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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by brooke484 on May 20, 2007, at 13:20:46
I'm VERY sensitive to meds so for the past week I've only been taking 5 mgs of Parnate and I'm having so many side effects. Palpitations, anxiety, fatigue, and worst of all, (and I knew about this) the insomnia. I've been averaging about 3-4 hours a night and can hardly stand up. Is it silly of me to think these side effects will go away in time (except for the insomnia)? Am I just wasting my time with this drug? I mean, I can barely tolerate 5 mgs and I'm supposed to go up to 60? Is EMSAM easier to tolerate if you're super sensitive to meds? I'm running out of options.
Thanks for your help.
Brooke :)
Posted by kaleidoscope on May 20, 2007, at 14:35:45
In reply to 5 mgs of Parnate and all kinds of side effects, posted by brooke484 on May 20, 2007, at 13:20:46
>I'm supposed to go up to 60mg.
Why? Setting high 'target doses' for meds you've never tried before is not sensible. You cannot predict in advance the dose which will work best for you. Clearly, if you are having unpleasant side effects at 5mg you will not be able to tolerate 60mg. 60mg is a high dose. Despite what you may have read on babble, 60mg in in excess of the usual effective dose. Dr. K. Gillman, a psychitrist who has extensive experience (allegedly having treated ~1000 patients over many yrs) with Parnate, reports on his website that the effective dose is usually between 30mg and 50mg per day. Some patients, of course, will respond to <30mg (this could be you) whereas others may need more than 50mg. In general, 60mg is the maximum dose. A small minority of patients will TRD will benefit from more than 60mg.
The fact that you are having pronounced side effects from 5mg suggests that you are very sensitive to its pharmacological effects. I cannot claim to know why this is, perhaps you are not metabolising it normally? Anyway.......if you can, stay at 5mg for a few weeks, you may gain an antidepressant effect at this dose. If you are having such pronounced side effects at this dose, the Parnate is clearly 'doing something', perhaps it's already inhibiting enougth MAO to relieve your depression?
>Is it silly of me to think these side effects will go away in time (except for the insomnia)?
Some of them will probably lessen or dissapear, but probably not all of them.
>Is EMSAM easier to tolerate if you're super sensitive to meds?
EmSam is a ludicrously overpriced product which is probably less effective than Parnate. I wouldn't recommend EmSam unless you find that you still can't tolerate 5mg Parnate after a few weeks. In the mean time, 10mg Ambien might help you sleep.
It's awful to have to put up with so many side effects. If you really are running out of options (as you say you are), it might be worth sticking it out....
Ed
Posted by Phillipa on May 20, 2007, at 16:54:29
In reply to Re: 5 mgs of Parnate and all kinds of side effects » brooke484, posted by kaleidoscope on May 20, 2007, at 14:35:45
Emsam has no dietary restrictions till you get to 9 or l2 mg and a lot of people take the patch off at night so the insomnis doesn't bother them. Love Phillipa
Posted by jost on May 20, 2007, at 17:03:54
In reply to 5 mgs of Parnate and all kinds of side effects, posted by brooke484 on May 20, 2007, at 13:20:46
I would agree with Ed: there's no particular reason that you'd have to go up to 60 mg, or even 30 mg. That range is the usual range-- but some people need less, some more. If you're very sensitive to meds, and are having significant side effects at 5 mg, it may be that less than 30 mg would produce an anti-depressant effect.
Good luck,
Jost
Posted by kaleidoscope on May 21, 2007, at 12:31:17
In reply to Re: 5 mgs of Parnate and all kinds of side effects, posted by Phillipa on May 20, 2007, at 16:54:29
Hi PJ
EmSam has a long duration of action even after the patch has been removed. Because of this, taking the patch off at night is not likely to prevent the insomnia. The side effects of EmSam will persist for several days after the patch has been removed.
x
Posted by brooke484 on May 21, 2007, at 13:58:18
In reply to Re: 5 mgs of Parnate and all kinds of side effects » brooke484, posted by kaleidoscope on May 20, 2007, at 14:35:45
Thanks for your response. I hate to give up on a med so easily but I don't think I can take this anymore. I don't really want to take something else for sleep, so I guess it's on to Nardil or Emsam. Do you know if Marplan and Manerix are still available?
Thanks again.
Posted by kaleidoscope on May 21, 2007, at 14:09:00
In reply to Re: 5 mgs of Parnate and all kinds of side effects, posted by brooke484 on May 21, 2007, at 13:58:18
>Do you know if Marplan and Manerix are still available?
What country are you in? Moclobemide (Manerix, Aurorix) is available in most countries apart from the US.
Posted by linkadge on May 21, 2007, at 16:00:59
In reply to Re: 5 mgs of Parnate and all kinds of side effects » brooke484, posted by kaleidoscope on May 21, 2007, at 14:09:00
You might try something like a low dose of seroquel, or perhaps trazodone.
There probably wouldn't be an interaction with trazodone as it is a weak SSRI, and emsam is a weak MAO-A inhibitor. But don't hold me to it.
