![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by bitkit on June 16, 2009, at 9:08:16
Hi everyone,
I've been on Parnate now at 40mg for several weeks.
It used to give me energy and obliterated carb cravings (my chosen method of self-medication) which may or may not have been "relief."
But my depression's returned this last week and additionally I now feel really angry. Furious and hopeless and wretched.
Have started therapy which may be having an unravelling effect. It seems that could cause anger and sadness but not so much the lessening of the effectiveness of Parnate.
I see my psychopharmacologist on Saturday. Previously I'd expressed my fears about Parnate's inteactions with meds (emergency situations, etc.) and some foods (I worry about accidents) and the fact that I've developed the blood pressure of a corpse. But he asked me to hang in there for a few more weeks so we could accurately judge efficacy and have that information for the future.
Other meds I've tried (but with no effect): Prozac, Zoloft, Wellbutrin, Effexor, Moclobemide.
I believe I have dysthymia, and/or atypical depression. One major depressive episode about ten years ago (the suicidal kind) and otherwise just swings from mediocre to bad. I can respond positively to positive life events. Anxiety is quite bad and I have no social life but am socially functioning for brief periods even when in a bad swing.
Any suggestions about my meds?
Thanks so much in advance.
Posted by Phillipa on June 16, 2009, at 12:09:51
In reply to Parnate and anger, posted by bitkit on June 16, 2009, at 9:08:16
Take any benzos with the parnate lots I read here do. Love Phillipa
Posted by Ron Hill on June 16, 2009, at 17:36:42
In reply to Parnate and anger, posted by bitkit on June 16, 2009, at 9:08:16
> But my depression's returned this last week and additionally I now feel really angry. Furious and hopeless and wretched.
> ... and otherwise just swings from mediocre to bad.
-----------------------Bitkit,
Just a thought. Have you ever been tested for bipolar disorder?
Here is a screening test:
http://i.cmpnet.com/CME/pt/PDF/MDQ_Quest.pdf
And, here is the grading instruction sheet:
http://i.cmpnet.com/CME/pt/PDF/MDQ_Instructs.pdf
Print the test and fill it out before looking at the grading sheet.
I am a bipolar patient, and I periodically experience depression mixed with raging anger. This is called a "mixed state".
Bipolar patients must have moodstabilizers onboard. If not, antidepressants will often worsen the mood swings.
Antiepileptic drugs (AED's) are typically used as moodstabilizers for bipolar II patients, and lithium is usually used for bipolar I patients.-- Ron
dx: Bipolar II, with ultra rapid cycling (15 days for one complete cycle), and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
30 mg/day Parnate
Posted by ColoradoSnowflake on June 17, 2009, at 10:31:56
In reply to Parnate and anger, posted by bitkit on June 16, 2009, at 9:08:16
Hi Bitkit:
I'm really sorry that you're having such a hard time. Anger is no fun.
I have had atypical major depression, PTSD, ADD, (treatment resistent), for a long time now. Actually, putting the plug in the jug of alcoholic drinking and amphetamine use some time ago was a major trigger of my first big breakdown and I've never felt good since. I've been on nortriptyline, amytriptyline, zoloft, serzone, valium, klonipin, xanax, librium, paxil, effexor, lexapro, cymbalta, prosac, lithium and lamictal,(not in that order) always going back to wellbutrin which would always work for me, but only about 30% relief.
I started Parnate May 4th after going up on amytriptyline for 6 weeks previously and slowly washing out the long term wellbutrin use. I have been nothing but tired tired and more tired. I haven't experienced anger (yet?) I went down on the elavil because of the fatigue but when my regular pdoc came back he had a FIT and I went back up on the amyt. He thinks the combo of certain tricyclics with Parnate is the bomb.
AFter reading a lot of great posts on this list I asked him if I could go up on the Parnate...several people here said it doesn't really kick in until over 40mg , so I'm up to 50mg Parnate and I think it's kicking in. He said I could go up to 60mg this weekend if I want to, but I have some heart palpitations so I'm going to take it slowly. I'm hopeful for the first time in a long time. I still have social anxiety and withdrawal but that could be from being depressed so long.
