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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by ColoradoSnowflake on September 12, 2009, at 17:10:03
Hi:
Rhodiola sounds like a really good, natural addition to one's meds!I take Parnate, Nortriptyline and Provigil.
Does anyone know if Rhodiola is OK to take with those drugs,,,,Parnate, especially?
Thanks!
Gayle
Posted by Sunbath on September 12, 2009, at 17:11:45
In reply to Rhodiola and Parnate, posted by ColoradoSnowflake on September 12, 2009, at 17:10:03
Yes yes yes please I'd also like to know that!
Hi Gayle :)
Posted by SLS on September 13, 2009, at 5:50:43
In reply to Rhodiola and Parnate, posted by ColoradoSnowflake on September 12, 2009, at 17:10:03
Hello.
> Rhodiola sounds like a really good, natural addition to one's meds!
I would recommend not adding more substances into the mix, unless you reach a plateau refractory to further dosage increases of the drugs you are already on. Plants are drugs, too.
What do you find lacking in your present condition?
You need to know that it is likely to take a few months before you reach the maximum improvement that your current treatment will produce. You also have quite a bit of room left on the nortriptyline dosage.
- Scott
Posted by Sunbath on September 13, 2009, at 5:58:19
In reply to Re: Rhodiola and Parnate » ColoradoSnowflake, posted by SLS on September 13, 2009, at 5:50:43
Hi Scott,
sorry don't want to hijhack the thread, but do you know anything about it being contraindicated or any interactions with Parnate?
I'd especially like to take it before the Parnate starts... thanks
Posted by SLS on September 13, 2009, at 6:13:06
In reply to Re: Rhodiola and Parnate » SLS, posted by Sunbath on September 13, 2009, at 5:58:19
> Hi Scott,
>
> sorry don't want to hijhack the thread, but do you know anything about it being contraindicated or any interactions with Parnate?
> I'd especially like to take it before the Parnate starts... thanksI don't know anything about Rhodiola, sorry.
I think you need to be careful about adding substances that promote serotonin activity. Several sources claim that Rhodiola acts as a MAOI. If this is true, then I wouldn't advise mixing it with Parnate.
I would wait for more input by people who have actually tried the combination. For all I know, it might be safe and effective.
- Scott
Posted by Phillipa on September 13, 2009, at 10:43:37
In reply to Re: Rhodiola and Parnate » Sunbath, posted by SLS on September 13, 2009, at 6:13:06
I know the MAOI's are wonder meds for so many of you fellow babblers. Just wanted to add that I have a neighbor 79 years old a bio chemist worked for Phizer. He was rather shocked to hear that these meds are still being used. In his words "I thought we were beyound this meds. You know they are very dangerous meds". He must have been in on the original Maoi's so please all be careful with additional meds. I hope this isn't offensive to anyone. I felt obligated to post this. Phillipa ps poor guy is going through his second bout with cancer. He's so courageous walks five miles even when he feels he can't do it.
Posted by bulldog2 on September 13, 2009, at 12:25:18
In reply to Rhodiola and Parnate, posted by ColoradoSnowflake on September 12, 2009, at 17:10:03
> Hi:
> Rhodiola sounds like a really good, natural addition to one's meds!
>
> I take Parnate, Nortriptyline and Provigil.
>
> Does anyone know if Rhodiola is OK to take with those drugs,,,,Parnate, especially?
>
> Thanks!
>
> GayleNo I wouldn't risk it.
Posted by ColoradoSnowflake on September 13, 2009, at 13:30:49
In reply to Re: Rhodiola and Parnate » ColoradoSnowflake, posted by SLS on September 13, 2009, at 5:50:43
> Hello.
>
> > Rhodiola sounds like a really good, natural addition to one's meds!
>
> I would recommend not adding more substances into the mix, unless you reach a plateau refractory to further dosage increases of the drugs you are already on. Plants are drugs, too.
>
> What do you find lacking in your present condition?WOW .... How did you guess?????
>
> You need to know that it is likely to take a few months before you reach the maximum improvement that your current treatment will produce. You also have quite a bit of room left on the nortriptyline dosage.
>
>
> - Scott
>
Scott:Thanks so much. You caught me!!
The weekend came and I went down the tubes again. I don't want to admit it.
