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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by EERRIICC on February 6, 2005, at 4:00:38
This is a major issue for me and I thank anyone who has any opinions or suggestions.
If Parnate is stopped for one or two days every fifth day (ie. on the weekends) could this allow its effectiveness to return?
Posted by cubbybear on February 6, 2005, at 6:55:38
In reply to Eliminating Parnate poop-out?, posted by EERRIICC on February 6, 2005, at 4:00:38
> This is a major issue for me and I thank anyone who has any opinions or suggestions.
>
> If Parnate is stopped for one or two days every fifth day (ie. on the weekends) could this allow its effectiveness to return?If the Parnate is working for you and you're merely wishing to stop taking it on weekends, this has nothing to do with poopout. Or HAS it actually pooped out? The technical term is tachyphylaxis and it refers to a drug that stops being effective after having done its job for a while.
You seem to be asking about dosing--if you can take Parnate on Monday-Friday and not take it on the weekends. Am I right? If, so, why do you want to do this? That is not the proper way to take any anti-depressant. You must keep a steady stream of the stuff in your system every day or you're going to invite problems. You'd be sending your nervous system very mixed signals.
But, I'm also curious as to why you want to take the Parnate only part-time anyway,. cubbybear
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Posted by Optimist on February 6, 2005, at 11:18:35
In reply to Eliminating Parnate poop-out?, posted by EERRIICC on February 6, 2005, at 4:00:38
> This is a major issue for me and I thank anyone who has any opinions or suggestions.
>
> If Parnate is stopped for one or two days every fifth day (ie. on the weekends) could this allow its effectiveness to return?
>
The weekends off regimand is done for a lot of dopaminergic drugs I know. Amphetamines, low dose Selegiline, Amineptine, as well as the adaptogens Ginseng and Rhodiola come to mind... anything that can cause downregulation.True antidepressants on the other hand should not be cycled IMO. They're not supposed to cause downregulation.
Brian
Posted by EERRIICC on February 7, 2005, at 6:23:31
In reply to Re: Eliminating Parnate poop-out? » EERRIICC, posted by Optimist on February 6, 2005, at 11:18:35
Sorry to be so vague. Parnate stops working and then I have to go off it for awhile (to try another drug or something) then when I go back on it, it works again for a few months. I have never tried stopping it for a couple days every week on a regular basis. Also, Parnate only begins to work for me at doses over 90mg. I have heard that the drug changes structure or mechanism of action at high doses.
Optimist: your information about dopaminergic drugs is very interesting, is there any place I can find more info.?
Thanks for your help!
Posted by Optimist on February 7, 2005, at 11:18:30
In reply to Re: Eliminating Parnate poop-out?, posted by EERRIICC on February 7, 2005, at 6:23:31
> Sorry to be so vague. Parnate stops working and then I have to go off it for awhile (to try another drug or something) then when I go back on it, it works again for a few months. I have never tried stopping it for a couple days every week on a regular basis. Also, Parnate only begins to work for me at doses over 90mg. I have heard that the drug changes structure or mechanism of action at high doses.
>
> Optimist: your information about dopaminergic drugs is very interesting, is there any place I can find more info.?
>
> Thanks for your help!Eric,
Do you have a bipolar dx by any chance? I've heard that's a common reason for AD poopout. AD's can exacerbate bipolar switches. If you've never experienced bipolar features before AD's, it's possible an AD may potentiate a small biological tendency towards it. Just a thought.
Adding a lower dose of lithium may help with the poopout. You wouldn't have to go to the extreme blood concentrations needed for full blown bipolar. A concentration of 0.4-0.8 mmol/L, may be sufficient. It's low enough to not get a lot of the nasty side effects, and it may even increase the AD effect of the Parnate.
I'm considering adding some low dose lithium to my regimand if I experience any poopout on Parnate myself. The Parnate starts in a week, once my Prozac is fully washed out. I've often wondered if I had some mild form of bipolar as I seem to have seasonal changes to my depression. Spring and fall seem to be my best times of the year.
I'm not too sure if the weekends off regimand would help with Parnate. Since it's bound to MAO for around 2 weeks or so, or at least a week anyways, I doubt taking a weekend off would make any difference. The weekends off is usually only recommend for very low doses of drugs anyways. If you're on a high dose of something, a weekend off isn't going to be enough time for it to recover. For example the doses recommended for this for Selegiline is around 1mg-5mg max during the week. Anything more and you'd need much more time to recover, thus negating a lot of point behind it. There's not much use to being off just as much as you're on or more so.
Regarding my info on dopaminergic drugs cycling, I can't really point you in any specific direction. It's basically from years of reading on the subject. One book that went in to it in some detail is "Hormonal Health" by Dr. Michael Colgan. He advocates low dose Selegiline to improve the dopaminergic system for emotional health as well as for cognitive longevity towards old age. I've also seen the 5 on, 2 off protocol for bodybuilding supplements that work on dopamine/testosterone production, if you want to go on something long term. Another option is 3 weeks on, 1 off, that they advocate. I wouldn't recommend that for Parnate though either.
p.s. How did the pdoc search go in the GTA? Did you find a good one you were looking for?
Brian
Posted by EERRIICC on February 7, 2005, at 15:35:22
In reply to Re: Eliminating Parnate poop-out? » EERRIICC, posted by Optimist on February 7, 2005, at 11:18:30
Found one at the CAMH (Center for Addiction and Mental Health), but it was a real hassle getting in there. Hope Parnate works out for you. How Parnate, or any antidepressant, works is really not known, so I figure I'll give the five day on and then one or two days off theory a try, just to see what happens. This is assuming I go back on Parnate (I'm on Mirapex 1.5mg t.i.d. right now)
Eric
Posted by SadDoggie on February 8, 2005, at 10:18:44
In reply to Re: Eliminating Parnate poop-out?, posted by EERRIICC on February 7, 2005, at 15:35:22
Hey Eric,
How did your memantine trial go?
