Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Justherself54 on August 27, 2008, at 10:10:48
This is week 13 for me and I've been at 50 mg. for 2 of them. I feel no different than I did at 20 mg.
I have had a partial response to Parnate and we were hoping that raising it to 50 mg. would help but nothing yet.It has helped to keep the depression somewhat manageable, however, I am so lethargic and unmotivated. I just realized that I haven't even turned on the TV in 13 weeks, and I can't focus on reading a book for more than a half hour at a time.
I know from previous threads that augmenting with a TCA could help, but 10 mg of amitriptalyne has knocked me out for 10 hours. The same with nortryptaline.
I've always had a problem with SSRI's when I've tried to revisit them. They just don't work again the way they used to and this Parnate trial feels the same. It's just not working like it did before. I had previous responses to 20 mg. although at that time I couldn't go any higher due to extreme hypotension.
So what say ye, learned friends..I see pdoc next week...
Posted by Phillipa on August 27, 2008, at 11:02:56
In reply to Parnate Trial - keep going or call it a day, posted by Justherself54 on August 27, 2008, at 10:10:48
Oh wow and I thought you were getting better. What about the cymbalta you were going to try? Don't know what to say as don't know parnate just offer my support. Love Phillipa
Posted by Nadezda on August 27, 2008, at 12:51:52
In reply to Parnate Trial - keep going or call it a day, posted by Justherself54 on August 27, 2008, at 10:10:48
You could try a higher dose, unless there's some reason that isn't possible. I needed to get to about 80 mg before I started to get a real reaction to it. Of course, going that high or higher is a very individual thing.
The other thing to try is adding provigil or maybe even adderall. They could help with energy. My pdoc also suggested lithium to boost my response to parnate. He works a lot with Maois.
Nadezda
Posted by Phoenix1 on August 27, 2008, at 16:34:39
In reply to Parnate Trial - keep going or call it a day, posted by Justherself54 on August 27, 2008, at 10:10:48
Hi Justherself,
I think that if you are tolerating the 50mg Parnate dose OK, you should try raising the dose further, say 10mg/2 weeks until you get a response, or experience intolerable side effects. It worked for you well before, and maybe this time, you just have to push the dose higher to get the same effect. You have responded better to MAOIs than other drugs in the past, so I would suggest sticking with parnate a little longer. I have read lots of posts in the archives from people who didn't get a response until 80 or even 100mg.
I'm crossing my fingers for you. I really hope you see some improvement soon. Let me know what your pdoc says.
Phoenix
Posted by Justherself54 on August 27, 2008, at 19:01:04
In reply to Re: Parnate Trial - keep going or call it a day » Justherself54, posted by Phoenix1 on August 27, 2008, at 16:34:39
I keep you posted for sure. My BP is running around 90/60..that's where my pdoc is going to see a problem with an increase. This has been recent, although I think the antibiotic I'm on is partly to blame.
I'm now getting constant bouts of hypotension. What I find frustrating, is I don't get the dizziness when I first stand up. It takes a couple of minutes, then it hits. It's a very uncomfortable feeling, as I also get a loud rushing noise in my head that takes awhile to go away. I've got one more day on the antibiotic, then we'll see if the dizziness goes away, as I've been lucky and had virtually no hypotensive episodes.
I'll keep monitoring my BP and take the readings when I see him and I quess we'll go from there. I would do another increase, but I'm getting frustrated as with each increase I'm not noticing much improvement. It'll just take that much longer to titrate down. So it's a wait and see game now.
Take care..
Posted by bleauberry on August 28, 2008, at 19:31:31
In reply to Parnate Trial - keep going or call it a day, posted by Justherself54 on August 27, 2008, at 10:10:48
Tough questions you ask. Same questions for most of us I guess.
On one hand it makes sense to raise the dose until you either get a response or you encounter intolerable side effects.
On another hand, well, it's been over 3 months already.
And yet on another hand, maybe the whole increased neurotransmitter level thing is only a piece of the puzzle, and that receptor blockade is the other. Things such as risperidone, olanzapine, mirtazapine.
People who have failed maois and ect have responded to milnacipran, milnacipran+risperidone, and fluvoxamine+risperidone, effexor+mirtazapine. I know you've been on the ssris, but maybe not prozac+zyprexa, zoloft+something?
I'm an ex-longtime user of zyprexa and though it was a good friend for many years, I still tend to shy away from the anitpsychotic class in general. No good reason why really, except maybe that the higher doses than needed which are often prescribed end up giving them a bad rap? I dunno. Anyway, I can say, when they work, they work fast. And they completely change the other med you are taking.
Just my experience and some thoughts.
Someone mentioned stimulants. Ritalin. Modafinil. Those are good candidates for you too.