Last week I said I was going up to 70mg Parnate, forgetting that I was taking 50mg. So, this last week I have been taking 60mg Parnate. I have tried taking more nortrip but if I take over 25mg it makes me so tired I feel even worse. 25mg seems to be the right amount for me to sleep ok.
My pdoc had said I could go up to 80mg Parnate on my own. I think I'll start taking 70mg today and send him an e-mail tomorrow and let him know I'm not doing well. I am also taking the full 200mg Provigil which helps. I am so relieved to have a source for it!
I've been taking the Parnate 30mg as soon as I get up with 50mg provigil, and 30mg Parnate at 1 or 2 in the afternoon with 100mg Provigil, then another 50mg Provigil at 4 or 5 in the afternoon. I've been afraid I would get insomnia. Maybe I should take it closer to the end of the day.
Last night I was so depressed when I got home about 5pm I thought about drinking. I've been sober in AA for a very long time, so I'm not going to do that. I rarely even think of drinking any more. I know that it is suicide in a very ugly bottle. Then I thought about the different benzo's that I have on hand, and decided that was potential trouble for me. So I went to bed with Ben and Jerry....in a carton,... and went to sleep, thinking I would be ok when I woke up. Wrong. Still depressed today. Sh--!I'm thinking I need to spread the Parnate out late into the day. I take the Provigil with it, so I should probably skip that late in the day. I take the Nortrip about 7pm.
I'm also thinking I'm having a big letdown from a year of wrangling in court over my grandson. It was successful, thank goodness.
I think also the court stuff was a distraction from dealing with the sudden death of my 18 year relationship with my manfriend and then my best girlfriend since grad school's sudden death as well. My insurance offers a "Grief Group" and maybe I should think about that.
I'm also having grief and fear and anger that this darn Parnate is pooping out on me. I'm in my fifth month on it. I promised my pdoc 6 months. But there isn't anything else out there except ECT and I have decided I absolutely will not do that, no matter what.
So I have to make this Parnate work. The worst part of my depression is terrible fatigue etc. I've tried so many other things...can't handle any SSN<Ri<'s, No lamictal etc etc. Only thing I could ever take was Wellbutrin.. Everything else gives me migraines and such bad balance that I fall all over the place. I have fallen 5 times now on Parnate/nortrip but its still "do-able" and getting better with time.
What are your suggestions?
Sorry to be such a downer. But very happy you saw right through me!!
Gayle
Posted by ColoradoSnowflake on September 13, 2009, at 13:31:28
In reply to Re: Rhodiola and Parnate » ColoradoSnowflake, posted by SLS on September 13, 2009, at 5:50:43
> Hello.
>
> > Rhodiola sounds like a really good, natural addition to one's meds!
>
> I would recommend not adding more substances into the mix, unless you reach a plateau refractory to further dosage increases of the drugs you are already on. Plants are drugs, too.
>
> What do you find lacking in your present condition?WOW .... How did you guess?????
>
> You need to know that it is likely to take a few months before you reach the maximum improvement that your current treatment will produce. You also have quite a bit of room left on the nortriptyline dosage.
>
>
> - Scott
>
Scott:Thanks so much. You caught me!!
The weekend came and I went down the tubes again. I don't want to admit it.
Last week I said I was going up to 70mg Parnate, forgetting that I was taking 50mg. So, this last week I have been taking 60mg Parnate. I have tried taking more nortrip but if I take over 25mg it makes me so tired I feel even worse. 25mg seems to be the right amount for me to sleep ok.
My pdoc had said I could go up to 80mg Parnate on my own. I think I'll start taking 70mg today and send him an e-mail tomorrow and let him know I'm not doing well. I am also taking the full 200mg Provigil which helps. I am so relieved to have a source for it!
I've been taking the Parnate 30mg as soon as I get up with 50mg provigil, and 30mg Parnate at 1 or 2 in the afternoon with 100mg Provigil, then another 50mg Provigil at 4 or 5 in the afternoon. I've been afraid I would get insomnia. Maybe I should take it closer to the end of the day.
