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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 50. Go back in thread:
Posted by g_g_g_unit on October 14, 2009, at 16:41:25
In reply to Re: Parnate and me » g_g_g_unit, posted by MAxime on October 14, 2009, at 14:25:33
> I am having a lot of trouble getting out of bed. I am not sleeping, but just laying there staring at the walls. All I want to do is hide in bed. I don't know if it's my depression or the Parnate. I hope it's the depression.
maybe both? hopefully it's a step on the way to remission, otherwise i don't think i can deal with this anger much longer
Posted by g_g_g_unit on October 14, 2009, at 16:45:47
In reply to Re: Parnate giving up, posted by delna on October 14, 2009, at 15:53:34
> I'm so frustrated with this drug
> I know it has been 15 days but I have yet to come across a drug that takes so long to get rid of suicidal feelings.
> Am up to 30mg but when I take 20mg together (at night) like my pdoc said I get hypotension and feel like I am going to have a black out. I sleep/pass out for a few hours. Plus I am sleepy all day despite the provigil 200mg. I am such a basically sleepy person and this drug is having no stimulant/lifting effect on me. I am thinking of stopping cold turkey since my dose has been 30mg for only 2 days. Then I think I will go on Effexor (high dose) with wellbutrin and provigil.
> I know people here are swearing by this pill but I don't understand how people have put up with such rocky, inconsistent and terrible days. This pill is just making me give up hope :( I wish I was equally strong willed as everyone else who has waited it out- I don't think I can make it.
> Maybe I am being impatient but this is making me more suicidal- the tiredness makes me depressed in its own right and because i cannot augment with ridiculously high does of provigil and wellbutrin i am pretty stuck.
> Very confused
> My parents and doctor dont feel I am giving it a fair trial but I feel worse than when I started (physically) and am still suicidal (although not so actively- but I am getting there)
> Just so confused......and sad :(
> Love to all
> Thanks for all your positive, kind words
> D
>sorry to hear that Delna :( if it's any concilitation i was on the verge of giving up at 30mg because i saw no effect at all. 40mg, which i've been on for two days, has made enough different to stick it out .. there's definitely some change happening. like you, the effect is very inconsistent in me - for one, these anger episodes are unbearable - but i think i'll wait it out a bit longer.
don't feel bad for giving up. it seems to have become a kind of trend to take Parnate here, so i know i felt weird for quitting at first - like i had failed some test. but it is a really hard drug to work with
Posted by ColoradoSnowflake on October 14, 2009, at 18:07:17
In reply to Re: Parnate giving up, posted by g_g_g_unit on October 14, 2009, at 16:45:47
Hi Fellow Parnate Sufferers
I agree with whomever said this was a difficult drug.
gggunit: Yes on the anger. I don't generally have anger issues but I did go through maybe 3 weeks of being very angry. I felt like a little kid. I wanted to STOMP around the house....throw things, kick things, say as bad words as I could think of. Tear up paper. I was glad to be living alone so I didn't have to be nice to anyone on a regular basis. I was mad at everything and everybody. It was kind of scary to me because I'm not used to it. At the time I thought it was me, maybe going more nuts. But then it just went away.
All of this is very confusing. And I do feel very very clear headed all the time. More than I'm used to.
So what can I say?
It IS confusing.....but most of the time now I feel pretty darn good.Hugs,
Gayle
Posted by MAxime on October 14, 2009, at 22:10:14
In reply to Re: Parnate giving up, posted by delna on October 14, 2009, at 15:53:34
How long will you have to wait before you can try the Effexor?
Posted by delna on October 14, 2009, at 22:51:20
In reply to Re: Parnate giving up » delna, posted by MAxime on October 14, 2009, at 22:10:14
> How long will you have to wait before you can try the Effexor?
2 weeks according to my pdoc and according to references. It will be a hard wait but I think I may feel better just being off this drug and on my 400mg provigil.
He says he will 'cover' me with a TCA which sounds pointless to me because by the time the TCA kicks in (if it does) it will be time to get off and TCA's have to be titrated down as they have a withdrawal syndrome of their own.
I think I will stay just on the Lamictal and provigil in the interim.
