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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 Don_Bristol on September 7, 2008, at 20:42:19
Can you please advice me on Parnate withdrawal.
I've been on 60mg Parnate for 2 years but recently I've realised it is having adverse effects on my cognitive ability.
I need to lower my Parnate as soon as possible. All other things being equal (although they never are!) how quickly could I go down to something like 30 or 40mg daily?
I once read that a side effect of Parnate withdrawal is agitation but that's strange as Parnate definitely energises me and I figured reducing Parnate would slow me down.
There's not much literature on Parnate. Does anyone know if there are studies showing percentage side effects from withdrawal (and also using Parnate normally
Thank you for any information.
---------------- START BACKGROUND DETAILSI think the Parnate probably always blunted my cognitive ability but I had enough mental function for the blunting to be insignificant.
Recent huge levels of stress from trauma have probably become subconscious but still lower my overall capability. So the Parnate blunting effect then becomes noticeable and is a problem.
I get trouble with MEMORY (even where I have just put something) and CONCENTRATION. This makes it hard to do things like: (A) writing a letter or a posting like this one; (B) reading a medium-difficulty newspaper article; (C) categorising & organising documents or books (D) filing of PC desktop icons or emails; (E) using a diary (writing or referring to it).
I take 20mg Parnate at 9am, midday and 4pm. This blunts me all day until about 9pm. After midnight I am substantially more alert and if I don't take a sleeping tablet then I can do a lot of work for several hours. The problem is that my mood plummets after a few days of working late into the night because I am so short of sleep.
---------------- END BACKGROUND DETAILS
Posted by Justherself54 on September 7, 2008, at 21:22:34
In reply to Seek info on Parnate withdrawal symptoms, posted by Don_Bristol on September 7, 2008, at 20:42:19
I'm withdrawing from 50 mg parnate. I screwed up even with a pill container and went down to 30 from 50 and had a day of brain zaps. I stayed at 30 for a week and am now at 20 mg. I have more motivation now than I did at 50. Focus and concentration are still pretty fuzzy. I have to leave my bills out in plain sight or I'll forget to pay them. So far it's been the easiest withdrawal I've had from any AD. I just hope I don't have a crash on the 14 day washout.
I don't know of any statistics, but there probably are posters here that do..and as far as using parnate normally, I would stay at the doseage that you feel the best at. Good luck!
Posted by Nadezda on September 7, 2008, at 22:16:26
In reply to Re: Seek info on Parnate withdrawal symptoms, posted by Justherself54 on September 7, 2008, at 21:22:34
I don't know any statistics, but I would taper gradually and fairly slowly. Although I was taking more than you when I went off, I tapered too rapidly and ended up having one of those massive panic attacks where you seriously think you need to get to the hospital asap--
I'm not sure there are concrete answers, because my pdoc is pretty experienced and didn't anticipate my reaction. I really do think it's pretty individual. It should be totally manageable, if you do it carefully, but consult a pdoc before doing anything, just in case.
Nadezda
Posted by Justherself54 on September 7, 2008, at 22:44:16
In reply to Re: Seek info on Parnate withdrawal symptoms, posted by Nadezda on September 7, 2008, at 22:16:26
How fast did you taper down and at what point in the taper did you get the panic attack? Part of me feels I'm tapering too quickly as I skipped a week but as I'm not feeling anything remotely like I have tapering on other AD's I'd just like to get it over and done with.
Posted by Phillipa on September 7, 2008, at 23:50:27
In reply to Re: Seek info on Parnate withdrawal symptoms » Nadezda, posted by Justherself54 on September 7, 2008, at 22:44:16
Maybe that's what poop out is the med just doesn't affect your mind body anymore? Love Phillipa good luck
Posted by Nadezda on September 8, 2008, at 9:17:25
In reply to Re: Seek info on Parnate withdrawal symptoms, posted by Justherself54 on September 7, 2008, at 21:22:34
I had cut down much faster than you, JH, so I think if you're not feeling any withdrawal, you could go down to 10 mg after a few days at 20 mg. You've been pretty conservative so far.