Last night I was so depressed when I got home about 5pm I thought about drinking. I've been sober in AA for a very long time, so I'm not going to do that. I rarely even think of drinking any more. I know that it is suicide in a very ugly bottle. Then I thought about the different benzo's that I have on hand, and decided that was potential trouble for me. So I went to bed with Ben and Jerry....in a carton,... and went to sleep, thinking I would be ok when I woke up. Wrong. Still depressed today. Sh--!I'm thinking I need to spread the Parnate out late into the day. I take the Provigil with it, so I should probably skip that late in the day. I take the Nortrip about 7pm.
I'm also thinking I'm having a big letdown from a year of wrangling in court over my grandson. It was successful, thank goodness.
I think also the court stuff was a distraction from dealing with the sudden death of my 18 year relationship with my manfriend and then my best girlfriend since grad school's sudden death as well. My insurance offers a "Grief Group" and maybe I should think about that.
I'm also having grief and fear and anger that this darn Parnate is pooping out on me. I'm in my fifth month on it. I promised my pdoc 6 months. But there isn't anything else out there except ECT and I have decided I absolutely will not do that, no matter what.
So I have to make this Parnate work. The worst part of my depression is terrible fatigue etc. I've tried so many other things...can't handle any SSN<Ri<'s, No lamictal etc etc. Only thing I could ever take was Wellbutrin.. Everything else gives me migraines and such bad balance that I fall all over the place. I have fallen 5 times now on Parnate/nortrip but its still "do-able" and getting better with time.
What are your suggestions?
Sorry to be such a downer. But very happy you saw right through me!!
Gayle
Posted by ColoradoSnowflake on September 13, 2009, at 13:34:15
In reply to Re: Rhodiola and Parnate, posted by ColoradoSnowflake on September 13, 2009, at 13:31:28
Posted by Maxime on September 13, 2009, at 13:40:00
In reply to Re: Rhodiola and Parnate, posted by Phillipa on September 13, 2009, at 10:43:37
Well my pdoc is 87 years old and he has a lot of faith in MAOIs. They are not dangerous if you stick to the diet. I think tricyclics are more dangerous.
Posted by Sunbath on September 13, 2009, at 14:17:58
In reply to Sorry= Sent above post twice (nm), posted by ColoradoSnowflake on September 13, 2009, at 13:34:15
Gayle! This IS bad news :(
But hey don't give up so easily, you are still on a somewhat "moderate" dose.. remember ppl going as high as 100mg-200mg!?
What's your next step?Wish you all the best and remember you ARE the parnate queen and Parnate hasn't failed you yet!
Posted by Sunbath on September 13, 2009, at 14:19:11
In reply to Re: Rhodiola and Parnate » Sunbath, posted by SLS on September 13, 2009, at 6:13:06
Thanks a lot Scott for your help all the time!
Yes, I won't take it until more is known.. maybe someone?
Posted by SLS on September 13, 2009, at 15:02:32
In reply to Re: Rhodiola and Parnate, posted by ColoradoSnowflake on September 13, 2009, at 13:30:49
Hi.
I can't make any guarantees of course, but one must sometimes give a dosage change a chance to settle in and allow side effects, both physical and mental, to dissipate. I strongly recommend that you get a test for the blood level of nortriptyline before you discount a dosage increase. Most people find that it takes 75mg to get the full antidepressant effect. In my experience, the addition of Parnate to nortriptyline does not somehow reduce the dosage needed of the nortriptyline.
Recovery from severe depression is rarely linear. It has peaks and valleys. I know it is difficult, but you may have to accept that there will be some down periods that punctuate the overall trend of improvement.
Having said all of that, you might want to try increasing the Parnate first, especially since you have been given the latitude by your doctor to do so. I would then get the nortriptyline blood test. If the level of nortriptyline falls below 50 ng/ml (range = 50-150), I would then look to increase the dosage if you remain dissatisfied with your progress.