I hope you start to feel better soon. Checking into the bipolar spectrum sounds promising. Don't give up! There are so many augmentations to try.
Keep us posted. You can BabbleMail me anytime.
Gayle
Posted by floatingbridge on June 17, 2009, at 12:33:34
In reply to Parnate and anger, posted by bitkit on June 16, 2009, at 9:08:16
Hi,
Thought while reading your post that anger might be result of justified dissapointment at drug not working that well and as a response to the protracted pain of dealing with an elusive, hard to diagnos illness. All perfectly reasonable reasons to feel anger, etc. (Consider this my two cents.)
Bipolar spectrum is really interesting and a new way of looking at depression and mood disorders. Myself am diagnoed as BPIII NOS (not otherwise specified). For me, this made more sense than the years of *just* dysthymia and major depression as well.
Good Luck!
Candace
Posted by desolationrower on June 19, 2009, at 18:57:38
In reply to Re: Parnate and anger, posted by floatingbridge on June 17, 2009, at 12:33:34
maybe nardil would be slight better fit
-d/r
Posted by bitkit on June 19, 2009, at 23:49:45
In reply to Re: Parnate and anger » bitkit, posted by Phillipa on June 16, 2009, at 12:09:51
Fascinating, Phillipa.
I remember taking Ativan to help me at my first job at 17! It was a very busy Starbucks and I couldn't handle the stress otherwise.
But since then I've generally felt no use... my mom's given me some Valium from time to time but I never seem to reach for it. When I'm anxious I just overeat.
Something to think about for sure. Thanks.
> Take any benzos with the parnate lots I read here do. Love Phillipa
Posted by bitkit on June 20, 2009, at 0:06:55
In reply to Re: Parnate and anger » bitkit, posted by Ron Hill on June 16, 2009, at 17:36:42
Ron, that's a fascinating topic and a loaded issue!
My father may or may not be bipolar. He's generally diagnosed and medicated as such but I don't believe I see much manic behaviour anymore. Still, it is the prevailing diagnosis. My mother is purely mildly depressed and lightly medicated with benzos on hand, too.
I share a psychopharmacologist with my father who keeps prodding me to reveal manic symptoms that I truly don't believe I have. This anger thing is new-- usually aggression from me is usually just depressive irritation at the world (slow walkers, thoughtless drivers, etc.) or self-hatred. This new generalized anger just kind of sits on top of the depression. It doesn't motivate me or energize me even falsely... so I don't think it's a mixed state.
On the quiz I only answered yes to the racing thoughts and money spending, but the money thing I liken to depressive overeating.
Thank you so much for this angle, though-- You are NOT alone in suggesting I consider it!
But truly, I have seen false energy and odd hyper activity in my father and do not believe I have ever felt or behaved that way. My mother seems to concur.
I really appreciate your perspective.
> > But my depression's returned this last week and additionally I now feel really angry. Furious and hopeless and wretched.
>
> > ... and otherwise just swings from mediocre to bad.
> -----------------------
>
> Bitkit,
>
> Just a thought. Have you ever been tested for bipolar disorder?
>
> Here is a screening test:
>
> http://i.cmpnet.com/CME/pt/PDF/MDQ_Quest.pdf
>
> And, here is the grading instruction sheet:
>
> http://i.cmpnet.com/CME/pt/PDF/MDQ_Instructs.pdf
>
> Print the test and fill it out before looking at the grading sheet.
>
> I am a bipolar patient, and I periodically experience depression mixed with raging anger. This is called a "mixed state".
>
> Bipolar patients must have moodstabilizers onboard. If not, antidepressants will often worsen the mood swings.
>
> Antiepileptic drugs (AED's) are typically used as moodstabilizers for bipolar II patients, and lithium is usually used for bipolar I patients.
>
> -- Ron
>
> dx: Bipolar II, with ultra rapid cycling (15 days for one complete cycle), and mild OCPD
>
> 600 mg/day Trileptal
> 200 mg/day Lamictal
> 500 mg/day Keppra
> 30 mg/day Parnate
>
Posted by bitkit on June 20, 2009, at 0:19:42
In reply to Re: Parnate and anger, posted by ColoradoSnowflake on June 17, 2009, at 10:31:56
Hi Gayle:
I'm glad you're moving up on the Parnate dosage. It does seem as though higher levels are needed for we poor unresponsive ones. I suspect my psych will try that on me unless I decide to put my foot down and end this drug that scares me and makes my blood pressure so low I am perpetually on the verge of a blackout.