TC
D
Posted by delna on October 14, 2009, at 23:50:50
In reply to Re: Parnate giving up, posted by g_g_g_unit on October 14, 2009, at 16:45:47
>
> don't feel bad for giving up. it seems to have become a kind of trend to take Parnate here, so i know i felt weird for quitting at first - like i had failed some test. but it is a really hard drug to work with
Thanks for that...
Yes, it is a hard drug to deal with and I am amazed and in awe that people have stuck through the worst side effects to achieve benefits.
Sorry to hear that it is giving you such problems but glad to hear that you are feeling a positive difference at a higher dose. As Gayle posted, she had awful anger issues but they went away. Even I have anger issues with Parnate but I like them because I really do feel its a sign that you are getting better (IMHO) but unlike you I am not having the psychomotor part which would be hard to stand. I DO hope it gets better.I'm pretty annoyed at my pdoc for giving me a drug like this especially when I was desperately suicidal when I went to see him. It is a drug you have to titrate up pretty slowly and one that gives many side effects- some hard to bear. Not ideal for someone who is already giving up on things...
I agree that it is common to be using Parnate on the board but I guess that is because it is supposed to be an amazing drug (when it works). Like the last word. Whatever I have read about is has been only positive- even on other patient sites and in books/ literature by forward-thinking pdocs.
Also I think most people on Parnate/Nardil have tried everything else already and have not felt better so it is the next logical step before (or even after) ECT.I'm just disappointed that it didn't have a positive effect on me even though, according to my pdoc and books I totally fit the profile for this drug therapy. But then again people react so differently to meds.
I mean who would think that low dose Geodon (40-60mg) could 100% lift (my) depression and deal with fatigue, in one go (and in a few doses). People curse Geodon but I was pretty unique in my reaction, from reading up. My pdoc in the US was not surprised, but I was. I thought he was crazy for prescribing it to me as it is sedating (and that was my main complaint as always although the depression was very serious when I saw him) Geodon is an antipsychotic- who would think it has such strong antidepressant/ stimulant properties used all alone, not even as an augmenting agent...? It doesn't even have FDA approval for depression but for me it was a miracle. (OK, so I eventually developed nerve pain on it -possibly TD related- but that was a freak side-effect and a very rare reaction totally unknown to the medical community)
Sorry about the ramble.....
Truly hope you see good effects very soon. And if you decide to give it up, its not like you failed. More like the drug failed you. If you give it up, what is the next step for you? Any other meds you can try? Has your pdoc chalked out any sort of plan for you?
What is your dX and what are your main complaints? Sorry, I haven't picked that up from your posts. I am such a space-cadet.
If you've already explained that, please link me to that post if it is easier.Take care.
Get better.
Love,
D
Posted by Sunbath on October 15, 2009, at 6:09:10
In reply to Re: Parnate giving up » g_g_g_unit, posted by delna on October 14, 2009, at 23:50:50
Hi Delna,
I'm really sorry :(
Have you already tried taking both your Parnate doses earlier in the day and sleeping a bit longer?
As I already said, I really feel like crap -even on Parnate- when I don't sleep enough for a few days!
Of course, you are right, no drug is for everyone and maybe effexor would work great for you! But you'll have to wait those 14days.. So did you already try taking Parnate during the day?I'd really try adjusting your Parnate doses.. also when 20mg at once are too much for you.. did you try splitting it even more? Like try taking 10mg every 2 hours or so..Good luck to you!!!
Posted by Maxime on October 15, 2009, at 10:54:05
In reply to Re: Parnate giving up » g_g_g_unit, posted by delna on October 14, 2009, at 23:50:50
Actually, Parnate isn't a med that needs to be titrated slowly ... it's just your doctor who is doing it that way. The first time I was on Parnate, we titrated it 10mg every 3 days so that I was on a decent dose quickly.
I wish you weren't giving up on it so soon. You really haven't given it a decent trial at all. I understand that you feel like crap and I know how that feels. Every day is a battle for me not to kill myself. But it's too bad you couldn't stick with it longer.
Posted by Sunbath on October 15, 2009, at 11:02:48
In reply to Re: Parnate giving up » delna, posted by Maxime on October 15, 2009, at 10:54:05
I just wanted to add that the strong hypotension you are experiencing should really pass as I understand it and maybe you can work around it by taking only 10mg at once every few hours... you don't need to take it at once!
