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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by willyee on August 29, 2005, at 20:42:12
This is to the more veteran parnate users.I typicaly range in dose between 30 mg to 60 mg,in increments of either 20 mg or 10.
The highest amount i can take is 50 mg,i tolerated it a few times,and a few times it got me,meaning it made me sweat and i felt uneasy,it was just not right period.
It seems certain things i take make a 50 mg dose more tolerable,for instance klonopin on a 50 mg dose would cause the bad reaction,BUT a small pieace tiny peiace of ablify when i had it let 50mg set in.
Im curious since one parnate user highly stressed to me i was NOT on a suffcient dose,having the reaction i did on 50mg,should i try for a 60 mg single dosing.He told me it actualy gets easier on u with higher doses,if this starts at 60 or not i dont know,but god i have to make this damn med work i have no options,im willing to go for a 60mg i just am curious is it gonna be like a 50 and tear me up sweating etc,is there anytrhing i can take to make the 60 mg settle in?
Als people like sls,im curious in what incrment amounts do u take ur parnate,what is the highest increment you have used?Thank you
Posted by djmmm on August 30, 2005, at 8:38:35
In reply to Parnate users,dosing amts, posted by willyee on August 29, 2005, at 20:42:12
> This is to the more veteran parnate users.I typicaly range in dose between 30 mg to 60 mg,in increments of either 20 mg or 10.
>
> The highest amount i can take is 50 mg,i tolerated it a few times,and a few times it got me,meaning it made me sweat and i felt uneasy,it was just not right period.
>
> It seems certain things i take make a 50 mg dose more tolerable,for instance klonopin on a 50 mg dose would cause the bad reaction,BUT a small pieace tiny peiace of ablify when i had it let 50mg set in.
>
> Im curious since one parnate user highly stressed to me i was NOT on a suffcient dose,having the reaction i did on 50mg,should i try for a 60 mg single dosing.He told me it actualy gets easier on u with higher doses,if this starts at 60 or not i dont know,but god i have to make this damn med work i have no options,im willing to go for a 60mg i just am curious is it gonna be like a 50 and tear me up sweating etc,is there anytrhing i can take to make the 60 mg settle in?
>
>
> Als people like sls,im curious in what incrment amounts do u take ur parnate,what is the highest increment you have used?Thank youParnate only comes in 10mg because it was never designed to be taken as a single dose.
I would not take 50mg or 60mg at once. It seems to me (from my experience with parnate) that this high of a dose would cause a significant pressor response. The sweating and feeling uneasy is a warning sign that your blood pressure is too high.You had less of a reaction when you took klonopin with the 50mg dose, simply because Klonopin decreases norepinehrine turn over-- so your spike in blood pressure would not be as high. Similar can be said about taking Abilify with the 50mg dose-- although Abilify's pharmacology is far more complex.
Typically 40mg works for the vast majority of Parnate users, often it effective at a LOWER dose.
Do not take 60mg at once. This does NOT make Parnate more effective, it simply exaggerates the potential side-effects. If you are having a blood-pressure reaction at 50mg, you will have a more severe reaction the higher dosage you take... I can assure you it doesn't get easier or better with higher doses (single doses).The best way to "find" the correct dose for you, is to take a starting dose (anywhere from 10mg-30mg) and then add a dose (10mg-20mg) a few hours later. If you need 60mg or higher (which you may very well need) take it in increments. Some people find they need to take 2 pills 3-4x a day (60mg-80mg)
Because of the pharmacology of MAOIs, be sure to be consistant with both the dosage, the increments, and even the time you take your medication. If you can tolerate up to 60mg in divided doses, then stick with that dose for a few weeks. good luck
Posted by Chairman_MAO on August 30, 2005, at 9:40:47
In reply to Re: Parnate users,dosing amts, posted by djmmm on August 30, 2005, at 8:38:35
I am the one he was talking about in his message.
