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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by metamorphosis on February 7, 2009, at 14:01:34
I see psychiatrist in a week.I've been doing alot of research/reading/peoples threads etc.I'm considering Parnate because of it's low side effect profile and stimulating properties.But I would probably have to augment with a more GABAcentric drug for it doesn't seem to target this area.I have GAD with mild to moderate depression and can be OCD at times.It manifests its self in very low energy levels and loss of interests in my passions + general motivation.It seems Parnate would help with this.Does it tend to cause hypertension and what could I augment it with?I've used gabapentin but seemed to lose it's effectiveness/poop out when I took it.I do take Klonopin daily but would like to ween off of it due to longterm cognitive damage it ossurs.
I've heard really good things about Nardil especially for the anxiety part of the equation but weight gain,sedation and possible liver toxcisisty(sp) are not acceptable.How common is this liver issue as does Parnate cause the same issue longterm.
Last,I've read more and more about the exceptional benefits Selegline and how in low doses it could be used in combo with an ssri likr Lexapro?
I would appreciate responses from anyone who has used any of the above meds or cmbonations listed above or has any suggestions.I see the doctor in a week and I am trying to get a plan of action startng a new med regiment.The Wellbutrn did not work and I've had to wait 2 weeks for a washout.My doctor and I are willing to try anything for a good trial run.
Again responses greatly appreciated.You guys/gals help ouy immensley!
Posted by metamorphosis on February 8, 2009, at 3:47:43
In reply to deciding between meds.I need a couse of action, posted by metamorphosis on February 7, 2009, at 14:01:34
all responses appreciated
Posted by Garnet71 on February 8, 2009, at 5:29:04
In reply to deciding between meds.I need a couse of action, posted by metamorphosis on February 7, 2009, at 14:01:34
Hi Metamophosis,
I'm here asking similar questions and am not one to give much advice concerning medications. I hope someone comes along to help you out.
I don't know why it has been so quiet here lately. Doesn't everyone want to spend their Saturday night here like I just did?
Hang in there for now, okay?
Posted by SLS on February 8, 2009, at 7:46:19
In reply to deciding between meds.I need a couse of action, posted by metamorphosis on February 7, 2009, at 14:01:34
People don't generally consider Parnate to be an anxiety medication, simply because it is "stimulant-like". Its metabolites may have "stimulants" in them (never isolated), or because there is nothing directly GABAergic about it, Parnate is rejected as the first choice to treat generalized anxiety disorder (GAD). Yet, this drug is almost as effective in treating social anxiety disorder (SAD) by itself. I like its side effect profile more than that of Nardil. The orthostatic hypotension disappeared completely for me after awhile. There are no sexual side effects beyond the first few weeks. It has less potential to produce difficulties with urination and edema. Just start low and titrate gradually, and you won't be blown away by it. You'll need at least 40mg to be insured a therapeutic effect.
Spontaneous hypertension occurs infrequently. Moving up the dosage should help protect you from this happening.
You might want to stay on Klonopin until you are settled in with Parnate to prevent any excess stimulation that you might experience during the first few weeks. This should disappear by itself at some point. You could then begin weaning off the Klonopin and look for a replacement drug if it is necessary. Lyrica or Buspar maybe?
If Neurontin did not work, there is still a possibility that Lyrica would too. You should know quickly, though.
You know, although long-term BZD usage can produce measurable changes in cognitive function, they usually aren't very apparent to the patient. I would research this thoroughly before discontinuing such an effective drug.
I think the bottom line is that traditional thought would place Nardil ahead of Parnate for the treatment of GAD and OCD. There is virtually no data on Parnate and these two conditions, and it might be worth a try if you find Nardil not to your current liking. You can alway switch. If I were in desperate shape, I would probably go with Nardil first, simply because I have personally seen it work for GAD and panic disorder (PD). If you feel that you have the luxury of time, which you apparently do as long as you continue with Klonopin, you can try to avoid the increased probability that Nardil has of producing the side effects that you are trying to avoid.
I don't think this post was particularly helpful, as you really did do your research on this one. If Parnate is as effective as Nardil for (SAD), then perhaps it has utility with GAD as well. I really don't know, and there is only one way to find out. You will be an explorer of sorts.