I relate to meds not having an effect. You know, not even Oxycontin has an effect on me? I took 4 once and just yawned. That kind of thing makes me worried about surgery... in addition to the MAO interaction worries... what if I'm frozen but feel every damn thing?
I really, really don't want to be someone with a medic alert bracelet. I don't want it all to be so conspicuous. I don't want to live this way.
Maybe this is part of why I'm so angry, which is in line with the comment below I haven't got to yet: I hate that Parnate is so serious a drug, that my body resists it anyway, that my p-doc is so unavailable (long story-- left my father in a lurch at the worst possible time, making my own life miserable for a week), that my new therapist is amazing but cancels constantly, that I can't eat many of my favourite foods and have to be vigilant now instead of relaxed and intuitive about eating.
Maybe it's not the drug that's pissing me off, but my circumstances! smile/frown/smile.
I completely agree that the social anxiety/withdrawal is complex. It becomes engrained... becomes your personality. Even when there's no more chemical reason for it, your own thoughts and habits and modes are seemingly permanently changed. Personally I become afraid to be social even when I feel good. I just don't feel confident enough to pull off normality.
I had never heard of combining a tricyclic with an MAO. So very interesting...
Catherine
> Hi Bitkit:
> I'm really sorry that you're having such a hard time. Anger is no fun.
> I have had atypical major depression, PTSD, ADD, (treatment resistent), for a long time now. Actually, putting the plug in the jug of alcoholic drinking and amphetamine use some time ago was a major trigger of my first big breakdown and I've never felt good since. I've been on nortriptyline, amytriptyline, zoloft, serzone, valium, klonipin, xanax, librium, paxil, effexor, lexapro, cymbalta, prosac, lithium and lamictal,(not in that order) always going back to wellbutrin which would always work for me, but only about 30% relief.
> I started Parnate May 4th after going up on amytriptyline for 6 weeks previously and slowly washing out the long term wellbutrin use. I have been nothing but tired tired and more tired. I haven't experienced anger (yet?) I went down on the elavil because of the fatigue but when my regular pdoc came back he had a FIT and I went back up on the amyt. He thinks the combo of certain tricyclics with Parnate is the bomb.
> AFter reading a lot of great posts on this list I asked him if I could go up on the Parnate...several people here said it doesn't really kick in until over 40mg , so I'm up to 50mg Parnate and I think it's kicking in. He said I could go up to 60mg this weekend if I want to, but I have some heart palpitations so I'm going to take it slowly. I'm hopeful for the first time in a long time. I still have social anxiety and withdrawal but that could be from being depressed so long.
> I hope you start to feel better soon. Checking into the bipolar spectrum sounds promising. Don't give up! There are so many augmentations to try.
> Keep us posted. You can BabbleMail me anytime.
> Gayle
Posted by bitkit on June 20, 2009, at 0:31:45
In reply to Parnate and anger, posted by bitkit on June 16, 2009, at 9:08:16
This link was very informative...
http://www.psycom.net/depression.central.lieber.html
I will do some more thinking about the perspectives raised here.
Just wish I got more than 8 minutes with my psych. Will I stay on it, raise it, go off and try something else (like what?) and is that dependent on a different diagnosis than the one I have (but have never been told)?
This is so hard. Many thanks to all.
Posted by bitkit on June 20, 2009, at 0:43:50
In reply to Re: Parnate and anger, posted by floatingbridge on June 17, 2009, at 12:33:34
HI Candace,
I think you're really on to something. My anger has a lot of legitimate causes. Since negative feelings usually just morph into self-hatred or general dread, I was having a hard time understanding this feeling. I mean to say, I've occassionally expressed outrage to a person but maybe a handful of times in my whole life... so to feel continuously enraged is so odd for me.