Posted by Sunbath on October 15, 2009, at 11:07:06
In reply to Re: Parnate giving up, posted by Sunbath on October 15, 2009, at 11:02:48
argh I again forgot something.. where's my brain?
I also wanted to tell you that I didn't feel well before I was taking 40mg...
Posted by delna on October 15, 2009, at 11:51:39
In reply to Re: Parnate giving up, posted by Sunbath on October 15, 2009, at 11:07:06
Hi
Thanks for the input.I wrote a letter to my doctor(hand delivered by my dad) but he hasn't replied/ called back . I wrote exactly what I wrote in my post here about giving it up and the reasons for doing so. My mum has tried calling him several times but he is not answering. She thinks he is washing his hands off me and doesn't want to see me anymore....I probably ask too many questions and doctors here HATE that.
Honestly, I do not want to give it up because that means I only have one other option left (efexor ++) and I'm not looking forward to that.Plus I don't know if it will even work considering that I was on Lexapro when this suicidal depression emerged (and welllbutrin, lamictal, provigil). So I really wish there was a way to make this drug work as it is almost my last resort. Plus the next 15 days are not going to be pleasant if i do give up.
I appreciate what you guys are saying- that perhaps I need to go up faster and frankly I have read that the starting dose is 30mg (Stahl) but my doctor is so incompetent and indifferent. He's not answering his phone, not calling back. This is not a drug I can titrate up myself and all the info I have on what to expect from this drug I have gotten from this board. My pdoc is just dragging this out and not giving me any feedback or telling me what to do.
As far as the effects of this drug go I cannot tolerate the sedation.I slept all today even though my last dose was at night. If he knows that higher doses give better/ more activating results why isn't he doing anything? My guess is that he knows nothing (having given this drug to 7-15 people during his 30 years of practice). Incidentally I found this out after he had started me on it already!
It's sad and scary but he is supposed to be the best pdoc in Mumbai (possibly India-wide) and I have found him to be MUCH better than the rest. I don't think there is another pdoc here who even prescribes Parnate.Sunbath, I could try taking small doses all day to avoid the hypotension (that makes sense) if I was continuing it. Without my pdoc I cannot move forward. I don't even know if I should take it tonight as I haven't had any all day (and its 10pm here. If I continue it I will try daytime dosing as you are suggesting...
Maxime, I'm sorry you too feel bad and I hope you come out of this depression and settle on this drug. So many people seem to have been helped bu this drug.
Anyway, thanks guys for the feedback and support.
I'm not sure what I will do....this is not a drug I dare take/ play with without a pdoc's input and guidance.Take care
Love
D
Posted by Maxime on October 15, 2009, at 13:48:21
In reply to Re: Parnate giving up- Sunbath/ Maxime, posted by delna on October 15, 2009, at 11:51:39
> I'm not sure what I will do....this is not a drug I dare take/ play with without a pdoc's input and guidance.
>
No offence, but I don't understand why it's so important to have your pdoc's guidance when he hardly has any experience with MAOIs. I would just continue increasing the med every week or so. Maybe you need to be telling your pdoc what you are doing rather the other way around. That's what I would do.
Posted by delna on October 15, 2009, at 14:27:02
In reply to Re: Parnate giving up- Sunbath/ Maxime » delna, posted by Maxime on October 15, 2009, at 13:48:21
Maybe :-D
> No offence, but I don't understand why it's so important to have your pdoc's guidance when he hardly has any experience with MAOIs. I would just continue increasing the med every week or so. Maybe you need to be telling your pdoc what you are doing rather the other way around. That's what I would do.
Posted by Sunbath on October 16, 2009, at 7:20:31
In reply to Re: Parnate giving up- Sunbath/ Maxime, posted by delna on October 15, 2009, at 11:51:39
Hi Delna,
how are you doing?
> I wrote a letter to my doctor(hand delivered by my dad) but he hasn't replied/ called back . I wrote exactly what I wrote in my post here about giving it up and the reasons for doing so. My mum has tried calling him several times but he is not answering. She thinks he is washing his hands off me and doesn't want to see me anymore....I probably ask too many questions and doctors here HATE that.