- Scott
Posted by desolationrower on September 13, 2009, at 16:38:09
In reply to Re: Rhodiola and Parnate » ColoradoSnowflake, posted by SLS on September 13, 2009, at 15:02:32
The effects of Rhodiola rosea extract on 5-HT level, cell proliferation and quantity of neurons at cerebral hippocampus of depressive rats
Phytomedicine, Volume 16, Issue 9, Pages 830-838
Q. Chen, Y. Zeng, Z. Qu, J. Tang, Y. Qin, P. Chung, R. Wong, U. HäggThe purpose of this study was to investigate the effects of Rhodiola rosea extract and depression on the serotonin (5-HT) level, cell proliferation and quantity of neurons at cerebral hippocampus of depressive rats induced by Chronic Mild Stress (CMS). Seventy male Sprague-Dawley rats were divided into seven groups (10 per group): normal control group, untreated depressive rat model group, negative control group, positive control group, low dosage Rhodiola rosea extract (1.5g/kg) group, medium dosage Rhodiola rosea extract (3g/kg) group and high dosage Rhodiola rosea extract (6g/kg) group. After the depressive rats induced by CMS had received Rhodiola rosea extract for 3 weeks, the 5-HT levels at cerebral hippocampus were detected by high performance liquid chromatography. Bromodeoxyuridine (BrdU) was injected in vivo to label the proliferating cells at hippocampus, and morphometry was used to count the hippocampal neurons. The results showed that the 5-HT level of the three experimental groups had recovered to normal status. The immunohistochemistry of hippocampus BrdU positive cells had returned to the normal level in the group of depressive rats with low dosage Rhodiola rosea extract. In conclusion the results demonstrated that Rhodiola rosea extract could improve 5-HT level in hippocampus in depressive rats, and low dosage Rhodiola rosea could induce neural stem cell proliferation at hippocampus to return to normal level, repairing the injured neurons at hippocampus.
************************which actually makes it sound likely to be safe, since it wasn't causing supranormal 5ht levels, so probably a downstream effect. i wouldn't be afraid to try it personally, but i like experimenting on my brain. have a 5ht2 antagonist and benzo on hand though.
-d/r
Posted by bulldog2 on September 13, 2009, at 16:40:03
In reply to Rhodiola and Parnate, posted by ColoradoSnowflake on September 12, 2009, at 17:10:03
> Hi:
> Rhodiola sounds like a really good, natural addition to one's meds!
>
> I take Parnate, Nortriptyline and Provigil.
>
> Does anyone know if Rhodiola is OK to take with those drugs,,,,Parnate, especially?
>
> Thanks!
>
> GayleHi Gayle
Don't give up on parnate as this is probably just a bump in the road. I've read if you're willing to play with all the variations of dose and combos you have over a 90 percent chance of remission. Now you could also try a true stimulant as this is sometimes used in trd. Of course you have a doc willing to try this.
I forget if it was Scott or maxime that has threads on parnate combos.
Also if you want to try natural alternatives to your parnate combo look into deplin.
For regular meds look into abilify.Good luck and I bet you will soon be back on the remission road.
Best Wishes
Bulldog
Posted by Ron Hill on September 13, 2009, at 17:39:39
In reply to Re: Rhodiola and Parnate, posted by desolationrower on September 13, 2009, at 16:38:09
> The effects of Rhodiola rosea extract on 5-HT level, cell proliferation and quantity of neurons at cerebral hippocampus of depressive rats
> Phytomedicine, Volume 16, Issue 9, Pages 830-838
> Q. Chen, Y. Zeng, Z. Qu, J. Tang, Y. Qin, P. Chung, R. Wong, U. Hägg
>
> The purpose of this study was to investigate the effects of Rhodiola rosea extract and depression on the serotonin (5-HT) level, cell proliferation and quantity of neurons at cerebral hippocampus of depressive rats induced by Chronic Mild Stress (CMS). Seventy male Sprague-Dawley rats were divided into seven groups (10 per group): normal control group, untreated depressive rat model group, negative control group, positive control group, low dosage Rhodiola rosea extract (1.5g/kg) group, medium dosage Rhodiola rosea extract (3g/kg) group and high dosage Rhodiola rosea extract (6g/kg) group. After the depressive rats induced by CMS had received Rhodiola rosea extract for 3 weeks, the 5-HT levels at cerebral hippocampus were detected by high performance liquid chromatography. Bromodeoxyuridine (BrdU) was injected in vivo to label the proliferating cells at hippocampus, and morphometry was used to count the hippocampal neurons. The results showed that the 5-HT level of the three experimental groups had recovered to normal status. The immunohistochemistry of hippocampus BrdU positive cells had returned to the normal level in the group of depressive rats with low dosage Rhodiola rosea extract. In conclusion the results demonstrated that Rhodiola rosea extract could improve 5-HT level in hippocampus in depressive rats, and low dosage Rhodiola rosea could induce neural stem cell proliferation at hippocampus to return to normal level, repairing the injured neurons at hippocampus.
