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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by emmanuel98 on July 28, 2010, at 21:44:05
I started taking parnate a year ago and from the very start, it gave me the most severe insomnia I ever experienced. I started taking seroquel and that worked, but made me gain weight (I am already overweight from several trials of AAPs).
I tried perphenazine and that worked for a while, but made me so dizzy (in combination with the parnate) when I got up in the middle of the night that I fell a couple of times. Since the stairwell is right between my bedroom and the bathroom, this was pretty dangerous.Finally, my p-doc prescribed ativan, 1mg, but I've found I need 2mg to get to sleep. As a result, I run out mid-month, then have night after night of no sleep. I asked my p-doc to increase the dose but now the pharmacy is balking that I have over-used the drug and am not scheduled for a refill for another 10 days. Also, I'm finding the ativan is less and less effective as time goes on and I need more and more of it to stay asleep.
Help!!! Any advice appreciated.
Posted by Christ_empowered on July 29, 2010, at 1:05:51
In reply to Parnate Insomnia, posted by emmanuel98 on July 28, 2010, at 21:44:05
Have you tried a drug specifically for insomnia? I was thinking Ambien, Lunesta, Sonata, maybe something a little more old school like Restoril. These drugs probably won't lose their effect quite as quickly as the Ativan, but they should help you get to sleep. If seroquel at a low dose helped, I would think hydroxyzine would help, too.
Posted by jedi on July 29, 2010, at 1:10:39
In reply to Parnate Insomnia, posted by emmanuel98 on July 28, 2010, at 21:44:05
> I started taking parnate a year ago and from the very start, it gave me the most severe insomnia I ever experienced. I started taking seroquel and that worked, but made me gain weight (I am already overweight from several trials of AAPs).
> I tried perphenazine and that worked for a while, but made me so dizzy (in combination with the parnate) when I got up in the middle of the night that I fell a couple of times. Since the stairwell is right between my bedroom and the bathroom, this was pretty dangerous.
>
> Finally, my p-doc prescribed ativan, 1mg, but I've found I need 2mg to get to sleep. As a result, I run out mid-month, then have night after night of no sleep. I asked my p-doc to increase the dose but now the pharmacy is balking that I have over-used the drug and am not scheduled for a refill for another 10 days. Also, I'm finding the ativan is less and less effective as time goes on and I need more and more of it to stay asleep.
>
> Help!!! Any advice appreciated.Hi, If low dose Seroquel worked, maybe you are sensitive to the histamine blockers like I am. I currently use 50mg of Benadryl to offset Nardil induced insomnia. Knocks me for a loop. I have used micro doses of Seroquel (12.5 and 25mg) with the same effect. Trazodone also works but I really dislike the drugged feeling I get with it. I'm actually quite amazed that I have not built tolerance to the sleepiness effect of the Benadryl. But the histamine blockers have always worked for me.
Good Luck,
Jedi
Posted by emmanuel98 on July 29, 2010, at 19:10:46
In reply to Re: Parnate Insomnia, posted by jedi on July 29, 2010, at 1:10:39
Unfortunately, both anti-histamines and trazodone are contra-indicated with MAOIs. I haven't tried the Ambien, etc., type drugs. My p-doc seems hesitant to prescribe them. But I'll see him next week and we can talk about it. Are they okay with Parnate?
Posted by Christ_empowered on July 29, 2010, at 19:34:53
In reply to Re: Parnate Insomnia, posted by emmanuel98 on July 29, 2010, at 19:10:46
I think the benzos and "z" hypnotics (ambien, lunesta, sonata, and Imovane) are OK. I didn't know antihistamines were contraindicated. Sorry for making that suggestion.
Its pretty common with activating ADs (MAOI and otherwise) to use benzos, hypnotics, and neuroleptics to deal with insomnia, agitation, anxiety, etc. Is your doc worried about dependence? I looked it up and low doses of Thorazine are still sometimes used for insomnia. Not exactly something I'd be really enthusiastic about, but the doses are like 15mgs or something; just enough to get you calmed down and into bed. I don't think EPS/TD would be an issue at those doses, but I guess that would depend on your own sensitivity to the medication.
Posted by emmanuel98 on July 29, 2010, at 20:49:57
In reply to Re: Parnate Insomnia, posted by Christ_empowered on July 29, 2010, at 19:34:53
Thanks. I'll ask about thorazine. It may have the same problem as perphenazine -- worsening parnate-driven postural hypotension, which has proved very dangerous for me. Or maybe not.
This is the end of the thread.
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