That's really unacceptable!! I'm sorry that you have such a doc.. are you really absolutely sure that there's no other doc available who's also educating himself and is up to date? But I can't imagine a doc would want to wash his hands off of you!?
> Honestly, I do not want to give it up because that means I only have one other option left (efexor ++) and I'm not looking forward to that.Plus I don't know if it will even work considering that I was on Lexapro when this suicidal depression emerged (and welllbutrin, lamictal, provigil). So I really wish there was a way to make this drug work as it is almost my last resort. Plus the next 15 days are not going to be pleasant if i do give up.
You are right in my opinion! If you haven't so many options left you really should give it enough time!! Of course tht's not always easy :(
Before the extreme tiredness passed, I was kind of frightened and wasn't sure whether this was the right med.. I also already had thoughts of giving it up, but then after 10days (and the first on 40mg) the tiredness suddenly faded.. I still got some hypotension from time to time (but since a few days I didn't have it anymore..) and even now I have some afternoon fatigue, but that's perfectly bearable! Maybe your brain needs a bit more time to get rid of most of the tiredness? What's your most troublesome side effects at the moment?Is it the hypotension when you take 20mg at once or is it more a psychological exhaustion/tiredness that lasts the whole day (like I had the first 7-10days)?
> I appreciate what you guys are saying- that perhaps I need to go up faster and frankly I have read that the starting dose is 30mg (Stahl) but my doctor is so incompetent and indifferent. He's not answering his phone, not calling back. This is not a drug I can titrate up myself and all the info I have on what to expect from this drug I have gotten from this board. My pdoc is just dragging this out and not giving me any feedback or telling me what to do.Again.. unbelievable :(
But even when you're on your own you can make it! After all you are not really completely alone ;)
> As far as the effects of this drug go I cannot tolerate the sedation.I slept all today even though my last dose was at night. If he knows that higher doses give better/ more activating results why isn't he doing anything? My guess is that he knows nothing (having given this drug to 7-15 people during his 30 years of practice). Incidentally I found this out after he had started me on it already!How did you find out?
What I believe -from my very short experience that is- is that Parnate is indeed stimulating and activating.. but at the same time it seems to be calming too. The most energizing effect I notice now is when I wake up in the morning.. But after my first 20mg I calm down which is not unpleasant!
But it also acutely seems to lowers blood pressure in many patients an effect which -I believe- is transient. So if you get strong hypotension I don't think it's a good idea to titrate up faster!Your doc might think it's necessary to wait that out..
How's your blood pressure? Did you try taking 10mg every few hours?Like 7am, 10am, 1pm, 3pm?
I think Scott once suggested that if ones blood pressure was dropping much after a bigger dose of Parnate.> It's sad and scary but he is supposed to be the best pdoc in Mumbai (possibly India-wide) and I have found him to be MUCH better than the rest. I don't think there is another pdoc here who even prescribes Parnate.
I understand, but it's really not so good when he isn't available and not answering your questions!
> Sunbath, I could try taking small doses all day to avoid the hypotension (that makes sense) if I was continuing it. Without my pdoc I cannot move forward. I don't even know if I should take it tonight as I haven't had any all day (and its 10pm here. If I continue it I will try daytime dosing as you are suggesting...
It would be interesting to know whether your sedation is partly from a low blood pressure.
But what I think would really improve when you took it during the day is your sleep! If you sleep only 5 hours a night I think you can't be anything but sedated during the day! At least it might worsen your sedation considerably..
But please don't take it spread over the whole day. I think you are suppsoed to take everything before 3pm to avoid worsening of sleep.
BTW: I'm now sleeping better and better it's really great!> I'm not sure what I will do....this is not a drug I dare take/ play with without a pdoc's input and guidance.
Please tell us your decision and how you are doing.
I wish you all the best and good luck!!
Looking forward hearing from you,
Sunbath
Posted by Maxime on October 16, 2009, at 11:30:15
In reply to Re: Parnate giving up » g_g_g_unit, posted by delna on October 14, 2009, at 23:50:50
Are you taking the Provigil with the Parnate? Because if you are that should help with the hypotension. There was someone on PB who had Adderall added to the Parnate to help with hypotension.
