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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Girlnterrupted78 on September 2, 2009, at 17:18:11
Hi everyone,
So this is my 3rd week on Parnate (I'm up to 40mgs) and just today my pdoc added 10mgs of Adderall (divided in 5mgs twice a day.)
He said he was adding Adderall for two reasons:
First, to deal with the hypotension (which is kind of severe) and exhaustion, and second, to "augment" the Parnate.
So I'm just curious if there's others here who have been on this specific combo, and what have been your results?
I was surprised he hasn't gone above 40mgs. His reasoning was that the hypotension is bad enough for me to go higher on the dose and make it even worse. I recall when I was on Nardil, the hypotension was the same at 60mgs, 70mgs and 90mgs, so I'm not sure if Parnate would behave similarly. Is anyone familiar with bad hypotension and how it will change with bigger doses of Parnate?
But my main question is: How long should I expect to wait until I might see some improvement through the augmentation with Adderall? Is this like most ADs, where it takes several weeks to see results, or is this a different process? What results can I expect?
Any info on this would be greatly appreciated.
ThanksGI
Posted by maxime on September 2, 2009, at 17:56:50
In reply to Parnate + Adderall. How long for any results?, posted by Girlnterrupted78 on September 2, 2009, at 17:18:11
You should feel a positive result fairly quickly. My only concern is that 10mg of Adderall is not enough. I was on 30 mg of the XR version whilst I was on 80 mg of Parnate. I found that the hypotension was the same at any dose I was on.
Posted by stargazer2 on September 2, 2009, at 20:46:05
In reply to Parnate + Adderall. How long for any results?, posted by Girlnterrupted78 on September 2, 2009, at 17:18:11
I was on NArdil and took generic Adderall and had a hypertensive reaction at 7.5 mg. Like you I had some hypotension and also have ADD. I'm still on Nardil and have asked my doc numerous times to add another med for ADD, like Provigil, Strattera. He flatly refuses since all drug references say the combination is contraindicated.
Is PArnate differnt than Nardil in safely combining it with stimulants?
I did continue to take only 5 mg of amphetamine salt, aka generic adderall, without any more reactions. I recently went onto Wellbutrin and Nardil and seem to be doing well, for the most part. Although I still miss the focus and concentration I had when on ADDerall XR 30 mg, combined with another AD (Celexa).
I often say I may do better off AD's and just on Adderall but I could never convince my doc of this and I'm too afraid to go off Nardil and risk a major relapse.
Good luck to you and use caution with a MAO combination with a stimulant. Does your doc have any trepidation with you on this combo? I guess not since (s)he prescribed, right?
Posted by Girlnterrupted78 on September 2, 2009, at 23:15:12
In reply to Re: Parnate + Adderall. How long for any results?, posted by maxime on September 2, 2009, at 17:56:50
> My only concern is that 10mg of Adderall is not enough. I was on 30 mg of the XR version whilst I was on 80 mg of Parnate. I found that the hypotension was the same at any dose I was on.
Thanks for your feedback, Maxime. You're right about the hypotension. I told this to my doc. He wasn't my doctor when I was on Nardil, and I told him I had the same hypotension on 60mgs and on 90mgs of Nardil. Looks like I'm just going to have to wait until he thinks it's the appropriate time to raise both meds.
> You should feel a positive result fairly quickly.
By fairly quickly do you mean the same day? Or longer than that?
Thanks again.
Posted by Girlnterrupted78 on September 2, 2009, at 23:23:25
In reply to Re: Parnate + Adderall. How long for any results?, posted by stargazer2 on September 2, 2009, at 20:46:05
Hi Stargazer, it's been a long time since we last spoke. And you're still on Nardil! Wow. I've been off it for over a year now. How's the weight? Still gaining or did you figure out a way to maintain?
> I was on Nardil and took generic Adderall and had a hypertensive reaction at 7.5 mg. Like you I had some hypotension and also have ADD.
Yes, I remember you told us about that. It's a shame. Did the 5mgs do anything at all?
> Is Parnate differnt than Nardil in safely combining it with stimulants?
To be honest, I don't really know.. I could ask my doctor next time I see him.
> Does your doc have any trepidation with you on this combo? I guess not since (s)he prescribed, right?
Not at all. It was actually *his* idea to add Adderall. I was telling him about nortriptyline, because other people have been successful on that here, but he has his own "list" of stuff to use, and Adderall was the first on his list, it seems.
Anyway, nice seeing you around. If I find out anything about this, I'll let you know.
Cheers,
Posted by g_g_g_unit on September 3, 2009, at 1:47:40
In reply to Re: Parnate + Adderall. How long for any results? » stargazer2, posted by Girlnterrupted78 on September 2, 2009, at 23:23:25
so does Parnate have very little efficacy in treating ADD in and of itself? does tolerance eventually develop to the 'stimulant' effect?
Posted by Girlnterrupted78 on September 3, 2009, at 3:58:12
In reply to Re: Parnate + Adderall. How long for any results?, posted by g_g_g_unit on September 3, 2009, at 1:47:40
I have another question, unrelated to the Adderall.
Does Parnate alone can cause shortness of breath? I've felt very short of breath for over a week now on 40mgs of Parnate.
I have to make a big effort to take a full breath, and I feel somewhat oxygen deprived. This is all the time, not just occasionally.
Other people ever had this?
Posted by Justherself54 on September 3, 2009, at 10:20:46
In reply to Re: Parnate + Adderall. How long for any results?, posted by Girlnterrupted78 on September 3, 2009, at 3:58:12
Hi. I didn't experience that on Parnate. How is your blood pressure? Perhaps a call to your doc is in order. That's got to be a little on the scary side. How is your anxiety? Sometimes when I'm really anxious I shallow breathe and have to focus on taking deep breaths. Hope you feel better soon.