SadDoggie> Found one at the CAMH (Center for Addiction and Mental Health), but it was a real hassle getting in there. Hope Parnate works out for you. How Parnate, or any antidepressant, works is really not known, so I figure I'll give the five day on and then one or two days off theory a try, just to see what happens. This is assuming I go back on Parnate (I'm on Mirapex 1.5mg t.i.d. right now)
>
> Eric
Posted by Optimist on February 8, 2005, at 10:51:06
In reply to Re: Eliminating Parnate poop-out?, posted by EERRIICC on February 7, 2005, at 15:35:22
> Found one at the CAMH (Center for Addiction and Mental Health), but it was a real hassle getting in there. Hope Parnate works out for you. How Parnate, or any antidepressant, works is really not known, so I figure I'll give the five day on and then one or two days off theory a try, just to see what happens. This is assuming I go back on Parnate (I'm on Mirapex 1.5mg t.i.d. right now)
>
> EricI'm pretty weary of you accepting my advice of a 5 on, 2 off schedule for your Parnate. Final decisions on your meds should defer to your pdoc and not some guy you met on an internet chat board if you know what I mean. :)
I'm not completely sold the reason for Parnate "poopout" is due to downregulating dopamine autoreceptors or some other dopamine mechanism. There could be many other variables behind your illeged "poopout" from; psychosocial factors, to depletion of dependent precursors/enzymes, a hidden bipolar diagnosis, etc... that's for your pdoc to decide. I am all for researching and arming one self with as much knowledge as possible, but it can be dangerous managing one's medication regimand. You need that objective view from a trained professional.
I think the best options to explore first would be to:
1. Make sure your micronutrient levels are up to snuff. i.e a high potentcy vitamin B-complex, inositol, phenylalanine/tyrosine, tryptophan/5-HTP, a good multivitamin/mineral. You would have to be careful with introducing the amino acids with MAOIs. More research on that would be needed.
2. Addition of low dose lithium, 0.4-0.8 mmol/LAnd besides I'm not a doctor, I just play one on the internet. :)
Brian
Posted by Willyee on February 8, 2005, at 23:16:23
In reply to Re: Eliminating Parnate poop-out? » EERRIICC, posted by Optimist on February 8, 2005, at 10:51:06
I agree anything on the net needs t be taken with a grain of salt..but just the same what is a "trained professional" gonna have access to that we dont.
Most of them will only use the PDR....Maois are complex i dont see a p-doc unless he specializes in Maois offering much more.
> > Found one at the CAMH (Center for Addiction
and Mental Health), but it was a real hassle getting in there. Hope Parnate works out for you. How Parnate, or any antidepressant, works is really not known, so I figure I'll give the five day on and then one or two days off theory a try, just to see what happens. This is assuming I go back on Parnate (I'm on Mirapex 1.5mg t.i.d. right now)
> >
> > Eric
>
> I'm pretty weary of you accepting my advice of a 5 on, 2 off schedule for your Parnate. Final decisions on your meds should defer to your pdoc and not some guy you met on an internet chat board if you know what I mean. :)
>
> I'm not completely sold the reason for Parnate "poopout" is due to downregulating dopamine autoreceptors or some other dopamine mechanism. There could be many other variables behind your illeged "poopout" from; psychosocial factors, to depletion of dependent precursors/enzymes, a hidden bipolar diagnosis, etc... that's for your pdoc to decide. I am all for researching and arming one self with as much knowledge as possible, but it can be dangerous managing one's medication regimand. You need that objective view from a trained professional.
>
> I think the best options to explore first would be to:
> 1. Make sure your micronutrient levels are up to snuff. i.e a high potentcy vitamin B-complex, inositol, phenylalanine/tyrosine, tryptophan/5-HTP, a good multivitamin/mineral. You would have to be careful with introducing the amino acids with MAOIs. More research on that would be needed.
> 2. Addition of low dose lithium, 0.4-0.8 mmol/L
>
> And besides I'm not a doctor, I just play one on the internet. :)
>
> Brian
Posted by djmmm on February 9, 2005, at 10:27:37
In reply to Eliminating Parnate poop-out?, posted by EERRIICC on February 6, 2005, at 4:00:38
> This is a major issue for me and I thank anyone who has any opinions or suggestions.
>
> If Parnate is stopped for one or two days every fifth day (ie. on the weekends) could this allow its effectiveness to return?
>
>
>
>Probably not, in fact I think that if you asked most of the people here who have stopped and re-started a medication, they would tell you it didn't work as well.
My advice: be very observant of when you take parnate, and if you take it with food, or not, with a lot of water, or not, with antacids, certain fruit juices, etc. Try to be consistant.
A good high potency B vitamin is always good.
You may want to also try D,L-Phenylalanine.
Posted by EERRIICC on February 9, 2005, at 18:08:37
In reply to Re: Eliminating Parnate poop-out?, posted by SadDoggie on February 8, 2005, at 10:18:44
Unfortunately I will not be able to try memantine with adderall for about one or two months. Like you I'am very interested in memantine's alleged ability to reverse/eliminate amphetamine tolerance. Please keep me updated, and I'll post as soon as possible.
This is the end of the thread.
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