Posted by delna on October 16, 2009, at 13:04:34
In reply to Re: Parnate giving up- Sunbath/ Maxime » delna, posted by Sunbath on October 16, 2009, at 7:20:31
Hi,
Thanks so much for asking. :-)
I am a million times better- and that is because I never took the Parnate yesterday! I actually have energy today - I slept 5 hours last night but have not needed to sleep at all during the day. It makes me positive when I feel like this.But, I know that even though I haven't taken Parnate for 24 hrs +, it has had some effect on my mood which is why today has been ok mood-wise.
However I still have suicidal thoughts so I know I need to get onto an AD really quick. I'm not sure if Parnate is for me. But I still have a few hours to decide if I am going to take today's dose......
But went to see pdoc today (to find out if I should continue and if so what next)with some interesting developments...He said to:
1) Go up to 60mg (up by 10mg every 3 days). Am on 30 now.
2) It will take 6-8 weeks to show an effect and I will probably be sedated till then (at least.) Suicidal feelings will be there till then (my parents were not pleased at this thought since he is going off on some conference in the US and there are no hospitals etc)
3) up the dose of Provigil to 400mg. I explained that this was not the type of sedation that provigil can take care of but he said up it anyway.
4)He tried to get me to add low dose Geodon (which has really worked for me in the past but gave me TD symptoms.) I was so annoyed- I mean, why would I need Parnate if I could have Geodon which solves all problems in one go?! I can't take a drug that gives me Tardive pain!
5) He pathologized me for knowing anything while he was fumbling with his PDR and on google looking up stuff on Parnate. (BTW I found out that he had only treated a handful of people with Parnate because my mum asked him flat out and he said '5' then quickly changed that to '15' since my mother's jaw dropped)
6) The worst was that he is not sure that the Parnate will sort out OCD (which I have a very bad case of- currently in remission but will be back as I just gave up my SSRI.)
He coolly said ' if Parnate doesn't take care of OCD, we will just withdraw you when it comes back!'.
I didn't think that was fair since I am apparently supposed to bear 6-8 weeks of feeling like rot just to be (probably) withdrawn again. Parnate has really limited success in OCD apparently from all the info available. But I have posted a message on the board for people's personal experiences which I think will help me make up my mind..For me, with Parnate the sedation is just too much. I don't think he gets how sleepy I am- I've been sent to sleep clinics before and they said I had idiopathic hypersomnia. That's how I managed to get Provigil in London (where they are also really strict). On top of that is the 'retarded depression' and fatigue. This makes sedation the worst drug side effect for me. I mean, I can put up with alot of side effects but not sedation (though so many people- and u- are saying it will pass)
I guess the hypotension doesn't come if I take 10mg at once. So breaking up the dose will get rid of that as you guys have suggested, if I stay on Parnate.Am so glad you are sleeping better and having more hours of being alert.
I hope things keep improving for you....
Thanks for being so supportive and helpful. It really has helped me.Love D
PS: Here's a (rather negative) article about Parnate and sedation. (I swear, I wasn't looking for bad news- I was just checking on OCD and stumbled on it.)I guess many people have had more positive experiences
http://www.ncbi.nlm.nih.gov/pubmed/3273886?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Posted by delna on October 16, 2009, at 13:13:32
In reply to Re: Parnate giving up » delna, posted by Maxime on October 16, 2009, at 11:30:15
Yes. 200mg Provigil. The hypotension is only a problem if I take more than 10mg at once. Am supposed to up the provigil to 400mg as well as the Parnate dose.
Saw the pdoc today but am still undecided about taking today's dose of Parnate. Have just posted about OCD and Parnate( I have OCD, Parnate is not supposed to be much help with that and my pdoc says he can't be sure) and I am hoping to hear about people's personal experiences because at the end of the day that's what really helps you decide if you should continue or not.Thanks so much for all your support
Love
D> Are you taking the Provigil with the Parnate? Because if you are that should help with the hypotension. There was someone on PB who had Adderall added to the Parnate to help with hypotension.
Posted by Sunbath on October 17, 2009, at 6:11:42
In reply to Re: Parnate giving up- Sunbath/ Maxime » Sunbath, posted by delna on October 16, 2009, at 13:04:34
Hi Delna!!! Glad that you are so much better :) !!!!!!!