But indeed, I am furious at depression, at anxiety, at both my psych and probably (shh... don't tell her) my therapist, definitely my father, etc. etc. I feel so neglected, defective, hopeless and scared. I am even acting out in bulimia again, which arises when I need to stuff and release anxiety. But neither of my psychs will touch my 15 year long e.d. with a ten foot pole. Argh. The med guy was surprised Parnate didn't help with bingeing urges since I'd told him it reduced my appetite. Well, silly man, bingeing has nothing whatsoever to do with hunger! /rant
Thanks for listening. I posted an interesting link one comment up, I think. I'm going to reflect more on its contents. Dysthmia really hits home, though, I have to say.
> Hi,
>
> Thought while reading your post that anger might be result of justified dissapointment at drug not working that well and as a response to the protracted pain of dealing with an elusive, hard to diagnos illness. All perfectly reasonable reasons to feel anger, etc. (Consider this my two cents.)
>
> Bipolar spectrum is really interesting and a new way of looking at depression and mood disorders. Myself am diagnoed as BPIII NOS (not otherwise specified). For me, this made more sense than the years of *just* dysthymia and major depression as well.
>
> Good Luck!
>
> Candace
Posted by bitkit on June 20, 2009, at 0:46:59
In reply to Re: Parnate and anger, posted by desolationrower on June 19, 2009, at 18:57:38
I am terrified of weight gain as I am not recovered from bulimia. Extra inches would be disastrous.Thanks, though. I just hope I'm able to express my worries tomorrow (7 hours from now) and leave without getting too upset about it all!
The people on these boards are great.
> maybe nardil would be slight better fit
>
> -d/r
Posted by floatingbridge on June 20, 2009, at 14:15:23
In reply to Re: Parnate and anger, posted by bitkit on June 20, 2009, at 0:43:50
Hey Bitkit,
I'm surprised your docs won't address the ed. Is there any medical protocol for treating it? Maybe they think it's strictly a therapy issue? That must be quite dismaying to have the ed surfacing again. (I was bulimic for a number of years from teens to early twenties--I was untreated back then. was distressing and confusing--isolating as well.)
Bookmarked the link you posted for when I have more time.
hang in there and courage--sounds like you have much insight into your situation,
Candace
> HI Candace,
>
> I think you're really on to something. My anger has a lot of legitimate causes. Since negative feelings usually just morph into self-hatred or general dread, I was having a hard time understanding this feeling. I mean to say, I've occasionally expressed outrage to a person but maybe a handful of times in my whole life... so to feel continuously enraged is so odd for me.
>
> But indeed, I am furious at depression, at anxiety, at both my psych and probably (shh... don't tell her) my therapist, definitely my father, etc. etc. I feel so neglected, defective, hopeless and scared. I am even acting out in bulimia again, which arises when I need to stuff and release anxiety. But neither of my psychs will touch my 15 year long e.d. with a ten foot pole. Argh. The med guy was surprised Parnate didn't help with bingeing urges since I'd told him it reduced my appetite. Well, silly man, bingeing has nothing whatsoever to do with hunger! /rant
>
> Thanks for listening. I posted an interesting link one comment up, I think. I'm going to reflect more on its contents. Dysthmia really hits home, though, I have to say.
>
>
>
> > Hi,
> >
> > Thought while reading your post that anger might be result of justified dissapointment at drug not working that well and as a response to the protracted pain of dealing with an elusive, hard to diagnos illness. All perfectly reasonable reasons to feel anger, etc. (Consider this my two cents.)
> >
> > Bipolar spectrum is really interesting and a new way of looking at depression and mood disorders. Myself am diagnoed as BPIII NOS (not otherwise specified). For me, this made more sense than the years of *just* dysthymia and major depression as well.
> >
> > Good Luck!
> >
> > Candace
>
>
Posted by morganpmiller on June 26, 2009, at 2:54:32
In reply to Re: Parnate and anger, posted by floatingbridge on June 20, 2009, at 14:15:23
Your going to experience depression in therapy. Stick with the parnate and do what you need to do. The depression should go away. Medications will never wipe depression clean. If you can function and feel somewhat normal, your med is still helping.
Therapy may be the reason for your depression and anger. Most of us have anger inside of us. It is one of the many things we will or should deal with in therapy.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.