My pdoc didn't give me any instructions, which is a bit unlike him, but I get the feeling he may generally underestimate the effect of discontinuation.
I think when I finally went back up again (after calling my pdoc in the middle of the night from the hospital waiting room), I went down about 10 mg every three or four days. I didn't have any problems with that.
Incidentally, my pdoc prescribed seroquel for me while I was still in the waiting room, which took about an hour, of course, but helped a great deal. Maybe your pdoc could give you a little of that, just in case.
Let me know if you have any problems.
Nadezda
Posted by Justherself54 on September 8, 2008, at 12:14:45
In reply to Re: Seek info on Parnate withdrawal symptoms, posted by Nadezda on September 8, 2008, at 9:17:25
Thanks Nazdesda.
I have seroquel on hand, as I take a small dose at night for sleep. I can also take extra clonazapam if things get a little rough during the washout period. I'm a little more anxious today, but not to the point where I have to take anything, at least not yet.
I grow weary with 5 years plus of constant med changes that only give relief for 6 months or so..I can't seem to get back where I was before the prolonged mania hit and the subsequent fall out.
Posted by Quintal on September 8, 2008, at 15:39:57
In reply to Seek info on Parnate withdrawal symptoms, posted by Don_Bristol on September 7, 2008, at 20:42:19
Hi Don, I don't remember having cognitive difficulties while I was on Parnate, but I wasn't doing anything at the time that would make me notice if it was mild. Quite often I would run out of Parnate before the end of the month and have to go a few days without. It was more of a lethargic feeling than agitation, and the depression came back again quickly. I think going down about 10mg/week is the recommended rate to avoid withdrawal symptoms.
Q
Posted by Don_Bristol on September 9, 2008, at 18:12:17
In reply to Re: Seek info on Parnate withdrawal symptoms, posted by Justherself54 on September 7, 2008, at 21:22:34
Strange that you feel muddled as you withdraw and create a Parnate "deficit" but I feel muddled when my parnate is in "surplus". Why would that be?
> I'm withdrawing from 50 mg parnate. I screwed up even with a
> pill container and went down to 30 from 50 and had a day of
> brain zaps. I stayed at 30 for a week and am now at 20 mg. I
> have more motivation now than I did at 50. Focus and
> concentration are still pretty fuzzy. I have to leave my bills
> out in plain sight or I'll forget to pay them. So far it's been
> the easiest withdrawal I've had from any AD. I just hope I
> don't have a crash on the 14 day washout.
>
> I don't know of any statistics, but there probably are posters
> here that do..and as far as using parnate normally, I would stay
> at the doseage that you feel the best at. Good luck!
Posted by Justherself54 on September 9, 2008, at 18:41:23
In reply to Re: Best way to take Parnate?, posted by Don_Bristol on September 9, 2008, at 18:12:17
Sorry, I didn't make myself very clear. Parnate did not work for me this time. I felt muddled a good part of the time, which is quite different on how it affected me the first time. As I just want to get this withdrawal over with, I stopped at 20 mg. yesterday. Brain zaps are unpleasant but I always get them going off any AD..the only difference is the degree and severity of the discontinuation symptoms.
Sorry if this post isn't very clear either..I'm just trying to get through today as best I can feeling like I have enough electricity in my brain to light up a room..
> Strange that you feel muddled as you withdraw and create a Parnate "deficit" but I feel muddled when my parnate is in "surplus". Why would that be?
>
> > I'm withdrawing from 50 mg parnate. I screwed up even with a
> > pill container and went down to 30 from 50 and had a day of
> > brain zaps. I stayed at 30 for a week and am now at 20 mg. I
> > have more motivation now than I did at 50. Focus and
> > concentration are still pretty fuzzy. I have to leave my bills
> > out in plain sight or I'll forget to pay them. So far it's been
> > the easiest withdrawal I've had from any AD. I just hope I
> > don't have a crash on the 14 day washout.
> >
> > I don't know of any statistics, but there probably are posters
> > here that do..and as far as using parnate normally, I would stay
> > at the doseage that you feel the best at. Good luck!
This is the end of the thread.
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