Though you say you've had a partial response, I don't know. You used to read books more than 30 minutes, but now you can't? You used to watch TV, but now you haven't wanted to in 13 weeks? Lethargic and not as engaged in life as you used to be? Kind of makes one wonder if life quality has partially improved or actually worsened.
Posted by Justherself54 on August 28, 2008, at 22:52:55
In reply to Re: Parnate Trial - keep going or call it a day, posted by bleauberry on August 28, 2008, at 19:31:31
I'm about ready to call it a day..a side effect from parnate has worsened my fibromyalgia to the point where I'm having trouble getting out of my chair. It's causing me to have spasms or muscle clenching in my sleep and being in a constant fibro flare is just bringing my mood lower.
He mentioned revisiting some of the SSRI's that worked really well for me in the past. We did try Zoloft (my fav) again before the MAOI's but it didn't work and at 200 mg...well lets just say my bowels objected mightily!
I tried resperidone but it make me very agitated and anxious. I do take a small amount of seroquel at bedtime.
The two SSRI's that I had a great response to were Zoloft and Lexapro, but the dreaded poop out always happens. I wish there was something to stop that from happening.
I dread coming off yet another med..I had an awful time coming off Nardil.
With your permission I'd like to print your post and take it to my pdoc, as I can't retain much in my pea brain right now.
I'll post again after I see my pdoc. Thanks to all who responded..I have a feeling I'm going to need some support.
Your post hit home Bleauberry. I just kept hoping that it would kick in..but the apathy and lack of motivation, notwithstanding the worsening of a chronic pain condition, has to be addressed.
Posted by Zeba on September 1, 2008, at 18:56:07
In reply to Re: Parnate Trial - keep going or call it a day » bleauberry, posted by Justherself54 on August 28, 2008, at 22:52:55
Do you think a lower dose of Parnate plus something else added such as has been suggested by others might help.
I am having some problems with Parnate now too. At 40 mg. I developed the sense of like ants crawling under my skin in the front of my ankles and can't keep my feet still. We tried going down to 30 mg., but now I am feeling more depressed, and I still have the sensation of the ants crawling under my skin in my ankles. Damn, maybe it is not the Parnate. I don't take any other psychotropic meds though.
I used to take Lithium with Parnate years ago, and that did seem to help for a time, but eventually the Lithium did nothing, and so I was just on Parnate which helped a lot back then.
Zeba
Posted by Justherself54 on September 1, 2008, at 20:25:10
In reply to Re: Parnate Trial - keep going or call it a day » Justherself54, posted by Zeba on September 1, 2008, at 18:56:07
Hi Zeba. The drop down did nothing but make me feel more depressed. We'll see what my pdoc days on Friday. I cannot tolerate TCA's whatsoever, unless I want to live my life sleeping.
I can't take the constant fibro flare. I've never had this much pain with it before. It has been a bit better today, however, I woke again in the night with my muscles clenched so tight my back was arched off the mattress. I think it is a side effect of the parnate. I will need narcotics soon if I can't get relief from this. I really don't want to go there.
I hope your skin sensation isn't due to parnate, but if you've never had this sensation before and are on nothing else, unfortunately it probably is the parnate. It must be driving you crazy!
I'll post again once I see my pdoc, but I think this trial is over, unless he pulls a rabbit out of his hat. He pretty much said if there was no partial response at 50 mg. we were going to discontinue it.
The next hurdle is what to try next as I've been on everything except remeron and I've put on so much weight with these drug trials I am now clinically obese with high blood pressure. I don't want to go on a med that's known for weight gain. I'm frustrated and frightened about what to do next.
Anyway, that's my tale of woe. I hope you can find out what's causing you skin sensation and what's causing your feet to keep moving.
Posted by Nadezda on September 1, 2008, at 21:58:44
In reply to Re: Parnate Trial - keep going or call it a day » Justherself54, posted by Zeba on September 1, 2008, at 18:56:07
Is it possible, then, that it isn't the parnate, and that you need to look into treatments for the sensation, and can continue with your prior dose of parnate?
It could be unrelated to medication.
Nadezda
Posted by Zeba on September 2, 2008, at 23:43:16
In reply to Re: Parnate Trial - keep going or call it a day » Zeba, posted by Justherself54 on September 1, 2008, at 20:25:10
My therapist/pdoc is not so sure my problem is from Parnate. My MRI from June I just learned was not normal,and my therapist wants me to go back to the neurolgist. I am having problems from the Chiari malformation which seems to have worsened since I did ECT last year. Also it looks like I had some small strokes with the ECT. ThERE is other stuff too. Testing -neuopsych revealed cognitive impairments since ECT. There is a lot to sort out.
Hope you can get to the bottom of your stuff.
Zeba
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