> I am a million times better- and that is because I never took the Parnate yesterday! I actually have energy today - I slept 5 hours last night but have not needed to sleep at all during the day. It makes me positive when I feel like this.
Absolutely great! And probably it was the Parnate anyway? As you know despite the acute effects its more permanent effects on MAO persist for many many days later..
> But, I know that even though I haven't taken Parnate for 24 hrs +, it has had some effect on my mood which is why today has been ok mood-wise.
> However I still have suicidal thoughts so I know I need to get onto an AD really quick. I'm not sure if Parnate is for me. But I still have a few hours to decide if I am going to take today's dose......Did you take it? Are u planning on switching to daytime dosing before 3pm? Sorry for all those questions :)
> But went to see pdoc today (to find out if I should continue and if so what next)with some interesting developments...
>
> He said to:
> 1) Go up to 60mg (up by 10mg every 3 days). Am on 30 now.That's great! I at least didn't feel any better before I was on 40mg!
> 2) It will take 6-8 weeks to show an effect and I will probably be sedated till then (at least.) Suicidal feelings will be there till then (my parents were not pleased at this thought since he is going off on some conference in the US and there are no hospitals etc)
Hmm please don't think that it must and WILL take you so long.. who knows? Mabye you are already starting feeling good next week!? For me it was all out of a sudden!
Also maybe you're already past the worst part of your sedation? How was it yesterday or today (IF you decided taking your dose)> 3) up the dose of Provigil to 400mg. I explained that this was not the type of sedation that provigil can take care of but he said up it anyway.
> 4)He tried to get me to add low dose Geodon (which has really worked for me in the past but gave me TD symptoms.) I was so annoyed- I mean, why would I need Parnate if I could have Geodon which solves all problems in one go?! I can't take a drug that gives me Tardive pain!
> 5) He pathologized me for knowing anything while he was fumbling with his PDR and on google looking up stuff on Parnate. (BTW I found out that he had only treated a handful of people with Parnate because my mum asked him flat out and he said '5' then quickly changed that to '15' since my mother's jaw dropped)Hahaha, but hey it's better than with my doc.. she has never treated ANY patient with it!
And don't think of it.. I also had so much pdcos who had some kind of "allergy" against me doing my own research or even suggesting something!!That's a big weekness in my opinion! I mean they shouldn't be bothered at all by that.. after all they even should be glad a patient is bringing in some ideas and that he/she isn't only passive!
Well at least that's what I believe!> 6) The worst was that he is not sure that the Parnate will sort out OCD (which I have a very bad case of- currently in remission but will be back as I just gave up my SSRI.)
Hey cool that your OCD isn't back already!Isn't that a good sign? I mean I also have OCD, though lucky me only at a very low level nowadays (obsessive thoughts which were really bad 7-8 years ago). I'm just at my 3rd week of parnate but for me it got rid of the remaining level of OCD COMPLETELY!!! I don't know if it will last, but till now it has had the greatest effect of any med I tried.. also on OCD!
And from my experience as soon as I withdrew from an SSRI my OCD symptoms reappeared very quickly.. is this different for you? Shouldn't your OCD be back already? I ask because maybe Parnate is helping you against your OCD already?> He coolly said ' if Parnate doesn't take care of OCD, we will just withdraw you when it comes back!'.
> I didn't think that was fair since I am apparently supposed to bear 6-8 weeks of feeling like rot just to be (probably) withdrawn again. Parnate has really limited success in OCD apparently from all the info available. But I have posted a message on the board for people's personal experiences which I think will help me make up my mind..That really sounds brutal how he said that, but really you may not have any other chance?But don't worry so much about what might be.. hopefully it will kick in for you really fast from now on!!
Hmm I think there aren't many or even big studies because there's a general lack of studies on Parnate in general, also maybe because it's such an old med.. Did they do much studies in the early 60's about OCD? I have no idea, but I would think probably not.. but if I'm wrong there might have been other reasons why the drug dompany didn't test it for so many conditions.. for example Parnate is really helping me A LOT against social anxiety.. but there haven't been so much studies done about that.. only past 2000 there has been one I think (which was very positive btw).. I often read that much of the evidence of Parnate's effects was from practitioners success with this drug, which may weigh even more than some drug company funded studies I guess.. there are a few case reports where OCD patients remitted on Parnate however..