It has been proven by correlating treatment response with measurement of platelet MAO inhibition that the therapeutic dose of Parnate is 0.8mg/kg (That is, the dosage that produces 80% MAO inhibition). That is not to say that it won't elevate your mood at lower doses, but rather that you cannot say that you've given Parnate a fair trial until you've hit 0.8mg/kg.
Personally, I found 120-200mg/day easier to tolerate than 60-80mg/day: no hypotension, no sexual dysfunction. This was due to its amphetamine-like metabolites reaching significant concentrations. Furthermore, I found that if I took it all at once in the morning (I had NO problems tolerating a single dose of 200mg), sleep required far less sleep aid medication than if I took it in divided doses. However, if I took it in divided doses I felt far less anxious, because the hypotensive effect (I think) of tranylcypromine counteracted the overactivation of the amphetaminelike metabolites. All-in-all, I gave up on Parnate because it was simply impossible to get a good night's sleep--which was ruining my life--and my docs will never prescribe the amount of downer I'd need to do so.
I gave up and switched to Nardil. It works a lot better for my social phobia/anxiety/dysthymia anyway (though parnate wasn't shabby at all, that's for sure). Unfortunately, the initial success I had with cabergoline managing the sexual dysfunction is no longer; even taking doses as large as Parkinson's patients do (over 2mg/day!) had no effect!
Out of desparation last weekend I decreased my dose from 90mg/day to 75mg/day, despite the fact that 90mg/day is clearly superior. I am a 25-year-old male, and simply will not tolerate *COMPLETE* sexual dysfunction; I couldn't maintain an erection during intercourse despite cabergoline, herbs (tribulus, dodder seed, and others), AND _60mg_ of tadalafil.
While I've only been at 75mg/day for three days, I now have some spontaneous erections, some increased sensitivity, and have been able to orgasm through masturbation again (although I am still taking shilajit, dodder seed, tribulus terrestris, AND horny goat weed to increase my potency/function/libido, and plan on adding more alternative treatments). Hopefully it will continue to get better over time, as I fear 60mg/day may not be a therapeutic dose for me.
This is the only thing I really miss about Parnate: the orgasms on Parnate at 120-200mg/day were BETTER than on no medication at all. All I had to do was use 10-20mg Cialis and I was rockin' in that department. I'd really hate to give up Nardil, though, as it works a lot better for my negative self-talk and other things related to social phobias/anxiety. Even at 75mg/day, I notice some of those negative thoughts are coming back, though things are still orders of magnitude better overall than when I'm not on medication. Perhaps this will get better, though, as I'm still experiencing "brain shocks" from the dosage reduction.
I am going to talk to my doctor about perhaps trying a cholinergic medication (bethanechol, neostigmine) for the sexual dysfunction. Another option I suppose is Wellbutrin, which due to Nardil's anxiolytic properties I may be able to tolerate now. Neostigmine is sometimes used to obtain semen samples from criminals when "traditional" methods are not working for whatever reason.
Posted by willyee on August 30, 2005, at 10:00:37
In reply to Re: Parnate users,dosing amts, posted by djmmm on August 30, 2005, at 8:38:35
I just finished reading an updated data sheet from the manfufacurer about max dose.This particular one,as ive noticed changes constantly to this sheet,has parnate at 30 mg dose.
It recomends to take parnate 20mg upon waking,10 mg per afternoon.
Also what i had said was klonopin actualy makes higher doses of parnate worse,they clash.Ablifly allowed me to take more of a higher dose of parnate.
Theres no way i could take parnate in 10 mg increments,i doubt im the only person who takes at the very least 20 mg increments.Heres is a snip and the actual linkk i got it from...
"Dosage And Administration: Dosage should be adjusted to the requirements of the individual patient. If the patient responds to therapy, the response is usually seen within 48 hours to 3 weeks after starting medication.
Recommended starting dosage is 20 mg/day (10 mg in the morning and 10 mg in the afternoon).