Posted by Maxime on September 3, 2009, at 10:50:54
In reply to Re: Parnate + Adderall. How long for any results? » maxime, posted by Girlnterrupted78 on September 2, 2009, at 23:15:12
> By fairly quickly do you mean the same day? Or longer than that?
>
> Thanks again.It worked the same day I took the first dosage of Adderall. Zippy stuff! I really liked the combo.
Posted by Phillipa on September 3, 2009, at 10:56:46
In reply to Re: Parnate + Adderall. How long for any results?, posted by Girlnterrupted78 on September 3, 2009, at 3:58:12
Haven't taken parnate but I'd call and report the shortness of breath. Phillipa
Posted by stargazer2 on September 3, 2009, at 20:49:24
In reply to Re: Parnate + Adderall. How long for any results? » stargazer2, posted by Girlnterrupted78 on September 2, 2009, at 23:23:25
Yea, I'm still on Nardil...can't ever mess with something that is working to restore a life once lost. Yes, I have gained but I don't care too much anymore as with age comes less focus on my appearance and although I gained, I haven't gotten any more rotund. Rotund is not the right descriptor, but you know what I mean. I stabalized about 10 # over my starting weight and that is acceptable to me for an improvement in my overall mental health. I had gotten to the point where I was desparate and Nardil has given me some of my life back. It is not the life I have had when I have felt really well on any number of meds and combinations of meds, but it has allowed me to return to a productive work life and that had escaped me for over a year. Chasing the perfect combination of meds is not my goal anymore because I am realistic about how much one's life is affected by depression (or other conditions) and how much is the result of genetics and upbringing, both of which have affected me greatly. Just like physical health, we will not all have perfect personalities and life experiences, but being able to function and coexist with others in a so-called "normal" world is a good trade-off. Sure I face challenges and bad days, but I am resilient again and don't take things so personally right now.
We may not all be what we want to be but worse than that is being nonfunctional and living a "life" that has no purpose. That was the place I was at before Nardil. So I am happy, but obviously, there is always the thought that I should feel better. For right now, most days I am thankful I can get up everyday, go to work, and enjoy things more than I was doing before Nardil.
I tried Parnate many years ago with absolutely no effect, so that was my experience with it. Good luck to your ongoing trials, I know doing these things takes an unbelievable amount of sacrafice and effort.
We'll "talk" again.
SG2
Posted by Girlnterrupted78 on September 4, 2009, at 4:49:51
In reply to Re: Parnate + Adderall. How long for any results?, posted by Justherself54 on September 3, 2009, at 10:20:46
> Hi. I didn't experience that on Parnate. How is your blood pressure?
My blood pressure is very low, that's one of the reasons my doctor is giving me Adderall, to try to bring it up a bit (and to augment the Parnate.) Although it doesn't seem like it's doing much for the blood pressure. It's still awfully low.
I'm having trouble exercising as well because of the hypotension. I love working out but now I find my arms and legs feeling strange, kind of heavy and very easily exhausted, and the exercise is not enjoyable. Most likely something to do with the low blood pressure, I guess.
> Perhaps a call to your doc is in order. That's got to be a little on the scary side. How is your anxiety? Sometimes when I'm really anxious I shallow breathe and have to focus on taking deep breaths. Hope you feel better soon.
Thanks. I think Parnate might be stimulating me a little too much and might be causing this. I don't feel anxious, but I do feel some stimulation of my nervous system in a different way that's probably causing the shortness of breath. I did actually tell my doctor about this last time. He didn't say anything about it.
Thanks a lot
Posted by Girlnterrupted78 on September 4, 2009, at 4:52:45
In reply to Re: Parnate + Adderall. How long for any results? » Girlnterrupted78, posted by Maxime on September 3, 2009, at 10:50:54
> It worked the same day I took the first dosage of Adderall. Zippy stuff! I really liked the combo.
Did you try different doses of Adderall, or you went straight to 30mgs? Did other doses work well, or only 30mgs did the trick? What about the Parnate doses, did you sort of experiment with this, and reached a dose that "worked" with the Adderall, or you were always on 80mgs Parnate?
Thanks!
Posted by Girlnterrupted78 on September 4, 2009, at 4:58:02
In reply to Re: Parnate + Adderall. How long for any results?, posted by g_g_g_unit on September 3, 2009, at 1:47:40
> so does Parnate have very little efficacy in treating ADD in and of itself? does tolerance eventually develop to the 'stimulant' effect?
Sorry, I couldn't answer that question because I'm just getting started on Parnate. It's my 3rd week. But there's other people who know the med better, maybe they'll respond to you.
Posted by Girlnterrupted78 on September 4, 2009, at 4:59:01
In reply to Re: Parnate + Adderall. How long for any results? » Girlnterrupted78, posted by Phillipa on September 3, 2009, at 10:56:46
> Haven't taken parnate but I'd call and report the shortness of breath. Phillipa
I did tell him last time I saw him. He didn't say anything and was more concerned about blood pressure and bringing it down. Thanks.
Posted by zzzz7 on September 7, 2009, at 20:14:14
In reply to Re: Parnate + Adderall. How long for any results? » Justherself54, posted by Girlnterrupted78 on September 4, 2009, at 4:49:51
"I love working out but now I find my arms and legs feeling strange, kind of heavy and very easily exhausted, and the exercise is not enjoyable. Most likely something to do with the low blood pressure, I guess."
I had something like this with clomipramine. My legs were totally dead and I found it impossible to exercise.
This is the end of the thread.
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