For me I feel a very strong anti obsessional effect, but I haven't been long enough on Parnate to be able to determine that..> For me, with Parnate the sedation is just too much. I don't think he gets how sleepy I am- I've been sent to sleep clinics before and they said I had idiopathic hypersomnia. That's how I managed to get Provigil in London (where they are also really strict). On top of that is the 'retarded depression' and fatigue. This makes sedation the worst drug side effect for me. I mean, I can put up with alot of side effects but not sedation (though so many people- and u- are saying it will pass)
:( I know you are suffering really much because of this damn sedation! But hey maybe the higher dose will kick in and also make the sedation leave you as it did with me? Maybe it wasn't all coincidence that the sedation finally left me when I increased to 40mg?I dunno...
> I guess the hypotension doesn't come if I take 10mg at once. So breaking up the dose will get rid of that as you guys have suggested, if I stay on Parnate.
Please tell us how that works out for you!
> Am so glad you are sleeping better and having more hours of being alert.
> I hope things keep improving for you....
> Thanks for being so supportive and helpful. It really has helped me.Thanks a lot :) I hope that too.. still afraid it might poop out on me..
You also helped me a lot Delna back when I was so sedated as you are now, thank you!Good luck to you!!! I really hope this damn sedation will leave you out of a sudden and soon as it did with me!
Please keep us updated :)
>
> PS: Here's a (rather negative) article about Parnate and sedation. (I swear, I wasn't looking for bad news- I was just checking on OCD and stumbled on it.)I guess many people have had more positive experiences
> http://www.ncbi.nlm.nih.gov/pubmed/3273886?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSumOkay, but the sedation they are talking about is the well known afternoon sleepiness which maybe is different than the sedation you are experiencing now.. I of course don't know, but I think the sedation I had at the beginning was really much different than it is now.. I was sooooo tired the whole day, not just in the afternoon.. now there's still *some* sedation left which feels totally different and which only appears in the afternoon! Also you are taking provigil which should get rid of that remaining sedation.. For example the article in current psychiatry 2002 about parnate in treatment resistent cases talks about the problem of afternoon fatigue and says they prescribe a stimulant to get rid of it like amphetamines, methylphenidate, or modafinil.
Posted by delna on October 17, 2009, at 14:06:22
In reply to Re: Parnate giving up- Sunbath/ Maxime » delna, posted by Sunbath on October 17, 2009, at 6:11:42
> Hi,
How are you doing?? Are things getting better every day for you?
>
> Did you take it?No I didnt take it. I am giving it up. Not only for the sedation (which I do believe may pass) but because of the OCD angle.)
>
> Hey cool that your OCD isn't back already!Isn't that a good sign?No, it means nothing because by OCD will suddenly appear and sometimes I can be off meds for 1-2 months without it coming back. Its a totally separate diagnosis which means that improving the depression does not mean I wont get an OCD recurrence. And it ALWAYS comes back (unless I am on the right med (usually an SSRI)
it got rid of the remaining level of OCD COMPLETELY!!! I don't know if it will last, but till now it has had the greatest effect of any med I tried.. also on OCD!Really???? Then maybe I should give it a shot. What type of OCD do you have. I wrote a post about mine. Is yours as severe? Will you please see it and let me know- maybe I can still try the Parnate. http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20091012/msgs/921138.html#921138
I'm glad your social anxiety is getting better!!
Thats great news.
> For me I feel a very strong anti obsessional effect, but I haven't been long enough on Parnate to be able to determine that..Well there is no reason why a drug should stop working for OCD. I feel if it is helping you then hopefully it will keep doig so.
But please read my post- I would really appreciate it....> Thanks a lot :) I hope that too.. still afraid it might poop out on me..
No, you mustn't think like that. Most people are saying it just gets better (and even if it poops out in many months Gayle had shared a possible strategy for dealing with it!)
> Good luck to you!!! I really hope this damn sedation will leave you out of a sudden and soon as it did with me!
>
> Please keep us updated :)Thanks so much... i will definitely post an update. Right now I was just talking to my dad and we decided that I should withdraw and start venlafaxine because the OCD thing is way too risky. But now I have read your post and I think maybe it will work on mine too.
