oxidase and was the worst stuff I ever tried in my life. Evidently, the Thai Health Ministry considers Parnate and Nardil too dangerous to be sold.
>
This is the end of the thread.
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