- Scott
Posted by metamorphosis on February 8, 2009, at 12:31:24
In reply to Re: deciding between meds.I need a couse of action » metamorphosis, posted by SLS on February 8, 2009, at 7:46:19
I'm definatley leaning towards the Parnate route.Gabapentin worked well for me for a short period of time when I tried it a year ago.it just pooped out and from what I read it seems to become dose resistant.I was at the higher dose of 2700mg and finally it just lost it's effectiveness.I've taken Lyrica once 50mg and felt very sluggish as if in dimly lit tunnel.I of course made the wise decision to take it right before work.Perfect time to experiment with a new med,right.Working as a a checker at a grocery store.Yawning as I check people out,slurred speech and all"did you find everything all right,"paper or plastic?,Huh!".I sure got some strange looks on that shift.I'm suprised they didn't drug test me after that one.I've heard Lyrica can help with Fibromyalgia and since it seems like about 50%-60% of people posting on SAD/Depression sites might suffer from this condition,myself included,it might be a viable option.I would just have to adjust to the med.Overall,I've heard of Buspar as being weak med but I have heard some positive feedbackA few people have said it has helped after a month or two.Recently,I've heard nothing but praise for Selegiline but in and of itself will not be as effective for SAD.Thanks for the responses.Any other thoughts on these psych.med matters for the old SAD/Depression/OCD/god knows what???
Posted by JadeKelly on February 8, 2009, at 20:36:10
In reply to Re: deciding between meds.I need a couse of action, posted by metamorphosis on February 8, 2009, at 12:31:24
Hi Metomorphosis,
I have been on Parnate for 3 1/2 months I believe. I started at 30mg per day and now I'm at 80mg per day (40-morn, 40 afternoon).My Primary dx was depression, but it was a nasty depression so add in the rest of the book. All types of anxiety, etc. I did not suffer from these prior to my depression so I'm not sure what to tell you about your anxiety. I definately think its a med that would help with SAD if you have that. The others I just don't know. All I can tell you is that I've heard many ways in which people reach a final remission on this med. What I mean by that is that s/e's vary CONSIDERABLY. I could tell you all of mine but yours may be completely different. I'll just mention a few I've seen in most people: daytime fatigue, I honestly can't say how much was Parnate and how much was my depression. Insomnia. What worked for me was Klonopin and melatonin at bedtime. Stay on a strict schedule. Most people get small periods of feeling great, followed by the original state. Some people take forever to respond (me), at larger doses, and some respond quickly, not many s/e's. I'm sure I just really confused you.
The point I want to make, my dx is MDD, and believe me when I tell you it was major, I thought it would take a bowling ball to the head to head rid of it. That was Parnate. But you HAVE to stick with it. I don't know anyone who has waited 3 months for an antidepressant to work,
especially when I was really sufferingduring that time. So how bad is it? Make the commitment now to stick to Parnate if you are going to take it. I believe it works better than most A/D's but you have to stick it out. I feel excellent compared to when I started but it took a while. To really kick it in my PDoc augments with Ritalin but with Anxiety, you would probably do better with something else, I don't know. I would not trade Parnate for any other A/D.Good Luck to you!!!
~Jade
Posted by JadeKelly on February 8, 2009, at 20:40:10
In reply to Re: deciding between meds.I need a couse of action » metamorphosis, posted by Garnet71 on February 8, 2009, at 5:29:04
Hi Garnet,
Did you post with med question? The one about short term relief? I'm gonna say another script for the benzo since you are out of school, but I'll mail you we can talk some more about it.
~Jade
Posted by garnet71 on February 8, 2009, at 23:37:41
In reply to Re: deciding between meds.I need a couse of action » Garnet71, posted by JadeKelly on February 8, 2009, at 20:40:10
Hey..I'm working my way back to my email shortly.
No-I still have school-UG. I was doing UG and G at same time; just dropped out of Grad. I have a month to finish a research thesis; I need something to stabilize me w/in the next week or I am screwed.
This is the end of the thread.
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