But even if I give it up, I can always come back to it if high dose velafaxine fails.
I hope you can shed some light on the OCD thing because if yours is like mine then there is a good chance Parnate will work for my OCD!!Lots of love
D
Posted by Sunbath on October 17, 2009, at 15:15:05
In reply to Re: Parnate giving up- helps OCD? Pls read. thnx » Sunbath, posted by delna on October 17, 2009, at 14:06:22
Hey Delna great to hear from you!
Yes my OCD was quite severe but isn't anymore since a few years (it's on a low level..)
I'll babblemail you now..
Posted by delna on October 17, 2009, at 15:59:49
In reply to Re: Parnate giving up- helps OCD? Pls read. thnx » delna, posted by Sunbath on October 17, 2009, at 15:15:05
> Hey Delna great to hear from you!
> Yes my OCD was quite severe but isn't anymore since a few years (it's on a low level..)
> I'll babblemail you now..Thanks
Looking forward to hearing your story....
Love
D
Posted by creepy on October 22, 2009, at 12:48:38
In reply to Parnate and me, posted by Sunbath on October 12, 2009, at 17:55:25
Dropping an antidepressant (especially abruptly) can lead to a rebound euthymic or even hypomanic episode. Be very careful with this. It is how meds often get a bad rap. 'I feel so much better OFF the pills'. It would be much safer if youre doing it with your doc onboard.
Drugs that are recommended for OCD seem to be SSRI's with sigma-1 affinity. Other drugs that do this are antipsychotics like haldol.
As for the insomnia and fatigue, NRIs can be used. NRIs also can raise blood pressure. Ive also heard amphetamine is common.
Posted by delna on October 23, 2009, at 13:23:13
In reply to Re: Parnate and me, posted by creepy on October 22, 2009, at 12:48:38
Hi,
Thanks for the input!I went back on the Parnate (having stopped it for a day) but I have given it a bit more time and have decided that is is not the drug for me. So am tapering (slightly fast as I am desperate to get rid of it and start an SNRI)
I really am not convinced that Parnate will help the OCD and further more augmenting has to be done in moderation.
I normally take 400mg Provigil and 300mg Wellbutrin (plus 200mg caffeine) when I'm on a non sedating drug to combat exhaustion but on Parnate I can only take 200mg Provigil and nothing else.Plus it is sedating in itself. I feel that adds to my depression.I can't use amphetamines as they are banned here in India.Although that is what my pdoc in NYC said would help. The next best thing is Ritalin but it destabilizes me too much and I hate it.
I have decided to shift to Effexor at high dose (around 300) and augment with Provigil (400mg) and Wellbutrin 300mg.You suggested an NRI- which do you think is best? Reboxetine? I may want to substitute the Wellbutrin with and NRI. What do you feel?
Anyway thanks do much for your input...greatly appreciated!
TC
D
Posted by Defective on May 18, 2011, at 14:44:56
In reply to Re: Parnate and me, posted by ColoradoSnowflake on October 12, 2009, at 19:40:15
Hi, I saw your messages on the Dr. Bob board and I was wondering if you could please answer a quick question. I started Parnate 13 days ago, day 1 I took 20 mg, day 2-8 I I took 30 mg, day 10-11 I took 40 mg, and the last two days I've been on 50 mg. I haven't felt anything yet and I was instructed to go up to 60 tomorrow. Based on your experience and others on the message board, when would you expect me to feel an anti-depressant response? Thanks in advance for any advice you may have to share with me.
Best,
Defective
Posted by Defective on May 18, 2011, at 14:47:27
In reply to Re: Parnate and me, posted by ColoradoSnowflake on October 12, 2009, at 19:40:15
Hi, I saw your messages on the Dr. Bob board and I was wondering if you could please answer a quick question. I started Parnate 13 days ago, day 1 I took 20 mg, day 2-8 I I took 30 mg, day 10-11 I took 40 mg, and the last two days I've been on 50 mg. I haven't felt anything yet and I was instructed to go up to 60 tomorrow. Based on your experience and others on the message board, when would you expect me to feel an anti-depressant response? Thanks in advance for any advice you may have to share with me.
Best,
Defective
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