>
>
> ************************
>
> which actually makes it sound likely to be safe, since it wasn't causing supranormal 5ht levels, so probably a downstream effect. i wouldn't be afraid to try it personally, but i like experimenting on my brain. have a 5ht2 antagonist and benzo on hand though.
>
> -d/r
-----------------------------------------------Desolationrower and ColoradoSnowflake,
I COULD NOT DISAGREE MORE WITH THE FOLLOWING STATEMENT!
> which actually makes it sound likely to be safe, since it wasn't causing supranormal 5ht levels, so probably a downstream effect. i wouldn't be afraid to try it personally, but i like experimenting on my brain. have a 5ht2 antagonist and benzo on hand though.
>
> -d/r
In the above researh, depression is induced using Chronic Mild Stress (CMS) and Rhodiola rosea is shown to be serotoninergic.Adding a serotoninergic substance to an MAOI can cause serotonin syndrome and, in the worst case, death.
ColoradoSnowflake, PLEASE, please, please, read the following article. If you are going to take an MAOI you must know the rules.
http://www.psy-world.com/1008CNS_Stahl.pdf
-- Ron
dx: Bipolar II with ultra rapid cycling and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
90 mg/day Nardil
Posted by Ron Hill on September 13, 2009, at 20:27:10
In reply to Rhodiola and Parnate, posted by ColoradoSnowflake on September 12, 2009, at 17:10:03
> Hi:
> Rhodiola sounds like a really good, natural addition to one's meds!
>
> I take Parnate, Nortriptyline and Provigil.
>
> Does anyone know if Rhodiola is OK to take with those drugs,,,,Parnate, especially?
>
> Thanks!
>
> Gayle
----------------------------
Gayle,Here is a thorough document on Rhodiola. As I said in my post above, serotonin syndrome is a risk if Rhodiola is taken with an MAOI due to the release of serotonin. Further, there might be a risk of hypertensive crisis due to the release of norepinephrine and stimulation of epinephrine by Rhodiola.
Anecdotally, I took Rhodiola several years ago prior to being on an MAOI. It caused me to become very irritable. GRRRRRR!
-- Ron
Posted by ColoradoSnowflake on September 13, 2009, at 23:51:38
In reply to Re: Rhodiola and Parnate » ColoradoSnowflake, posted by Ron Hill on September 13, 2009, at 20:27:10
HI:
You guys are great!! I really appreciate all the good info from all of you along with the caring and support. Thank you all so much!
I wont be taking Rhodiola. I think I need to concentrate on what I'm doing with the Parnate/Nortriptyline/Provigil.
Thanks Scott also for the reminder of the ups and downs, among other things.
I always like to complicate everything. It seems to be a part of my nature, or maybe being a Gemini!Thanks Ron for the excellent paper on MAOI's. I scanned it, didn't understand a lot, printed it up so I can take some time reading it tomorrow.
Parnate itself seems to make me touchy and CRANKY as it is! Grrr Grrr
Thanks everybody, so much!!!
Gayle
Posted by SLS on September 14, 2009, at 5:44:02
In reply to Re: Rhodiola and Parnate, posted by desolationrower on September 13, 2009, at 16:38:09
> have a 5ht2 antagonist and benzo on hand though.
Which 5-HT2 receptors need to be blocked? All of them?
I wish we had ritanserin to work with.
- Scott
Posted by Ron Hill on September 14, 2009, at 13:03:45
In reply to Re: Rhodiola and Parnate, posted by desolationrower on September 13, 2009, at 16:38:09
> which actually makes it sound likely to be safe, since it wasn't causing supranormal 5ht levels, so probably a downstream effect. i wouldn't be afraid to try it personally, but i like experimenting on my brain. have a 5ht2 antagonist and benzo on hand though.
>
> -d/rDesolationrower,
I meant no disrespect to you by using CAPITAL letters in my post above. Instead, I was merely trying to catch the attention of ColoradoSnowflake.
Thanks.
-- Ron
Posted by desolationrower on September 15, 2009, at 0:48:34
In reply to Re: Rhodiola and Parnate » desolationrower, posted by SLS on September 14, 2009, at 5:44:02
i don't remember seeing any note made of one being more important.
-d/r
This is the end of the thread.
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