Continue this dosage for 2 to 3 weeks.
If no signs of a response appear, increase dosage to 30 mg daily (20 mg upon arising and 10 mg in the afternoon).
Continue this dosage for at least 1 week. If no improvement occurs, continued administration is unlikely to be beneficial. Although dosages above 30 mg/day have been used, it should be borne in mind that the incidence and severity of side effects may increase as dosage is raised. Dosage increases should be made in increments of 10 mg/day and ordinarily at intervals of 1 to 3 weeks.
When a satisfactory response is obtained, dosage may be reduced to a maintenance level.
Some patients will be maintained on 20 mg/day; many will need only 10 mg daily. "
Posted by Chairman_MAO on August 30, 2005, at 10:37:00
In reply to Re: Parnate users,dosing amts, posted by willyee on August 30, 2005, at 10:00:37
Is this drug maker located on Mars? I'd like to find all of the people who've been put on MAOIs due to the failure of multiple other agents who do well on 10mg/day. There is *NO WAY* that is a therapeutic dose for most people with significant mental illness.
I feel this drug maker simply wanted to avoid lawsuits, etc. and so used an insanely low dose cap in its investigations. At the very least, I cannot see why else they would intimate that one could be maintained on 10mg/day of Parnate for major depression.
Posted by willyee on August 30, 2005, at 13:08:53
In reply to Re: Parnate users,dosing amts » willyee, posted by Chairman_MAO on August 30, 2005, at 10:37:00
No i posted that to djmm as he said no one should be taking parnate in higher than a single dose increment...(single 10mg tab)
I know he said that and i know theres is a old data sheet that i actualy have here that implies what he said,about no more than a single tab.However after speaking with the company,and posting a more previous verison of the data sheet,you can see they dont mentionion NOT dosing multiple tabs,BUT in fact do mention it.
There has been a number of updates to parnates data,sheet going from max 30 mg to max 60 mg,theres pubmed ranges going well above 100,so obviously this med was old enough and given up on quick enough to where the known pharmacology of it is stll very very iffy.
I have been on the drug a very long time,i was aware of the info djmmm posted to my question,although gratefeful for the time he took to reply,am shocked that he would assume i dident know the very baisics of the mdication,and hrpertensive crisis.
The reason i asked such a question was i wanted to get past common data sheet answers such as he provided and wanted real life experiaces such as your and a few others who have used the drug in high amounts,i just dont know EXACTLY who they are.
Posted by Declan on August 30, 2005, at 14:42:34
In reply to Re: Parnate users,dosing amts, posted by willyee on August 30, 2005, at 13:08:53
Hey, you would have read that Lauren had that funny sweaty reaction to the 30mg she took, having already had 20mg in the morning.
I think it depends on how bad your depression is, what sort it is, and what you are prepared to put up with to get rid of it.
For example I'm sure as I can be that Parnate would have been disasterous for my mother's agitated depression. She couldn't sleep anyway.
And another off topic thing for me is that I'm not in a hurry to reregulate brain thingos unless it's worth it for me.
But I wouldn't feel happy with that sort of reaction, Willy. But EERRIICC knows about this stuff.
I'm dying to ask you about the neostygmine, semen and criminals, Chairman. I need to start my day on a nice note.
Declan
Posted by laurenjb on August 30, 2005, at 20:39:04
In reply to Re: Parnate users,dosing amts, posted by Declan on August 30, 2005, at 14:42:34
As Declan says, I have had temperature regulation problems -- run hot and cold a lot and I'm at 50mg now. I take 30mg first thing in the morning (or at like 3am if I can't sleep --less of a problem at 50 than at 40) and try to take the next 20 before 1pm so it doesn't affect my sleep. I do have to say, I've played with when I take my pills, have never taken them all at once -- it doesn't seem to really make any difference when I take them. I was thinking of going back down to 40 because the orthostatic hypotension has been way worse and the higher dose isn't helping my depression. Anyway, maybe I'll try taking it all it once and see if anything changes. Take care, Lauren
> Hey, you would have read that Lauren had that funny sweaty reaction to the 30mg she took, having already had 20mg in the morning.