Linkadge
Posted by stargazer2 on May 21, 2007, at 18:48:00
In reply to Re: 5 mgs of Parnate and all kinds of side effects, posted by brooke484 on May 21, 2007, at 13:58:18
Brooke, I took Marplan last Spring so it should still be available...SG
Posted by stargazer2 on May 21, 2007, at 18:48:09
In reply to Re: 5 mgs of Parnate and all kinds of side effects, posted by brooke484 on May 21, 2007, at 13:58:18
Brooke, I took Marplan last Spring so it should still be available...SG
Posted by brooke484 on May 21, 2007, at 19:52:37
In reply to Re: 5 mgs of Parnate and all kinds of side effects » brooke484, posted by kaleidoscope on May 21, 2007, at 14:09:00
I'm in the US. I thought if it was available I would have another option (I need as many as I can get!).
brooke
Posted by brooke484 on May 21, 2007, at 19:57:03
In reply to Re: 5 mgs of Parnate and all kinds of side effects, posted by stargazer2 on May 21, 2007, at 18:48:09
How did it work for you? I read on another website that it's supposed to be one of the weaker antidepressants.
Posted by stargazer2 on May 21, 2007, at 22:35:12
In reply to Re: 5 mgs of Parnate and all kinds of side effects, posted by brooke484 on May 21, 2007, at 19:52:37
Brooke, I'm in the US too, so marplan is available here. Unfortunately it did not work for me as it had worked beautifully when I took in from 1992-1994 until Roche upbruptly discontinued it based on a "business decision" (poor earnings). I heard it was reformulated and like so many others, that can affect the way it works so the second time around it didn't work for me.
But if I were you I would give it a try to see if you have any luck with it. Then you can eliminate it if it doesnt work, that's what I did.
SG2
Posted by brooke484 on May 22, 2007, at 8:57:59
In reply to Re: 5 mgs of Parnate and all kinds of side effects, posted by stargazer2 on May 21, 2007, at 22:35:12
Thanks for the info. I'm starting Nardil in about a week so we'll see how that goes. If that doesn't work it's on to another MAOI. Parnate is making me freak out!
brooke :)
Posted by stargazer2 on May 22, 2007, at 22:11:02
In reply to stargazer, posted by brooke484 on May 22, 2007, at 8:57:59
I just started Nardil a week ago today and it's going very well. I'm only sorry I waited so long to try it again. It was at my insistence that Nardil was tried. I told my doc yeterday I was craving the pills like my body was needing whatever the Nardil provided my brain. I had effects after the first 2 to 3 days.
I guess MAO's are the only meds that I respond to, what does this tell me about the type of depression I have if none of the other meds ever worked very well or for very long???
We'll have to share our stories as we go down Nardil Lane together....where is Ugotta and other Nardilites to cheer us on???
SG2
Posted by brooke484 on May 23, 2007, at 8:56:27
In reply to Brooke484/Calling Nardilites for support+cheer, posted by stargazer2 on May 22, 2007, at 22:11:02
I've been reading some old posts and I'm a little concerned about this "new" Nardil. Is it really as bad as they make it sound? I guess I was taking the old stuff back in 1996 and I had fairly good results. Do I need to worry??? You said it's going well for you so far so that's encouraging.
brooke
Posted by kaleidoscope on May 23, 2007, at 15:16:01
In reply to new vs old, posted by brooke484 on May 23, 2007, at 8:56:27
>I've been reading some old posts and I'm a little concerned about this "new" Nardil. Is it really as bad as they make it sound?
No, I'm sure it will be fine. I would strongly recommend that you avoid reading these posts, they will do nothing but cause unnecessary anxiety.
Ed
Posted by stargazer2 on May 23, 2007, at 18:28:03
In reply to new vs old, posted by brooke484 on May 23, 2007, at 8:56:27
Brooke I took it back in 1987 to 1989 when I was taken off it by a crazy, naive pdoc who wanted to charge me for a visit when I missed an appt but when she missed an appt, she didn't see that as the same thing. Crazy, I fired her after that.
Anyway, the biggest difference is you may need a higher dose. I tood 30 mg then, i'm on 45mg now so that's the only thing I've been made aware of.
Like Ed said, you have to ignore alot of other's negativity when you're trying something new. I do best staying off PB during a new drug trial becasue everyone's experiences are so varied, it makes no sense to try and get another opinion of a drug. Just trust your own instincts and listen to your body tell you if it's helping or not.
SG2
Posted by Phillipa on May 23, 2007, at 19:59:16
In reply to Re: new vs old, posted by stargazer2 on May 23, 2007, at 18:28:03
Hence when the site was down I was able to up my luvox and down my valium. Love Phillipa
Posted by brooke484 on May 23, 2007, at 21:15:34
In reply to Re: new vs old » brooke484, posted by kaleidoscope on May 23, 2007, at 15:16:01
You are right. Everyone is different. I should know better.
Posted by brooke484 on May 23, 2007, at 21:18:40
In reply to Re: new vs old, posted by stargazer2 on May 23, 2007, at 18:28:03
AS long as I don't have more side effects I'll be fine. The first time I took it I didn't have any at all which is so rare for me.
Thanks for all your help!
Posted by stargazer2 on May 23, 2007, at 21:57:40
In reply to Re: new vs old - stargazer, posted by brooke484 on May 23, 2007, at 21:18:40
Same here, no SE's back then . Currently dealing with afternoon drowsiness and early AM wakening(5am) but still better than before the Nardil so I have no complaints. Any improvement is major since I have not had any medication work well since 1994 when I took marplan. Since then I've taken every medication for depression, bipolar and psychosis, some worked a little, none worked very well. Many years of a wasted life. Many lost opportunities but hopefully now I can catch up with my life which has been on hold.
SG2
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