>
> I think it depends on how bad your depression is, what sort it is, and what you are prepared to put up with to get rid of it.
>
> For example I'm sure as I can be that Parnate would have been disasterous for my mother's agitated depression. She couldn't sleep anyway.
>
> And another off topic thing for me is that I'm not in a hurry to reregulate brain thingos unless it's worth it for me.
>
> But I wouldn't feel happy with that sort of reaction, Willy. But EERRIICC knows about this stuff.
>
> I'm dying to ask you about the neostygmine, semen and criminals, Chairman. I need to start my day on a nice note.
>
> Declan
Posted by djmmm on August 30, 2005, at 20:50:21
In reply to Re: Parnate users,dosing amts, posted by willyee on August 30, 2005, at 13:08:53
> No i posted that to djmm as he said >
> I know he said that and i know theres is a old data sheet that i actualy have here that implies what he said,about no more than a single tab.However after speaking with the company,and posting a more previous verison of the data sheet,you can see they dont mentionion NOT dosing multiple tabs,BUT in fact do mention it.
>
> There has been a number of updates to parnates data,sheet going from max 30 mg to max 60 mg,theres pubmed ranges going well above 100,so obviously this med was old enough and given up on quick enough to where the known pharmacology of it is stll very very iffy.
>
> I have been on the drug a very long time,i was aware of the info djmmm posted to my question,although gratefeful for the time he took to reply,am shocked that he would assume i dident know the very baisics of the mdication,and hrpertensive crisis.
>
> The reason i asked such a question was i wanted to get past common data sheet answers such as he provided and wanted real life experiaces such as your and a few others who have used the drug in high amounts,i just dont know EXACTLY who they are.
NOTE: I did NOT say "no one should be taking parnate in higher than a single dose increment...(single 10mg tab)" I believe you have misread my post.FWIW, I take 30mg in the morning and another 20mg at noon...
I said not to take a high dose (i think it was 50mg) at one time-- as a single dose... my comments on hypertension were based on the specific reaction resulting from the single 50mg dose.
also, I assumed you DIDNT know a lot of the info on hypertension-- only because you seemed to be questioning the "uneasy feeling" and the "sweating", after consuming a single 50mg dose... and then stating that you were thinking about taking 60mg at once.
Posted by willyee on August 31, 2005, at 2:17:26
In reply to Re: Parnate users,dosing amts, posted by djmmm on August 30, 2005, at 20:50:21
I dont doubt for a second i misread your post,with emails and other things online,i actualy have limited time her and fly by,i get tempted and read posts when i know i dont have the time,guess im addicted,anyway if i did misread your post then apologies due,theres no way i can stay on top of things,i have barly enough time to read my posts,im sure im not the only one.
As far as the high dose,im surprised lauren that u do not find a difference in how high you dose,if im hearing u right.If i am,well i know i find a HUGE difference from a subtle 20mg-30mg dose,then 40 and above the effects are different very different.
The 50 mg isnt a reaction,or full blow one,as its happened and sweating is the main problem,the one time i did have a reaction i remeber there was a headache invovled,heart beat very fast,spots on me and i can go on and on.
I just sweat and feel fatigue at 50,but its happened on occasion and on occasion it was fine.
Deciding whether or not a 60 mg dose would brake some sort of barrier and act totaly different i suppose is far fetched,prob be more of the same as in the 50 mg dose.I was jus curious if anyone actualy ever took a 60 mg dose latly at once.Again sorry if i came off wrong when ur not speaking but instead typing sometimes ur statements can take a different tone than what ur trying to portay,any thanks.
This is the end of the thread.
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